Gravidade do trauma avaliada na fase pré-hospitalar Trauma severity assessment in prehospital setting

Directory of Open Access Journals (Sweden)

I.Y. Whitaker

1998-06-01

Full Text Available A avaliação da gravidade do trauma e a instituição de manobras para manutenção básica da vida, no local do evento, podem representar a oportunidade de sobrevida para as vítimas de trauma até a sua chegada ao hospital. OBJETIVO: Estudar vítimas de causas externas avaliadas por um índice fisiológico denominado Trauma Score modificado (TSm aplicado durante o atendimento pré-hospitalar. MATERIAL E MÉTODO: Analisaram-se, retrospectivamente, 1.414 vítimas de causas externas atendidas pelo Sistema de Atendimento Móvel às Urgências (SAMU-RESGATE-SP no município de São Paulo, no ano de 1991. Os dados foram obtidos da ficha de atendimento pré-hospitalar e laudo de necropsia. RESULTADOS: O atendimento pré-hospitalar em 81,31% ocorreu até 40 minutos, dos quais 83,96% das vítimas não-fatais obtiveram escores TSm 12 e 11, e 53,96% das vítimas fatais obtiveram escores 0, 1 e 2. Superfície externa (30,25% e região da cabeça/pescoço (20,98% foram as mais acometidas. Das vítimas fatais, 63,63% com Injury Severity Score (ISS > ou = 16 morreram nas primeiras 24 horas. No cotejamento dos escores TSm e ISS, verificou-se que vítimas fatais com escore TSm entre 0 e 11 foram confirmadas como com ISS crítico (ISS > ou = 16. CONCLUSÃO: Constataram-se fortes indícios de que vítimas fatais com escores TSm baixos relacionaram-se com escores ISS altos.The trauma severity assessment and basic life support maneuvers in prehospital setting can represent to the trauma victim the opportunity of survival until his/her can get assistance in the hospital. PURPOSE: To study external cause victims assessed in the prehospital phase by the physiologic index named Trauma Score modificado (TSm. METHODS: Retrospective analyses were made of 1414 victims attended by Sistema de Atendimento Móvel às Urgências (SAMU-RESGATE-SP in the Municipality of São Paulo during 1991. Data were gathered from prehospital data recording sheets and necropsy records

The New Injury Severity Score Versus the Injury Severity Score in Predicting Patient Outcome: A Comparative Evaluation on Trauma Service Patients of the Auckland Hospital

OpenAIRE

Samin, Oliver A.; Civil, Ian D.

1999-01-01

Retrospectively calculated NISS was compared with the prospectively calculated ISS from data derived from the trauma registry of the Trauma Services of the Auckland Hospital as to which test is a better predictor of patient outcome, which is defined as the likelihood of death. The area under the curve (AUC) for ISS and NISS were computed using the non-parametric approach. AUC for ISS = 0.95835, and AUC for NISS = 0.97350, p

THE PANC 3 SCORE PREDICTING SEVERITY OF ACUTE PANCREATITIS.

Science.gov (United States)

Beduschi, Murilo Gamba; Mello, André Luiz Parizi; VON-Mühlen, Bruno; Franzon, Orli

2016-03-01

About 20% of cases of acute pancreatitis progress to a severe form, leading to high mortality rates. Several studies suggested methods to identify patients that will progress more severely. However, most studies present problems when used on daily practice. To assess the efficacy of the PANC 3 score to predict acute pancreatitis severity and its relation to clinical outcome. Acute pancreatitis patients were assessed as to sex, age, body mass index (BMI), etiology of pancreatitis, intensive care need, length of stay, length of stay in intensive care unit and mortality. The PANC 3 score was determined within the first 24 hours after diagnosis and compared to acute pancreatitis grade of the Revised Atlanta classification. Out of 64 patients diagnosed with acute pancreatitis, 58 met the inclusion criteria. The PANC 3 score was positive in five cases (8.6%), pancreatitis progressed to a severe form in 10 cases (17.2%) and five patients (8.6%) died. Patients with a positive score and severe pancreatitis required intensive care more often, and stayed for a longer period in intensive care units. The PANC 3 score showed sensitivity of 50%, specificity of 100%, accuracy of 91.4%, positive predictive value of 100% and negative predictive value of 90.6% in prediction of severe acute pancreatitis. The PANC 3 score is useful to assess acute pancreatitis because it is easy and quick to use, has high specificity, high accuracy and high predictive value in prediction of severe acute pancreatitis.

Assessing injury severity in bicyclists involved in traffic accidents to more effectively prevent fatal bicycle injuries in Japan.

Science.gov (United States)

Gomei, Sayaka; Hitosugi, Masahito; Ikegami, Keiichi; Tokudome, Shogo

2013-10-01

The objective of this study was to clarify the relationship between injury severity in bicyclists involved in traffic accidents and patient outcome or type of vehicle involved in order to propose effective measures to prevent fatal bicycle injuries. Hospital records were reviewed for all patients from 2007 to 2010 who had been involved in a traffic accident while riding a bicycle and were subsequently transferred to the Shock Trauma Center of Dokkyo Medical University Koshigaya Hospital. Patient outcomes and type of vehicle that caused the injury were examined. The mechanism of injury, Abbreviated Injury Scale (AIS) score, and Injury Severity Score (ISS) of the patient were determined. A total of 115 patients' records were reviewed. The mean patient age was 47.1 ± 27.4 years. The average ISS was 23.9, with an average maximum AIS (MAIS) score of 3.7. The ISS, MAIS score, head AIS score, and chest AIS score were well correlated with patient outcome. The head AIS score was significantly higher in patients who had died (mean of 4.4); however, the ISS, MAIS score, and head AIS score did not differ significantly according to the type of vehicle involved in the accident. The mean head AIS scores were as high as 2.4 or more for accidents involving any type of vehicle. This study provides useful information for forensic pathologists who suspect head injuries in bicyclists involved in traffic accidents. To effectively reduce bicyclist fatalities from traffic accidents, helmet use should be required for all bicyclists.

Prehospital severity scoring at major rock concert events.

Science.gov (United States)

Erickson, T B; Koenigsberg, M; Bunney, E B; Schurgin, B; Levy, P; Willens, J; Tanner, L

1997-01-01

Rock and contemporary music concerts are popular, recurrent events requiring on-site medical staffing. To describe a novel severity score used to stratify the level of acuity of patients presenting to first-aid stations at these events. Retrospective review of charts generated at the first-aid stations of five major rock concerts within a 60,000 spectator capacity, outdoor, professional sports stadium. Participants included all concert patrons presenting to the stadium's first-aid stations as patients. Data were collected on patient demographics, history of drug or ethanol usage while at the concert event, first-aid station time, treatment rendered, diagnosis, and disposition. All patients evaluated were retrospectively assigned a "DRUG-ROCK" Injury Severity Score (DRISS) to stratify their level of acuity. Individual concert events and patient dispositions were compared statistically using chi-square, Fisher's exact, and the ANOVA Mean tests. Approximately 250,000 spectators attended the five concert events. First-aid stations evaluated 308 patients (utilization rate of 1.2 per 1,000 patrons). The most common diagnosis was minor trauma (130; 42%), followed in frequency by ethanol/illicit drug intoxication (98; 32%). The average time in the first-aid station was 23.5 +/- 22.5 minutes (+/- standard deviation; range: 5-150 minutes). Disposition of patients included 100 (32.5%) who were treated and released; 98 (32%) were transported by paramedics to emergency departments (EDs); and 110 (35.5%) signed-out against medical advise (AMA), refusing transport. The mean DRISS was 4.1 (+/- 2.65). Two-thirds (67%) of the study population were ranked as mild by DRISS criteria (score = 1-4), with 27% rated as moderate (score = 5-9), and 6% severe (score > 10). The average of severity scores was highest (6.5) for patients transported to hospitals, and statistically different from the scores of the average of the treated and released and AMA groups (p rock concerts.

External validation of the NOBLADS score, a risk scoring system for severe acute lower gastrointestinal bleeding.

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Tomonori Aoki

Full Text Available We aimed to evaluate the generalizability of NOBLADS, a severe lower gastrointestinal bleeding (LGIB prediction model which we had previously derived when working at a different institution, using an external validation cohort. NOBLADS comprises the following factors: non-steroidal anti-inflammatory drug use, no diarrhea, no abdominal tenderness, blood pressure ≤ 100 mmHg, antiplatelet drug use, albumin < 3.0 g/dL, disease score ≥ 2, and syncope.We retrospectively analyzed 511 patients emergently hospitalized for acute LGIB at the University of Tokyo Hospital, from January 2009 to August 2016. The areas under the receiver operating characteristic curves (ROCs-AUCs for severe bleeding (continuous and/or recurrent bleeding were compared between the original derivation cohort and the external validation cohort.Severe LGIB occurred in 44% of patients. Several clinical factors were significantly different between the external and derivation cohorts (p < 0.05, including background, laboratory data, NOBLADS scores, and diagnosis. The NOBLADS score predicted the severity of LGIB with an AUC value of 0.74 in the external validation cohort and one of 0.77 in the derivation cohort. In the external validation cohort, the score predicted the risk for blood transfusion need (AUC, 0.71, but was not adequate for predicting intervention need (AUC, 0.54. The in-hospital mortality rate was higher in patients with a score ≥ 5 than in those with a score < 5 (AUC, 0.83.Although the external validation cohort clinically differed from the derivation cohort in many ways, we confirmed the moderately high generalizability of NOBLADS, a clinical risk score for severe LGIB. Appropriate triage using this score may support early decision-making in various hospitals.

Development and validation of the International Hidradenitis Suppurativa Severity Score System (IHS4), a novel dynamic scoring system to assess HS severity

DEFF Research Database (Denmark)

Zouboulis, C C; Tzellos, T; Kyrgidis, A

2017-01-01

BACKGROUND: A validated tool for the dynamic severity assessment of hidradenitis suppurativa/acne inversa (HS) is lacking. OBJECTIVES: To develop and validate a novel dynamic scoring system to assess the severity of HS. METHODS: A Delphi voting procedure was conducted among the members......, as well as examination for correlation (Spearman's rho) and agreement (Cohen's kappa) with existing scores, were engaged to recognize the variables for a new International HS4 (IHS4) that was established by a second Delphi round. RESULTS: Consensus HS4 was based on number of skin lesions, number of skin....... Three candidate scores were presented to the second Delphi round. The resulting IHS4 score is arrived at by the number of nodules (multiplied by 1) plus the number of abscesses (multiplied by 2) plus the number of draining tunnels (multiplied by 4). A total score of 3 or less signifies mild, 4...

Scoring systems of severity in patients with multiple trauma.

Science.gov (United States)

Rapsang, Amy Grace; Shyam, Devajit Chowlek

2015-04-01

Trauma is a major cause of morbidity and mortality; hence severity scales are important adjuncts to trauma care in order to characterize the nature and extent of injury. Trauma scoring models can assist with triage and help in evaluation and prediction of prognosis in order to organise and improve trauma systems. Given the wide variety of scoring instruments available to assess the injured patient, it is imperative that the choice of the severity score accurately match the application. Even though trauma scores are not the key elements of trauma treatment, they are however, an essential part of improvement in triage decisions and in identifying patients with unexpected outcomes. This article provides the reader with a compendium of trauma severity scales along with their predicted death rate calculation, which can be adopted in order to improve decision making, trauma care, research and in comparative analyses in quality assessment. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Assessment of PANC3 score in predicting severity of acute pancreatitis

Directory of Open Access Journals (Sweden)

Avreen Singh Shah

2017-01-01

Full Text Available Introduction: Acute pancreatitis is inflammatory process of the pancreas associated with local and systemic complications. At present, there are lots of scores (such as Ransons, APACHE II, bedside index for severity in acute pancreatitis that help us in predicting severity at the time of admission but these are time consuming or require complex calculation and are costly. Material and Methods: PANC3 Scoring System is one of the better systems because the three criteria used (hematocrit, body mass index, and pleural effusion are simple, easy to assess, readily available, and economic. In this prospective study, 100 cases were evaluated to see the prospects of PANC3 scoring in predicting the severity of acute pancreatitis as decided by modified Marshals score. Results: The results showed that PANC3 score had a 96.43% specificity, 75% sensitivity, 80% positive predictive value, and 95.29% negative predictive value. Conclusion: Hence, the PANC3 score is a cost-effective, promising score that helps in predicting the severity of acute pancreatitis leading to prompt treatment and early referral to higher center.

High spatial resolution infrared camera as ISS external experiment

Science.gov (United States)

Eckehard, Lorenz; Frerker, Hap; Fitch, Robert Alan

High spatial resolution infrared camera as ISS external experiment for monitoring global climate changes uses ISS internal and external resources (eg. data storage). The optical experiment will consist of an infrared camera for monitoring global climate changes from the ISS. This technology was evaluated by the German small satellite mission BIRD and further developed in different ESA projects. Compared to BIRD the presended instrument uses proven sensor advanced technologies (ISS external) and ISS on board processing and storage capabili-ties (internal). The instrument will be equipped with a serial interfaces for TM/TC and several relay commands for the power supply. For data processing and storage a mass memory is re-quired. The access to actual attitude data is highly desired to produce geo referenced maps-if possible by an on board processing.

Salvage versus amputation: Utility of mangled extremity severity score in severely injured lower limbs

Directory of Open Access Journals (Sweden)

Kumar M

2007-01-01

Full Text Available Background: The purpose of the present study was to evaluate the clinical utility of Mangled extremity severity score (MESS in severely injured lower limbs. Materials and Methods: Retrospectively 25 and prospectively 36 lower limbs in 58 patients with high-energy injuries were evaluated with the use of MESS, to assist in the decision-making process for the care of patients with such injuries. Difference between the mean MESS scores for amputated and salvaged limbs was analyzed. Results: In the retrospective study 4.65 (4.65 ± 1.32 was the mean score for the salvaged limbs and 8.80 (8.8 ± 1.4 for the amputated limbs. In the prospective study 4.53 (4.53 ± 2.44 was the mean score for the salvaged limbs and 8.83 (8.83 ± 2.34 for the amputated limbs. There was a significant difference in the mean scores for salvaged and amputated limbs. Retrospective 21 (84% and prospective 29 (80.5% limbs remained in the salvage pathway six months after the injury. Conclusion: MESS could predict amputation of severely injured lower limbs, having score of equal or more than 7 with 91% sensitivity and 98% specificity. There was a significant difference in the mean MESS scores in the prospective study (n=36, 4.53 (4.53 ± 2.44 in thirty salvaged limbs (83.33% and 8.83 (8.83 ± 2.34 in six amputated limbs (16.66% with a P -value 0.002 ( P -value < 0.01. Similarly there was a significant difference in the mean MESS score in the retrospective study (n=25, 4.65 (4.65 ± 1.32 in twenty salvaged limbs (80% and 8.80 (8.8 ± 1.4 in five amputated limbs (20% with a P -value 0.00005 ( P -value < 0.01. MESS is a simple and relatively easy and readily available scoring system which can help the surgeon to decide the fate of the lower extremity with a high-energy injury.

Spheres: from Ground Development to ISS Operations

Science.gov (United States)

Katterhagen, A.

2016-01-01

SPHERES (Synchronized Position Hold Engage and Reorient Experimental Satellites) is an internal International Space Station (ISS) Facility that supports multiple investigations for the development of multi-spacecraft and robotic control algorithms. The SPHERES National Lab Facility aboard ISS is managed and operated by NASA Ames Research Center (ARC) at Moffett Field California. The SPHERES Facility on ISS consists of three self-contained eight-inch diameter free-floating satellites which perform the various flight algorithms and serve as a platform to support the integration of experimental hardware. SPHERES has served to mature the adaptability of control algorithms of future formation flight missions in microgravity (6 DOF (Degrees of Freedom) / long duration microgravity), demonstrate key close-proximity formation flight and rendezvous and docking maneuvers, understand fault diagnosis and recovery, improve the field of human telerobotic operation and control, and lessons learned on ISS have significant impact on ground robotics, mapping, localization, and sensing in three-dimensions - among several other areas of study.

Development of a severity score for CRPS.

Science.gov (United States)

Harden, R Norman; Bruehl, Stephen; Perez, Roberto S G M; Birklein, Frank; Marinus, Johan; Maihofner, Christian; Lubenow, Timothy; Buvanendran, Asokumar; Mackey, Sean; Graciosa, Joseph; Mogilevski, Mila; Ramsden, Christopher; Schlereth, Tanja; Chont, Melissa; Vatine, Jean-Jacques

2010-12-01

The clinical diagnosis of Complex Regional Pain Syndrome (CRPS) is a dichotomous (yes/no) categorization necessary for clinical decision-making. However, such dichotomous diagnostic categories do not convey an individual's subtle and temporal gradations in severity of the condition, and have poor statistical power when used as an outcome measure in research. This study evaluated the validity and potential utility of a continuous type score to index severity of CRPS. Psychometric and medical evaluations were conducted in 114 CRPS patients and 41 non-CRPS neuropathic pain patients. Based on the presence/absence of 17 clinically-assessed signs and symptoms of CRPS, an overall CRPS Severity Score (CSS) was derived. The CSS discriminated well between CRPS and non-CRPS patients (pCRPS diagnoses using both IASP diagnostic criteria (Eta=0.69) and proposed revised criteria (Eta=0.77-0.88). Higher CSS was associated with significantly higher clinical pain intensity, distress, and functional impairments, as well as greater bilateral temperature asymmetry and thermal perception abnormalities (p'sCRPS, and support its validity as an index of CRPS severity. Its utility as an outcome measure in research studies is also suggested, with potential statistical advantages over dichotomous diagnostic criteria. Copyright © 2010. Published by Elsevier B.V.

Environmental Effects on ISS Materials Aging (1998 to 2008)

Science.gov (United States)

Alred, John; Dasgupta, Rajib; Koontz, Steve; Soares, Carlos; Golden, John

2009-01-01

The performance of ISS spacecraft materials and systems on prolonged exposure to the low- Earth orbit (LEO) space flight are reported in this paper. In-flight data, flight crew observations, and the results of ground-based test and analysis directly supporting programmatic and operational decision-making are described. The space flight environments definitions (both natural and induced) used for ISS design, material selection, and verification testing are shown, in most cases, to be more severe than the actual flight environment accounting, in part, for the outstanding performance of ISS as a long mission duration spacecraft. No significant ISS material or system failures have been attributed to spacecraft-environments interactions. Nonetheless, ISS materials and systems performance data is contributing to our understanding of spacecraft material interactions with the spaceflight environment so as to reduce cost and risk for future spaceflight projects and programs. Orbital inclination (51.6 deg) and altitude (nominally near 360 km) determine the set of natural environment factors affecting the functional life of materials and systems on ISS. ISS operates in an electrically conducting environment (the F2 region of Earth s ionosphere) with well-defined fluxes of atomic oxygen, other charged and neutral ionospheric plasma species, solar UV, VUV, and x-ray radiation as well as galactic cosmic rays, trapped radiation, and solar cosmic rays. The LEO micrometeoroid and orbital debris environment is an especially important determinant of spacecraft design and operations. The magnitude of several environmental factors varies dramatically with latitude and longitude as ISS orbits the Earth. The high latitude orbital environment also exposes ISS to higher fluences of trapped energetic electrons, auroral electrons, solar cosmic rays, and galactic cosmic rays than would be the case in lower inclination orbits, largely as a result of the overall shape and magnitude of the

Analyzing an Aging ISS

Science.gov (United States)

Scharf, R.

2014-01-01

The ISS External Survey integrates the requirements for photographic and video imagery of the International Space Station (ISS) for the engineering, operations, and science communities. An extensive photographic survey was performed on all Space Shuttle flights to the ISS and continues to be performed daily, though on a level much reduced by the limited available imagery. The acquired video and photo imagery is used for both qualitative and quantitative assessments of external deposition and contamination, surface degradation, dynamic events, and MMOD strikes. Many of these assessments provide important information about ISS surfaces and structural integrity as the ISS ages. The imagery is also used to assess and verify the physical configuration of ISS structure, appendages, and components.

Bone scan as a screening test for missed fractures in severely injured patients.

Science.gov (United States)

Lee, K-J; Jung, K; Kim, J; Kwon, J

2014-12-01

In many cases, patients with severe blunt trauma have multiple fractures throughout the body. These fractures are not often detectable by history or physical examination, and their diagnosis can be delayed or even missed. Thus, screening test fractures of the whole body is required after initial management. We performed this study to evaluate the reliability of bone scans for detecting missed fractures in patients with multiple severe traumas and we analyzed the causes of missed fractures by using bone scan. A bone scan is useful as a screening test for fractures of the entire body of severe trauma patients who are passed the acute phase. We reviewed the electronic medical records of severe trauma patients who underwent a bone scan from September 2009 to December 2010. Demographic and medical data were compared and statistically analyzed to determine whether missed fractures were detected after bone scan in the two groups. A total of 382 patients who had an injury severity score [ISS] greater than 16 points with multiple traumas visited the emergency room. One hundred and thirty-one patients underwent bone scan and 81 patients were identified with missed fractures by bone scan. The most frequent location for missed fractures was the rib area (55 cases, 41.98%), followed by the extremities (42 cases, 32.06%). The missed fractures that required surgery or splint were most common in extremities (11 cases). In univariate analysis, higher ISS scores and mechanism of injury were related with the probability that missed fractures would be found with a bone scan. The ISS score was statistically significant in multivariate analysis. Bone scan is an effective method of detecting missed fractures among patients with multiple severe traumas. Level IV, retrospective study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

ISS Local Environment Spectrometers (ISLES)

Science.gov (United States)

Krause, Linda Habash; Gilchrist, Brian E.

2014-01-01

In order to study the complex interactions between the space environment surrounding the ISS and the ISS surface materials, we propose to use lowcost, high-TRL plasma sensors on the ISS robotic arm to probe the ISS space environment. During many years of ISS operation, we have been able to condut effective (but not perfect) extravehicular activities (both human and robotic) within the perturbed local ISS space environment. Because of the complexity of the interaction between the ISS and the LEO space environment, there remain important questions, such as differential charging at solar panel junctions (the so-called "triple point" between conductor, dielectric, and space plasma), increased chemical contamination due to ISS surface charging and/or thruster activation, water dumps, etc, and "bootstrap" charging of insulating surfaces. Some compelling questions could synergistically draw upon a common sensor suite, which also leverages previous and current MSFC investments. Specific questions address ISS surface charging, plasma contactor plume expansion in a magnetized drifting plasma, and possible localized contamination effects across the ISS.

An epistaxis severity score for hereditary hemorrhagic telangiectasia.

Science.gov (United States)

Hoag, Jeffrey B; Terry, Peter; Mitchell, Sally; Reh, Douglas; Merlo, Christian A

2010-04-01

Hereditary hemorrhagic telangiectasia (HHT)-related epistaxis leads to alterations in social functioning and quality of life. Although more than 95% experience epistaxis, there is considerable variability of severity. Because no standardized method exists to measure epistaxis severity, the purpose of this study was to determine factors associated with patient-reported severity to develop a severity score. Prospective, survey-based study. HHT care providers and a focus group of patients were interviewed to determine epistaxis-associated factors. From this, an electronic survey was developed and administered to patients with HHT. Descriptive analyses were performed with calculations of means and medians for continuous and proportions for categorical variables. Multiple ordinal logistic and linear regression models were developed to determine risk factors for epistaxis severity. Nine hundred respondents from 21 countries were included. Eight hundred fifty-five (95%) subjects reported epistaxis. The mean (standard deviation) age was 52.1 (13.9) years, and 61.4% were female. Independently associated risk factors for self-reported epistaxis severity included epistaxis frequency (odds ratio [OR] 1.57), duration (OR 2.17), intensity (OR 2.45), need for transfusion (OR 2.74), anemia (OR 1.44), and aggressiveness of treatment required (OR 1.53, P epistaxis severity in patients with HHT include frequency, duration, and intensity of episodes; invasiveness of prior therapy required to stop epistaxis; anemia; and the need for blood transfusion. From these factors, an epistaxis severity score will be presented.

Automatic scoring of the severity of psoriasis scaling

DEFF Research Database (Denmark)

Gomez, David Delgado; Ersbøll, Bjarne Kjær; Carstensen, Jens Michael

2004-01-01

In this work, a combined statistical and image analysis method to automatically evaluate the severity of scaling in psoriasis lesions is proposed. The method separates the different regions of the disease in the image and scores the degree of scaling based on the properties of these areas. The pr...... with scores made by doctors. This and the fact that the obtained measures are continuous indicate the proposed method is a suitable tool to evaluate the lesion and to track the evolution of dermatological diseases....

SU-E-T-192: FMEA Severity Scores - Do We Really Know?

International Nuclear Information System (INIS)

Tonigan, J; Johnson, J; Kry, S; Balter, P; Court, L; Stingo, F; Followill, D

2014-01-01

Purpose: Failure modes and effects analysis (FMEA) is a subjective risk mitigation technique that has not been applied to physics-specific quality management practices. There is a need for quantitative FMEA data as called for in the literature. This work focuses specifically on quantifying FMEA severity scores for physics components of IMRT delivery and comparing to subjective scores. Methods: Eleven physical failure modes (FMs) for head and neck IMRT dose calculation and delivery are examined near commonly accepted tolerance criteria levels. Phantom treatment planning studies and dosimetry measurements (requiring decommissioning in several cases) are performed to determine the magnitude of dose delivery errors for the FMs (i.e., severity of the FM). Resultant quantitative severity scores are compared to FMEA scores obtained through an international survey and focus group studies. Results: Physical measurements for six FMs have resulted in significant PTV dose errors up to 4.3% as well as close to 1 mm significant distance-to-agreement error between PTV and OAR. Of the 129 survey responses, the vast majority of the responders used Varian machines with Pinnacle and Eclipse planning systems. The average years of experience was 17, yet familiarity with FMEA less than expected. Survey reports perception of dose delivery error magnitude varies widely, in some cases 50% difference in dose delivery error expected amongst respondents. Substantial variance is also seen for all FMs in occurrence, detectability, and severity scores assigned with average variance values of 5.5, 4.6, and 2.2, respectively. Survey shows for MLC positional FM(2mm) average of 7.6% dose error expected (range 0–50%) compared to 2% error seen in measurement. Analysis of ranking in survey, treatment planning studies, and quantitative value comparison will be presented. Conclusion: Resultant quantitative severity scores will expand the utility of FMEA for radiotherapy and verify accuracy of FMEA

Epidemiology of severe trauma.

Science.gov (United States)

Alberdi, F; García, I; Atutxa, L; Zabarte, M

2014-12-01

Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Intracranial pressure monitoring in severe blunt head trauma: does the type of monitoring device matter?

Science.gov (United States)

Aiolfi, Alberto; Khor, Desmond; Cho, Jayun; Benjamin, Elizabeth; Inaba, Kenji; Demetriades, Demetrios

2018-03-01

OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma. METHODS This retrospective observational study was based on the American College of Surgeons Trauma Quality Improvement Program database, which was searched for all patients with isolated severe blunt head injury who had an ICP monitor placed in the 2-year period from 2013 to 2014. Extracted variables included demographics, comorbidities, mechanisms of injury, head injury specifics (epidural, subdural, subarachnoid, intracranial hemorrhage, and diffuse axonal injury), Abbreviated Injury Scale (AIS) score for each body area, Injury Severity Score (ISS), vital signs in the emergency department, and craniectomy. Outcomes included 30-day mortality, complications, number of ventilation days, intensive care unit and hospital lengths of stay, and functional independence. RESULTS During the study period, 105,721 patients had isolated severe traumatic brain injury (head AIS score ≥ 3). Overall, an ICP monitoring device was placed in 2562 patients (2.4%): 1358 (53%) had an IVD and 1204 (47%) had an IPD. The severity of the head AIS score did not affect the type of ICP monitoring selected. There was no difference in the median ISS; ISS > 15; head AIS Score 3, 4, or 5; or the need for craniectomy between the 2 device groups. Unadjusted 30-day mortality was significantly higher in the group with IVDs (29% vs 25.5%, p = 0.046); however, stepwise logistic regression analysis showed that the type of ICP monitoring was not an independent risk factor for death

MR imaging of acute pancreatitis: Correlation of abdominal wall edema with severity scores

Energy Technology Data Exchange (ETDEWEB)

Yang, Ru, E-mail: yangru0904@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Jing, Zong Lin, E-mail: jzl325@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Zhang, Xiao Ming, E-mail: zhangxm@nsmc.edu.cn [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Tang, Wei, E-mail: tw-n-g-up@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Xiao, Bo, E-mail: xiaoboimaging@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Huang, Xiao Hua, E-mail: nc_hxh1966@yahoo.com.cn [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Yang, Lin, E-mail: llinyangmd@163.com [Sichuan Key laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Feng, Zhi Song, E-mail: fengzhisong@medmail.com.cn [Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China)

2012-11-15

Objective: To study MRI findings of abdominal wall edema (AWE) in acute pancreatitis as well as correlations between AWE and the severity of acute pancreatitis according to the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation III (APACHE III) scoring system. Materials and methods: A total of 160 patients with AP admitted to our institution between December 2009 and March 2011 were included in this study. MRI was performed within 48 h after admission. MRI findings of acute pancreatitis were noted, including AWE on the MRI. The abdominal wall area was divided into quarters, and each area involved was recorded as 1 point to score the severity of AWE. The severity of acute pancreatitis was studied using both the MRSI and the APACHE III scoring system. Spearman correlation of AWE with the MRSI and the APACHE III scoring system was analyzed. Results: In 160 patients with acute pancreatitis, 53.8% had AWE on MRI. The average AWE score was 1.2 {+-} 1.4 points. The prevalence of AWE was 30.5%, 64.5% and 100% in mild, moderate and severe AP, respectively, according to MRSI. AWE on MRI was correlated with MRSI scores (r = 0.441, p = 0.000). According to APACHE III scores, the averages were 2.0 {+-} 1.1 and 2.6 {+-} 1.1 points in mild AP and severe AP, respectively (P = 0.016). AWE was slightly correlated with the APACHE III scores (r = 0.222, p = 0.005). Conclusion: AWE on MRI in acute pancreatitis is common, which may be a supplementary indicator in determining the severity of AP.

Proposing melasma severity index: A new, more practical, office-based scoring system for assessing the severity of melasma

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Imran Majid

2016-01-01

Full Text Available Background: Melasma Area and Severity Index (MASI, the scoring system in melasma, needs to be refined. Aims and Objectives: To propose a more practical scoring system, named as Melasma Severity Index (MSI, for assessing the disease severity and treatment response in melasma. Materials and Methods: Four dermatologists were trained to calculate MASI and also the proposed MSI scores. For MSI, the formula used was 0.4 (a × p 2 l + 0.4 (a × p 2 r + 0.2 (a × p 2 n where "a" stands for area, "p" for pigmentation, "l" for left face, "r" for right face, and "n" for nose. On a single day, 30 enrolled patients were randomly examined by each trained dermatologist and their MASI and MSI scores were calculated. Next, each rater re-examined every 6 th patient for repeat MASI and MSI scoring to assess intra- and inter-rater reliability of MASI and MSI scores. Validity was assessed by comparing the individual scores of each rater with objective data from mexameter and ImageJ software. Results: Inter-rater reliability, as assessed by intraclass correlation coefficient, was significantly higher for MSI (0.955 as compared to MASI (0.816. Correlation of scores with objective data by Spearman′s correlation revealed higher rho values for MSI than for MASI for all raters. Limitations: Sample population belonged to a single ethnic group. Conclusions: MSI is simpler and more practical scoring system for melasma.

Dengue infection severity score – improvised disease management

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Mahmood SU

2016-08-01

Full Text Available Syed Uzair Mahmood,1 Maryam Jamil Syed,1 Aisha Jamal,1 Maria Shoaib2 1Sindh Medical College, Jinnah Sindh Medical University, Karachi, Pakistan; 2Dow Medical College, Dow University of Health Sciences, Karachi, PakistanWe would like to add our views regarding the paper “Validation of Dengue infection severity score” by Pongpan et al.1 As the paper outlines, the purpose of the Dengue Severity Score is to classify individuals with dengue infection into three levels of severity with clinically acceptable underestimation or overestimation. View the original paper by Pongpan and colleagues. 

Industry's Commercial Initiatives on ISS

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Shields, C. E.; Kessler, C.; Lavitola, M. S.

2002-01-01

For more than ten years, private industry has worked to develop a commercial human space market and to create a sustainable ISS commercial utilization customer base. Before ISS assembly was underway - and long before NASA and the international space agencies began to craft ISS commercial business terms and conditions - industry planted and nurtured the seeds of interest in exploiting human space utilization for commerce. These early initiatives have yielded the impetus and framework for industry approaches to ISS commercial utilization today and for NASA's and the International Partners' planned accommodation of private sector interests and desires on the ISS. This paper chronicles major industry initiatives for commercial ISS utilization, emphasizing successful marketing and business approaches and why these approaches have a higher likelihood of success than others. It provides an overview of individual companies' initiatives, as well as collaborative efforts that cross company lines and country borders; and it assesses the relative success of each. Rather than emphasize negative issues and barriers, this paper characterizes and prioritizes actionable success factors for industry and government to make ISS commercial utilization a sustainable reality.

Sparse Learning of the Disease Severity Score for High-Dimensional Data

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Ivan Stojkovic

2017-01-01

Full Text Available Learning disease severity scores automatically from collected measurements may aid in the quality of both healthcare and scientific understanding. Some steps in that direction have been taken and machine learning algorithms for extracting scoring functions from data have been proposed. Given the rapid increase in both quantity and diversity of data measured and stored, the large amount of information is becoming one of the challenges for learning algorithms. In this work, we investigated the direction of the problem where the dimensionality of measured variables is large. Learning the severity score in such cases brings the issue of which of measured features are relevant. We have proposed a novel approach by combining desirable properties of existing formulations, which compares favorably to alternatives in accuracy and especially in the robustness of the learned scoring function. The proposed formulation has a nonsmooth penalty that induces sparsity. This problem is solved by addressing a dual formulation which is smooth and allows an efficient optimization. The proposed approach might be used as an effective and reliable tool for both scoring function learning and biomarker discovery, as demonstrated by identifying a stable set of genes related to influenza symptoms’ severity, which are enriched in immune-related processes.

ISS Logistics Hardware Disposition and Metrics Validation

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Rogers, Toneka R.

2010-01-01

I was assigned to the Logistics Division of the International Space Station (ISS)/Spacecraft Processing Directorate. The Division consists of eight NASA engineers and specialists that oversee the logistics portion of the Checkout, Assembly, and Payload Processing Services (CAPPS) contract. Boeing, their sub-contractors and the Boeing Prime contract out of Johnson Space Center, provide the Integrated Logistics Support for the ISS activities at Kennedy Space Center. Essentially they ensure that spares are available to support flight hardware processing and the associated ground support equipment (GSE). Boeing maintains a Depot for electrical, mechanical and structural modifications and/or repair capability as required. My assigned task was to learn project management techniques utilized by NASA and its' contractors to provide an efficient and effective logistics support infrastructure to the ISS program. Within the Space Station Processing Facility (SSPF) I was exposed to Logistics support components, such as, the NASA Spacecraft Services Depot (NSSD) capabilities, Mission Processing tools, techniques and Warehouse support issues, required for integrating Space Station elements at the Kennedy Space Center. I also supported the identification of near-term ISS Hardware and Ground Support Equipment (GSE) candidates for excessing/disposition prior to October 2010; and the validation of several Logistics Metrics used by the contractor to measure logistics support effectiveness.

AN OBSERVATIONAL CLINICAL STUDY OF ASSESSING THE UTILITY OF PSS (POISON SEVERITY SCORE AND GCS (GLASGOW COMA SCALE SCORING SYSTEMS IN PREDICTING SEVERITY AND CLINICAL OUTCOMES IN OP POISONING

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S. Chandrasekhar

2017-05-01

Full Text Available BACKGROUND Organophosphorus compound poisoning is the most common poisonings in India because of easy availability often requiring ICU care and ventilator support. Clinical research has indicated that respiratory failure is the most important cause of death due to organophosphorus poisoning. It results in respiratory muscle weakness, pulmonary oedema, respiratory depression, increased secretions and bronchospasm. These complications and death can be prevented with timely institution of ventilator support. MATERIALS AND METHODS Hundred consecutive patients admitted with a history of organophosphorus poisoning at Kurnool Medical College, Kurnool, were taken for study after considering the inclusion and exclusion criteria. Detailed history, confirmation of poisoning, examination and other than routine investigations, serum pseudocholinesterase and arterial blood gas analysis was done. The severity and clinical outcomes in OP poisoning is graded by PSS (poison severity score and GCS (Glasgow coma scale scoring systems. RESULTS This study was conducted in 100 patients with male preponderance. Majority of poisoning occurred in 21-30 age group (n=5. Most common compound consumed in our study was methyl parathion and least common was phosphoran. Slightly more than half of the patients consumed less than 50 mL of poison. 21 patients consumed between 50 to 100 mL. Distribution of poison severity score of patients studied showed 45 cases of grade 1 poisoning. 26 cases of grade 2 poisoning, 23 cases of grade 3 poisoning and 6 cases of grade 4 poisoning (death within first 24 hours. Distribution of GCS score of patients studied GCS scores were <10 in 25 patients at admission and 24 patients after 24 hours. GCS scores were ≥10 in 75 patients at admission and 76 patients after 24 hours. Poison severity score is not prognostic, but merely defines severity of OP poisoning at a given time. CONCLUSION Both Glasgow coma scale and poison severity scoring systems

International Space Station (ISS) Emergency Mask (EM) Development

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Toon, Katherine P.; Hahn, Jeffrey; Fowler, Michael; Young, Kevin

2011-01-01

The Emergency Mask (EM) is considered a secondary response emergency Personal Protective Equipment (PPE) designed to provide respiratory protection to the International Space Station (ISS) crewmembers in response to a post-fire event or ammonia leak. The EM is planned to be delivered to ISS in 2012 to replace the current air purifying respirator (APR) onboard ISS called the Ammonia Respirator (AR). The EM is a one ]size ]fits ]all model designed to fit any size crewmember, unlike the APR on ISS, and uses either two Fire Cartridges (FCs) or two Commercial Off-the-Shelf (COTS) 3M(Trademark). Ammonia Cartridges (ACs) to provide the crew with a minimum of 8 hours of respiratory protection with appropriate cartridge swap ]out. The EM is designed for a single exposure event, for either post ]fire or ammonia, and is a passive device that cannot help crewmembers who cannot breathe on their own. The EM fs primary and only seal is around the wearer fs neck to prevent a crewmember from inhaling contaminants. During the development of the ISS Emergency Mask, several design challenges were faced that focused around manufacturing a leak free mask. The description of those challenges are broadly discussed but focuses on one key design challenge area: bonding EPDM gasket material to Gore(Registered Trademark) fabric hood.

Commonly used severity scores are not good predictors of mortality in sepsis from severe leptospirosis: a series of ten patients.

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Velissaris, Dimitrios; Karanikolas, Menelaos; Flaris, Nikolaos; Fligou, Fotini; Marangos, Markos; Filos, Kriton S

2012-01-01

Introduction. Severe leptospirosis, also known as Weil's disease, can cause multiorgan failure with high mortality. Scoring systems for disease severity have not been validated for leptospirosis, and there is no documented method to predict mortality. Methods. This is a case series on 10 patients admitted to ICU for multiorgan failure from severe leptospirosis. Data were collected retrospectively, with approval from the Institution Ethics Committee. Results. Ten patients with severe leptospirosis were admitted in the Patras University Hospital ICU in a four-year period. Although, based on SOFA scores, predicted mortality was over 80%, seven of 10 patients survived and were discharged from the hospital in good condition. There was no association between SAPS II or SOFA scores and mortality, but survivors had significantly lower APACHE II scores compared to nonsurvivors. Conclusion. Commonly used severity scores do not seem to be useful in predicting mortality in severe leptospirosis. Early ICU admission and resuscitation based on a goal-directed therapy protocol are recommended and may reduce mortality. However, this study is limited by retrospective data collection and small sample size. Data from large prospective studies are needed to validate our findings.

Comparison of severity of illness scoring systems in the prediction of hospital mortality in severe sepsis and septic shock

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Crowe Colleen

2010-01-01

Full Text Available Background : New scoring systems, including the Rapid Emergency Medicine Score (REMS, the Mortality in Emergency Department Sepsis (MEDS score, and the confusion, urea nitrogen, respiratory rate, blood pressure, 65 years and older (CURB-65 score, have been developed for emergency department (ED use in various patient populations. Increasing use of early goal directed therapy (EGDT for the emergent treatment of sepsis introduces a growing population of patients in which the accuracy of these scoring systems has not been widely examined. Objectives : To evaluate the ability of the REMS, MEDS score, and CURB-65 score to predict mortality in septic patients treated with modified EGDT. Materials and Methods : Secondary analysis of data from prospectively identified patients treated with modified EGDT in a large tertiary care suburban community hospital with over 85,000 ED visits annually and 700 inpatient beds, from May 2007 through May 2008. We included all patients with severe sepsis or septic shock, who were treated with our modified EGDT protocol. Our major outcome was in-hospital mortality. The performance of the scores was compared by area under the ROC curves (AUCs. Results : A total of 216 patients with severe sepsis or septic shock were treated with modified EGDT during the study period. Overall mortality was 32.9%. Calculated AUCs were 0.74 [95% confidence interval (CI: 0.67-0.81] for the MEDS score, 0.62 (95% CI: 0.54-0.69 for the REMS, and 0.59 (95% CI: 0.51-0.67 for the CURB-65 score. Conclusion : We found that all three ED-based systems for scoring severity of illness had low to moderate predictive capability. The MEDS score demonstrated the largest AUC of the studied scoring systems for the outcome of mortality, although the CIs on point estimates of the AUC of the REMS and CURB-65 scores all overlap.

Predicting the need for massive transfusion in trauma patients: the Traumatic Bleeding Severity Score.

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Ogura, Takayuki; Nakamura, Yoshihiko; Nakano, Minoru; Izawa, Yoshimitsu; Nakamura, Mitsunobu; Fujizuka, Kenji; Suzukawa, Masayuki; Lefor, Alan T

2014-05-01

The ability to easily predict the need for massive transfusion may improve the process of care, allowing early mobilization of resources. There are currently no clear criteria to activate massive transfusion in severely injured trauma patients. The aims of this study were to create a scoring system to predict the need for massive transfusion and then to validate this scoring system. We reviewed the records of 119 severely injured trauma patients and identified massive transfusion predictors using statistical methods. Each predictor was converted into a simple score based on the odds ratio in a multivariate logistic regression analysis. The Traumatic Bleeding Severity Score (TBSS) was defined as the sum of the component scores. The predictive value of the TBSS for massive transfusion was then validated, using data from 113 severely injured trauma patients. Receiver operating characteristic curve analysis was performed to compare the results of TBSS with the Trauma-Associated Severe Hemorrhage score and the Assessment of Blood Consumption score. In the development phase, five predictors of massive transfusion were identified, including age, systolic blood pressure, the Focused Assessment with Sonography for Trauma scan, severity of pelvic fracture, and lactate level. The maximum TBSS is 57 points. In the validation study, the average TBSS in patients who received massive transfusion was significantly greater (24.2 [6.7]) than the score of patients who did not (6.2 [4.7]) (p operating characteristic curve, sensitivity, and specificity for a TBSS greater than 15 points was 0.985 (significantly higher than the other scoring systems evaluated at 0.892 and 0.813, respectively), 97.4%, and 96.2%, respectively. The TBSS is simple to calculate using an available iOS application and is accurate in predicting the need for massive transfusion. Additional multicenter studies are needed to further validate this scoring system and further assess its utility. Prognostic study

Comparison of an expert system with other clinical scores for the evaluation of severity of asthma.

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Gautier, V; Rédier, H; Pujol, J L; Bousquet, J; Proudhon, H; Michel, C; Daurès, J P; Michel, F B; Godard, P

1996-01-01

"Asthmaexpert" was produced at the special request of several clinicians in order to obtain a better understanding of the medical decisions taken by clinical experts in the management of asthmatic patients. In order to assess the severity of asthma, a new score called Artificial Intelligence score (AI score), produced by Asthmaexpert, was compared with three other scores (Aas, Hargreave and Brooks). One hundred patients were enrolled prospectively in the study during their first consultation in the out-patient clinic. Distribution of severity level according to the different scores was studied, and the reliability between AI and other scores was evaluated by Kappa and MacNemar tests. Correlations with functional parameters were performed. The AI score assessed higher levels of severity than the other scores (Kappa = 18, 28 and 10% for Aas, Hargreave and Brooks, respectively) with significant MacNemar test in all cases. There was a significant correlation between AI score and forced expiratory volume in one second (FEV1) (r = 0.73). These data indicate that the AI score is a severity score which defines higher levels of severity than the chosen scores. Correlations for functional parameters are good. This score appears easy to use for the first consultation of an asthmatic patient.

ISS Operations Cost Reductions Through Automation of Real-Time Planning Tasks

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Hall, Timothy A.; Clancey, William J.; McDonald, Aaron; Toschlog, Jason; Tucker, Tyson; Khan, Ahmed; Madrid, Steven (Eric)

2011-01-01

In 2007 the Johnson Space Center s Mission Operations Directorate (MOD) management team challenged their organizations to find ways to reduce the cost of operations for supporting the International Space Station (ISS) in the Mission Control Center (MCC). Each MOD organization was asked to define and execute projects that would help them attain cost reductions by 2012. The MOD Operations Division Flight Planning Branch responded to this challenge by launching several software automation projects that would allow them to greatly improve console operations and reduce ISS console staffing and intern reduce operating costs. These tasks ranged from improving the management and integration mission plan changes, to automating the uploading and downloading of information to and from the ISS and the associated ground complex tasks that required multiple decision points. The software solutions leveraged several different technologies including customized web applications and implementation of industry standard web services architecture; as well as engaging a previously TRL 4-5 technology developed by Ames Research Center (ARC) that utilized an intelligent agent-based system to manage and automate file traffic flow, archive data, and generate console logs. These projects to date have allowed the MOD Operations organization to remove one full time (7 x 24 x 365) ISS console position in 2010; with the goal of eliminating a second full time ISS console support position by 2012. The team will also reduce one long range planning console position by 2014. When complete, these Flight Planning Branch projects will account for the elimination of 3 console positions and a reduction in staffing of 11 engineering personnel (EP) for ISS.

C-reactive protein, procalcitonin, clinical pulmonary infection score, and pneumonia severity scores in nursing home acquired pneumonia.

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Porfyridis, Ilias; Georgiadis, Georgios; Vogazianos, Paris; Mitis, Georgios; Georgiou, Andreas

2014-04-01

Patients with nursing home acquired pneumonia (NHAP) present a distinct group of lower respiratory track infections with different risk factors, clinical presentation, and mortality rates. To evaluate the diagnostic value of clinical pulmonary infection score (CPIS), C-reactive protein, and procalcitonin and to compare the accuracy of pneumonia severity scores (confusion, urea nitrogen, breathing frequency, blood pressure, ≥ 65 y of age [CURB-65]; pneumonia severity index; NHAP index; systolic blood pressure, multilobar involvement, albumin, breathing frequency, tachycardia, confusion, oxygen, arterial pH [SMART-COP]; and systolic blood pressure, oxygen, age > 65 y, breathing frequency [SOAR]) in predicting in-patient mortality from NHAP. Nursing home residents admitted to the hospital with acute respiratory illness were enrolled in the study. Subjects were classified as having NHAP (Group A) or other pulmonary disorders (Group B). Clinical, imaging, and laboratory data were assessed to compute CPIS and severity scores. C-reactive protein and procalcitonin were measured by immunonephelometry and immunoassay, respectively. Fifty-eight subjects were diagnosed with NHAP (Group A) and 29 with other pulmonary disorders (Group B). The mean C-reactive protein ± SD was 16.38 ± 8.6 mg/dL in Group A and 5.2 ± 5.6 mg/dL in Group B (P 1.1 ng/mL was an independent predictor of in-patient mortality. Of the pneumonia severity scores, CURB-65 showed greater accuracy in predicting in-patient mortality (area under the curve of 0.68, 95% CI 0.53-0.84, P = .06). CPIS, procalcitonin, and C-reactive protein are reliable for the diagnosis of NHAP. Procalcitonin and CURB-65 are accurate in predicting in-patient mortality in NHAP.

Severity assessment scores to guide empirical use of antibiotics in community acquired pneumonia.

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Singanayagam, Aran; Chalmers, James D

2013-10-01

Severity assessment scores were first developed to predict the 30 day mortality in community acquired pneumonia; however, several guidelines have extended their use to guide empirical antibiotic prescription decisions. This approach has theoretical advantages because a decrease in broad-spectrum antibiotic treatment in low-risk patients might reduce antibiotic-related side-effects, and to give broad-spectrum therapy to patients at higher risk of death is intuitive. However, evidence in support of this approach is not clear. In particular, the British Thoracic Society guidelines suggest withholding a macrolide from patients with low CURB 65 scores, despite evidence that these patients have a higher frequency of atypical pathogens than do those with a higher severity of pneumonia. Severity scores do not perform well in some groups and might overestimate disease severity in elderly people, leading to inappropriate broad-spectrum treatment to those at high risk of complications such as Clostridium difficile infection. In this Review, we discuss the evidence for antibiotic prescribing guided by severity score and suggest that more evidence of effect and implementation is needed before this approach can be universally adopted. Copyright © 2013 Elsevier Ltd. All rights reserved.

Tale of Two Patent Ductus Arteriosus Severity Scores: Similarities and Differences.

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Fink, Daniel; El-Khuffash, Afif; McNamara, Patrick J; Nitzan, Itamar; Hammerman, Cathy

2018-01-01

 Several echocardiographic scoring systems have been developed to assess the severity of patent ductus arteriosus (PDA) shunting in preterm infants.  The objective of this study was to compare the ability of two different scoring systems to evaluate the hemodynamic significance of the PDA and to predict long-term PDA-associated morbidities.  El-Khuffash cohort (previously described) was derived from a multicenter, prospective, observational study conducted in tertiary neonatal intensive care units in Ireland, Canada, and Australia.  A total of 141 infants with a mean gestational age of 26 ± 1.4 weeks and a mean birth weight of 952 ± 235 g were evaluated on day 2 of life. The two scores were well correlated with each other and both scores positively predicted chronic lung disease/death in this population.  There appears to be an overall stepwise progression in the incidence of poor outcome parameters from "closed" to "borderline" to "hemodynamically significant" PDA. Both the El-Khuffash and Shaare Zedek scores are predictive of PDA-associated morbidities. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

KSC ISS Logistics Support

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Tellado, Joseph

2014-01-01

The presentation contains a status of KSC ISS Logistics Operations. It basically presents current top level ISS Logistics tasks being conducted at KSC, current International Partner activities, hardware processing flow focussing on late Stow operations, list of KSC Logistics POC's, and a backup list of Logistics launch site services. This presentation is being given at the annual International Space Station (ISS) Multi-lateral Logistics Maintenance Control Panel meeting to be held in Turin, Italy during the week of May 13-16. The presentatiuon content doesn't contain any potential lessons learned.

ISS Operations Cost Reductions Through Automation of Real-Time Planning Tasks

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Hall, Timothy A.

2011-01-01

In 2008 the Johnson Space Center s Mission Operations Directorate (MOD) management team challenged their organization to find ways to reduce the costs of International Space station (ISS) console operations in the Mission Control Center (MCC). Each MOD organization was asked to identify projects that would help them attain a goal of a 30% reduction in operating costs by 2012. The MOD Operations and Planning organization responded to this challenge by launching several software automation projects that would allow them to greatly improve ISS console operations and reduce staffing and operating costs. These projects to date have allowed the MOD Operations organization to remove one full time (7 x 24 x 365) ISS console position in 2010; with the plan of eliminating two full time ISS console support positions by 2012. This will account for an overall 10 EP reduction in staffing for the Operations and Planning organization. These automation projects focused on utilizing software to automate many administrative and often repetitive tasks involved with processing ISS planning and daily operations information. This information was exchanged between the ground flight control teams in Houston and around the globe, as well as with the ISS astronaut crew. These tasks ranged from managing mission plan changes from around the globe, to uploading and downloading information to and from the ISS crew, to even more complex tasks that required multiple decision points to process the data, track approvals and deliver it to the correct recipient across network and security boundaries. The software solutions leveraged several different technologies including customized web applications and implementation of industry standard web services architecture between several planning tools; as well as a engaging a previously research level technology (TRL 2-3) developed by Ames Research Center (ARC) that utilized an intelligent agent based system to manage and automate file traffic flow

Risk factors affecting injury severity determined by the MAIS score.

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Ferreira, Sara; Amorim, Marco; Couto, Antonio

2017-07-04

Traffic crashes result in a loss of life but also impact the quality of life and productivity of crash survivors. Given the importance of traffic crash outcomes, the issue has received attention from researchers and practitioners as well as government institutions, such as the European Commission (EC). Thus, to obtain detailed information on the injury type and severity of crash victims, hospital data have been proposed for use alongside police crash records. A new injury severity classification based on hospital data, called the maximum abbreviated injury scale (MAIS), was developed and recently adopted by the EC. This study provides an in-depth analysis of the factors that affect injury severity as classified by the MAIS score. In this study, the MAIS score was derived from the International Classification of Diseases. The European Union adopted an MAIS score equal to or greater than 3 as the definition for a serious traffic crash injury. Gains are expected from using both police and hospital data because the injury severities of the victims are detailed by medical staff and the characteristics of the crash and the site of its occurrence are also provided. The data were obtained by linking police and hospital data sets from the Porto metropolitan area of Portugal over a 6-year period (2006-2011). A mixed logit model was used to understand the factors that contribute to the injury severity of traffic victims and to explore the impact of these factors on injury severity. A random parameter approach offers methodological flexibility to capture individual-specific heterogeneity. Additionally, to understand the importance of using a reliable injury severity scale, we compared MAIS with length of hospital stay (LHS), a classification used by several countries, including Portugal, to officially report injury severity. To do so, the same statistical technique was applied using the same variables to analyze their impact on the injury severity classified according to LHS

Etiology, clinical profile, severity and outcome of acute pancreatitis in relation to bed side index for severity of acute pancreatitis bisap and CT severity index [CTSI] scores

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Bezwada Srinivasa Rao, Matta SreeVani, V.Sarat Chandra

2014-11-01

Full Text Available Background: Acute pancreatitis is an inflammatory process of the pancreas with involvement of regional tissues or remote organ systems and with potentially devastating consequences. Early prediction of outcome of acute pancreatitis within 24 hrs by clinically based bed Side Index of Severity of Acute Pancreatitis [BISAP] Score and radiological based CT Severity Index [CTSI] later on being useful in initiation of early treatment, assessing severity, to prevent morbidity and mortality. In those who survive, it can progress to chronic pancreatitis resulting in malabsorption and permanent diabetes. Aim: The aim was to study aetiology, clinical profile, severity, outcome of acute pancreatitis in relation to BISAP Score and CTSI. Materials and Methods: This was an observational and prospective study. The present study enrolled 55 patients who were diagnosed as acute pancreatitis and patients with chronic pancreatitis were excluded from the study. Vital data like pulse rate, blood Pressure, temperature, respiratory rate, conscious level using Glasgow coma scale, serum amylase, lipase, Chest x-ray, US abdomen and CT abdomen [both CECT & NCCT] were done. BISAP Score was obtained at the time of presentation or within 24 hours of presentation and radiological based CT Severity Index [CTSI] was calculated using the Balthazar grading system and Necrosis Scoring system to assess the severity, morbidity and mortality. The results: In this study, the most common aetiology being alcohol intake followed by gall stones. BISAP Score 3 had organ dysfunction and Score 4 had 100% mortality. The relation between CTSI score and Organ dysfunction showed increased organic dysfunction and higher mortality with higher CTSI Scores. p value < 0.0001 was calculated using Pearson Chi-square test and found to be statistically significant. Conclusions: Both BISAP and CTSI scores had positive correlation with morbidity and mortality.

Relation between both oxidative and metabolic-osmotic cell damages and initial injury severity in bombing casualties

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Vučeljić Marina

2006-01-01

Full Text Available Background/Aim. We have recently reported the development of oxidative cell damages in bombing casualties within a very early period after the initial injury. The aim of this study, was to investigate malondialdehyde (MDA, as an indicator of lipid peroxidation, and osmolal gap (OG, as a good indicator of metabolic cell damages and to assess their relationship with the initial severity of the injury in bombing casualties. Methods. The study included the males (n = 52, injured during the bombing with the Injury Severity Score (ISS ranging from 3 to 66. The whole group of casualties was devided into a group of less severely (ISS < 25, n = 24 and a group of severely (ISS ≥ 26, n = 28 injured males. The uninjured volunteers (n = 10 were the controls. Osmolality, MDA, sodium, glucose, urea, creatinine, total bilirubin and total protein levels were measured in the venous blood, sampled daily, within a ten-day period. Results. In both groups of casualties, MDA and OG levels increased, total protein levels decreased, while other parameters were within the control limits. MDA alterations correlated with ISS (r = 0.414, p < 0.01, while a statistically significant correlation between OG and ISS was not obtained. Interestingly, in spite of some differences in MDA and OG trends, at the end of the examined period they were at the similar level in both groups. Conclusion. The initial oxidative damages of the cellular membrane with intracellular metabolic disorders contributed to the gradual development of metabolic-osmotic damages of cells, which, consequently caused the OG increase. In the bombing casualties, oxidative cell damages were dependent on the initial injury severity, while metabolic-osmotic cell damages were not.

Performance of a novel clinical score, the Pediatric Asthma Severity Score (PASS), in the evaluation of acute asthma.

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Gorelick, Marc H; Stevens, Molly W; Schultz, Theresa R; Scribano, Philip V

2004-01-01

To evaluate the reliability, validity, and responsiveness of a new clinical asthma score, the Pediatric Asthma Severity Score (PASS), in children aged 1 through 18 years in an acute clinical setting. This was a prospective cohort study of children treated for acute asthma at two urban pediatric emergency departments (EDs). A total of 852 patients were enrolled at one site and 369 at the second site. Clinical findings were assessed at the start of the ED visit, after one hour of treatment, and at the time of disposition. Peak expiratory flow rate (PEFR) (for patients aged 6 years and older) and pulse oximetry were also measured. Composite scores including three, four, or five clinical findings were evaluated, and the three-item score (wheezing, prolonged expiration, and work of breathing) was selected as the PASS. Interobserver reliability for the PASS was good to excellent (kappa = 0.72 to 0.83). There was a significant correlation between PASS and PEFR (r = 0.27 to 0.37) and pulse oximetry (r = 0.29 to 0.41) at various time points. The PASS was able to discriminate between those patients who did and did not require hospitalization, with area under the receiver operating characteristic curve of 0.82. Finally, the PASS was shown to be responsive, with a 48% relative increase in score from start to end of treatment and an overall effect size of 0.62, indicating a moderate to large effect. This clinical score, the PASS, based on three clinical findings, is a reliable and valid measure of asthma severity in children and shows both discriminative and responsive properties. The PASS may be a useful tool to assess acute asthma severity for clinical and research purposes.

ISS & Nordea

DEFF Research Database (Denmark)

Pedersen, Torben; Petersen, Bent

2012-01-01

on the core business of banking. In Denmark, Finland, and Sweden, some services had been outsourced to one of the leaders in the facility management (FM) market, the global service provider ISS. The relationship between Nordea and ISS on the delivery of facility services had a long history, but a new contract......Nordea Bank had emerged as the largest financial group in the Nordic region. As part of its consolidated approach, Nordea’s top management had made the strategic decision to outsource a number of the company’s peripheral activities, such as catering, security, and cleaning, in order to focus...

International Space Station (ISS) Oxygen High Pressure Storage Management

Science.gov (United States)

Lewis, John R.; Dake, Jason; Cover, John; Leonard, Dan; Bohannon, Carl

2004-01-01

High pressure oxygen onboard the ISS provides support for Extra Vehicular Activities (EVA) and contingency metabolic support for the crew. This high pressure 02 is brought to the ISS by the Space Shuttle and is transferred using the Oxygen Recharge Compressor Assembly (ORCA). There are several drivers that must be considered in managing the available high pressure 02 on the ISS. The amount of O2 the Shuttle can fly up is driven by manifest mass limitations, launch slips, and on orbit Shuttle power requirements. The amount of 02 that is used from the ISS high pressure gas tanks (HPGT) is driven by the number of Shuttle docked and undocked EVAs, the type of EVA prebreath protocol that is used and contingency use of O2 for metabolic support. Also, the use of the ORCA must be managed to optimize its life on orbit and assure that it will be available to transfer the planned amount of O2 from the Shuttle. Management of this resource has required long range planning and coordination between Shuttle manifest on orbit plans. To further optimize the situation hardware options have been pursued.

Improvement in GOS and GOSE scores 6 and 12 months after severe traumatic brain injury.

Science.gov (United States)

Corral, Luisa; Ventura, José Luis; Herrero, José Ignacio; Monfort, Jose Luis; Juncadella, Montserrat; Gabarrós, Andreu; Bartolomé, Carlos; Javierre, Casimiro F; García-Huete, Lucía

2007-11-01

To assess improvements in Glasgow Outcome Scale (GOS) and GOS extended (GOSE) scores between 6 months and 1 year following severe traumatic brain injury (TBI). One studied 214 adult patients with severe TBI with Glasgow Coma Scale (GCS) GOSE at 6 months and 1 year) was better in the high GCS score at admission (6-8) group than in the low score group (3-5). The improvement in GOS scores between 6 months and 1 year was greater in the high GCS score at admission group than in the low score group. At 6 months, 75 patients had died and 120 survived. None died between the 6-12-month assessments; at 12 months, 36% had improved GOS score. GOS scores improved between 6-12 months after severe TBI in 36% of survivors and it is concluded that the expectancy of improvement is incomplete at 6 months. This improvement was greater in patients with better GCS scores (6-8) at admission than in those with worse GCS scores (3-5).

Preliminary Analysis of ISS Maintenance History and Implications for Supportability of Future Missions

Science.gov (United States)

Watson, Kevin J.; Robbins, William W.

2004-01-01

The International Space Station (ISS) enables the study of supportability issues associated with long-duration human spaceflight. The ISS is a large, complex spacecraft that must be maintained by its crew. In contrast to the Space Shuttle Orbiter vehicle, but similar to spacecraft that will be component elements of future missions beyond low-Earth orbit, ISS does not return to the ground for servicing and provisioning of spares is severely constrained by transportation limits. Although significant technical support is provided by ground personnel, all hands-on maintenance tasks are performed by the crew. It is expected that future missions to distant destinations will be further limited by lack of resupply opportunities and will, eventually, become largely independent of ground support. ISS provides an opportunity to begin learning lessons that will enable future missions to be successful. Data accumulated over the first several years of ISS operations have been analyzed to gain a better understanding of maintenance-related workload. This analysis addresses both preventive and corrective maintenance and includes all U.S segment core systems. Systems and tasks that are major contributors to workload are identified. As further experience accrues, lessons will be learned that will influence future system designs so that they require less maintenance and, when maintenance is required, it can be performed more efficiently. By heeding the lessons of ISS it will be possible to identify system designs that should be more robust and point towards advances in both technology and design that will offer the greatest return on investment.

The Pooling-score (P-score): inter- and intra-rater reliability in endoscopic assessment of the severity of dysphagia.

Science.gov (United States)

Farneti, D; Fattori, B; Nacci, A; Mancini, V; Simonelli, M; Ruoppolo, G; Genovese, E

2014-04-01

This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swallowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or reflex swallowing acts ( 5). Four judges evaluated 30 short films of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The films were randomly distributed on two CDs, which differed in terms of the sequence of the films, and were given to judges (after an explanatory session) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coefficient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the films was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be influenced by the different consistencies of the boluses, was not

ISS Potable Water Quality for Expeditions 26 through 30

Science.gov (United States)

Straub, John E., II; Plumlee, Debrah K.; Schultz, John R.; McCoy, J. Torin

2012-01-01

International Space Station (ISS) Expeditions 26-30 spanned a 16-month period beginning in November of 2010 wherein the final 3 flights of the Space Shuttle program finished ISS construction and delivered supplies to support the post-shuttle era of station operations. Expedition crews relied on several sources of potable water during this period, including water recovered from urine distillate and humidity condensate by the U.S. water processor, water regenerated from humidity condensate by the Russian water recovery system, and Russian ground-supplied potable water. Potable water samples collected during Expeditions 26-30 were returned on Shuttle flights STS-133 (ULF5), STS-134 (ULF6), and STS-135 (ULF7), as well as Soyuz flights 24-27. The chemical quality of the ISS potable water supplies continued to be verified by the Johnson Space Center s Water and Food Analytical Laboratory (WAFAL) via analyses of returned water samples. This paper presents the chemical analysis results for water samples returned from Expeditions 26-30 and discusses their compliance with ISS potable water standards. The presence or absence of dimethylsilanediol (DMSD) is specifically addressed, since DMSD was identified as the primary cause of the temporary rise and fall in total organic carbon of the U.S. product water that occurred in the summer of 2010.

An analysis of the relationship between bodily injury severity and fall height in victims of fatal falls from height

Directory of Open Access Journals (Sweden)

Grzegorz Teresiński

2017-03-01

Full Text Available Aim of the study : One of the basic issues discussed in forensic literature regarding falls from a height is determination of fall heights and differentiation between suicidal and accidental falls. The aim of the study was to verify the usefulness of the available methods for the purposes of forensic expertises. Material and methods : The study encompassed fatalities of falls from a height whose autopsies were performed in the Department of Forensic Medicine in Lublin. Results : Similarly to other authors, the severity of injuries was assessed using the Abbreviated Injury Scale (AIS and injury severity score (ISS. The study findings demonstrated a statistically significant correlation between the fall height and the severity of injuries according to ISS and a statistically significant difference in fall heights between the groups of accidents and suicides.

Alternatives to the ISS Plasma Contacting Units

Science.gov (United States)

Ferguson, Dale C.

2002-01-01

A spacecraft in a high-density equatorial LEO plasma will float negative relative to the ambient plasma. Because of the electron collection of exposed conductors on its solar arrays, it may float negative by up to its array voltage. The floating potential depends on the relative areas of electron and ion collection of the spacecraft. Early estimates of the International Space Station (ISS) potential were about -140 V relative to the surrounding plasma, because of its 160 V solar array string voltage. Because of the possibility of arcing of ISS structures and astronaut EMUs (spacesuits) into the space plasma, Plasma Contacting Units (PCUs) were added to the ISS design, to reduce the highly negative floating potentials by emitting electrons (effectively increasing the ion collecting area). In addition to the now-operating ISS PCUs, safety rules require another independent arc-hazard control method. In this paper, I discuss alternatives to the ISS PCUs for keeping the ISS floating potential at values below the arc-thresholds of ISS and EMU surface materials. Advantages and disadvantages of all of the recline loss will be presented.

ISS Solar Array Management

Science.gov (United States)

Williams, James P.; Martin, Keith D.; Thomas, Justin R.; Caro, Samuel

2010-01-01

The International Space Station (ISS) Solar Array Management (SAM) software toolset provides the capabilities necessary to operate a spacecraft with complex solar array constraints. It monitors spacecraft telemetry and provides interpretations of solar array constraint data in an intuitive manner. The toolset provides extensive situational awareness to ensure mission success by analyzing power generation needs, array motion constraints, and structural loading situations. The software suite consists of several components including samCS (constraint set selector), samShadyTimers (array shadowing timers), samWin (visualization GUI), samLock (array motion constraint computation), and samJet (attitude control system configuration selector). It provides high availability and uptime for extended and continuous mission support. It is able to support two-degrees-of-freedom (DOF) array positioning and supports up to ten simultaneous constraints with intuitive 1D and 2D decision support visualizations of constraint data. Display synchronization is enabled across a networked control center and multiple methods for constraint data interpolation are supported. Use of this software toolset increases flight safety, reduces mission support effort, optimizes solar array operation for achieving mission goals, and has run for weeks at a time without issues. The SAM toolset is currently used in ISS real-time mission operations.

Customization of a Severity of Illness Score Using Local Electronic Medical Record Data.

Science.gov (United States)

Lee, Joon; Maslove, David M

2017-01-01

Severity of illness (SOI) scores are traditionally based on archival data collected from a wide range of clinical settings. Mortality prediction using SOI scores tends to underperform when applied to contemporary cases or those that differ from the case-mix of the original derivation cohorts. We investigated the use of local clinical data captured from hospital electronic medical records (EMRs) to improve the predictive performance of traditional severity of illness scoring. We conducted a retrospective analysis using data from the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) database, which contains clinical data from the Beth Israel Deaconess Medical Center in Boston, Massachusetts. A total of 17 490 intensive care unit (ICU) admissions with complete data were included, from 4 different service types: medical ICU, surgical ICU, coronary care unit, and cardiac surgery recovery unit. We developed customized SOI scores trained on data from each service type, using the clinical variables employed in the Simplified Acute Physiology Score (SAPS). In-hospital, 30-day, and 2-year mortality predictions were compared with those obtained from using the original SAPS using the area under the receiver-operating characteristics curve (AUROC) as well as the area under the precision-recall curve (AUPRC). Test performance in different cohorts stratified by severity of organ injury was also evaluated. Most customized scores (30 of 39) significantly outperformed SAPS with respect to both AUROC and AUPRC. Enhancements over SAPS were greatest for patients undergoing cardiovascular surgery and for prediction of 2-year mortality. Custom models based on ICU-specific data provided better mortality prediction than traditional SAPS scoring using the same predictor variables. Our local data approach demonstrates the value of electronic data capture in the ICU, of secondary uses of EMR data, and of local customization of SOI scoring. © The Author(s) 2015.

A stepwise composite echocardiographic score predicts severe pulmonary hypertension in patients with interstitial lung disease.

Science.gov (United States)

Bax, Simon; Bredy, Charlene; Kempny, Aleksander; Dimopoulos, Konstantinos; Devaraj, Anand; Walsh, Simon; Jacob, Joseph; Nair, Arjun; Kokosi, Maria; Keir, Gregory; Kouranos, Vasileios; George, Peter M; McCabe, Colm; Wilde, Michael; Wells, Athol; Li, Wei; Wort, Stephen John; Price, Laura C

2018-04-01

European Respiratory Society (ERS) guidelines recommend the assessment of patients with interstitial lung disease (ILD) and severe pulmonary hypertension (PH), as defined by a mean pulmonary artery pressure (mPAP) ≥35 mmHg at right heart catheterisation (RHC). We developed and validated a stepwise echocardiographic score to detect severe PH using the tricuspid regurgitant velocity and right atrial pressure (right ventricular systolic pressure (RVSP)) and additional echocardiographic signs. Consecutive ILD patients with suspected PH underwent RHC between 2005 and 2015. Receiver operating curve analysis tested the ability of components of the score to predict mPAP ≥35 mmHg, and a score devised using a stepwise approach. The score was tested in a contemporaneous validation cohort. The score used "additional PH signs" where RVSP was unavailable, using a bootstrapping technique. Within the derivation cohort (n=210), a score ≥7 predicted severe PH with 89% sensitivity, 71% specificity, positive predictive value 68% and negative predictive value 90%, with similar performance in the validation cohort (n=61) (area under the curve (AUC) 84.8% versus 83.1%, p=0.8). Although RVSP could be estimated in 92% of studies, reducing this to 60% maintained a fair accuracy (AUC 74.4%). This simple stepwise echocardiographic PH score can predict severe PH in patients with ILD.

Early Communication System (ECOMM) for ISS

Science.gov (United States)

Gaylor, Kent; Tu, Kwei

1999-01-01

The International Space Station (ISS) Early Communications System (ECOMM) was a Johnson Space Center (JSC) Avionic Systems Division (ASD) in-house developed communication system to provide early communications between the ISS and the Mission Control Center-Houston (MCC-H). This system allows for low rate commands (link rate of 6 kbps) to be transmitted through the Tracking and Data Relay Satellite System (TDRSS) from MCC-H to the ISS using TDRSS's S-band Single Access Forward (SSA/) link service. This system also allows for low rate telemetry (link rate of 20.48 kbps) to be transmitted from ISS to MCC-H through the TDRSS using TDRSS's S-band Single Access Return (SSAR) link service. In addition this system supports a JSC developed Onboard Communications Adapter (OCA) that allows for a two-way data exchange of 128 kbps between MCC-H and the ISS through TDRSS. This OCA data can be digital video/audio (two-way videoconference), and/or file transfers, and/or "white board". The key components of the system, the data formats used by the system to insure compatibility with the future ISS S-Band System, as well as how other vehicles may be able to use this system for their needs are discussed in this paper.

Shuttle and ISS Food Systems Management

Science.gov (United States)

Kloeris, Vickie

2000-01-01

Russia and the U.S. provide the current International Space Station (ISS) food system. Each country contributes half of the food supply in their respective flight food packaging. All of the packaged flight food is stowed in Russian provided containers, which interface with the Service Module galley. Each country accepts the other's flight worthiness inspections and qualifications. Some of the food for the first ISS crew was launched to ISS inside the Service Module in July of 2000, and STS-106 in September 2000 delivered more food to the ISS. All subsequent food deliveries will be made by Progress, the Russian re-supply vehicle. The U.S. will ship their portion of food to Moscow for loading onto the Progress. Delivery schedules vary, but the goal is to maintain at least a 45-day supply onboard ISS at all times. The shelf life for ISS food must be at least one year, in order to accommodate the long delivery cycle and onboard storage. Preservation techniques utilized in the US food system include dehydration, thermo stabilization, intermediate moisture, and irradiation. Additional fresh fruits and vegetables will be sent with each Progress and Shuttle flights as permitted by volume allotments. There is limited refrigeration available on the Service Module to store fresh fruits and vegetables. Astronauts and cosmonauts eat half U.S. and half Russian food. Menu planning begins 1 year before a planned launch. The flight crews taste food in the U.S. and in Russia and rate the acceptability. A preliminary menu is planned, based on these ratings and the nutritional requirements. The preliminary menu is then evaluated by the crews while training in Russia. Inputs from this evaluation are used to finalize the menu and flight packaging is initiated. Flight food is delivered 6 weeks before launch. The current challenge for the food system is meeting the nutritional requirements, especially no more than 10 mg iron, and 3500 mg sodium. Experience from Shuttle[Mir also indicated

Utilizing ISS Camera Systems for Scientific Analysis of Lightning Characteristics and comparison with ISS-LIS and GLM

Science.gov (United States)

Schultz, C. J.; Lang, T. J.; Leake, S.; Runco, M.; Blakeslee, R. J.

2017-12-01

Video and still frame images from cameras aboard the International Space Station (ISS) are used to inspire, educate, and provide a unique vantage point from low-Earth orbit that is second to none; however, these cameras have overlooked capabilities for contributing to scientific analysis of the Earth and near-space environment. The goal of this project is to study how georeferenced video/images from available ISS camera systems can be useful for scientific analysis, using lightning properties as a demonstration. Camera images from the crew cameras and high definition video from the Chiba University Meteor Camera were combined with lightning data from the National Lightning Detection Network (NLDN), ISS-Lightning Imaging Sensor (ISS-LIS), the Geostationary Lightning Mapper (GLM) and lightning mapping arrays. These cameras provide significant spatial resolution advantages ( 10 times or better) over ISS-LIS and GLM, but with lower temporal resolution. Therefore, they can serve as a complementarity analysis tool for studying lightning and thunderstorm processes from space. Lightning sensor data, Visible Infrared Imaging Radiometer Suite (VIIRS) derived city light maps, and other geographic databases were combined with the ISS attitude and position data to reverse geolocate each image or frame. An open-source Python toolkit has been developed to assist with this effort. Next, the locations and sizes of all flashes in each frame or image were computed and compared with flash characteristics from all available lightning datasets. This allowed for characterization of cloud features that are below the 4-km and 8-km resolution of ISS-LIS and GLM which may reduce the light that reaches the ISS-LIS or GLM sensor. In the case of video, consecutive frames were overlaid to determine the rate of change of the light escaping cloud top. Characterization of the rate of change in geometry, more generally the radius, of light escaping cloud top was integrated with the NLDN, ISS-LIS and

Selection of Leafy Green Vegetable Varieties for a Pick-and-Eat Diet Supplement on ISS

Science.gov (United States)

Massa, Gioia D.; Wheeler, Raymond M.; Stutte, Gary W.; Richards, Jeffrey T.; Spencer, LaShelle E.; Hummerick, Mary E.; Douglas, Grace L.; Sirmons, Takiyah

2015-01-01

Several varieties of leafy vegetables were evaluated with the goal of selecting those with the best growth, nutrition, and organoleptic acceptability for ISS. Candidate species were narrowed to commercially available cultivars with desirable growth attributes for space (e.g., short stature and rapid growth). Seeds were germinated in controlled environment chambers under conditions similar to what might be found in the Veggie plant growth chamber on ISS. Eight varieties of leafy greens were grown: 'Tyee' spinach, 'Flamingo' spinach, 'Outredgeous' Red Romaine lettuce, 'Waldmann's Dark Green' leaf lettuce, 'Bull's Blood' beet, 'Rhubarb' Swiss chard, 'Tokyo Bekana' Chinese cabbage, and Mizuna. Plants were harvested at maturity and biometric data on plant height, diameter, chlorophyll content, and fresh mass were obtained. Tissue was ground and extractions were performed to determine the tissue elemental content of Potassium (K), Magnesium (Mg), Calcium (Ca) and Iron (Fe). Following the biometric/elemental evaluation, four of the eight varieties were tested further for levels of anthocyanins, antioxidant (ORAC-fluorescein) capacity, lutein, zeaxanthin, and Vitamin K. For sensory evaluation, 'Outredgeous' lettuce, Swiss chard, Chinese cabbage, and Mizuna plants were grown, harvested when mature, packaged under refrigerated conditions, and sent to the JSC Space Food Systems Laboratory. Tasters evaluated overall acceptability, appearance, color intensity, bitterness, flavor, texture, crispness and tenderness. All varieties received acceptable scores with overall ratings greater than 6 on a 9-point hedonic scale. Chinese cabbage was the highest rated, followed by Mizuna, 'Outredgeous' lettuce, and Swiss chard. Based on our results, the selected varieties of Chinese cabbage, lettuce, Swiss chard and Mizuna seem suitable for a pick-and-eat scenario on ISS with a ranking based on all factors analyzed to help establish priority.

SIRS score on admission and initial concentration of IL-6 as severe acute pancreatitis outcome predictors.

Science.gov (United States)

Gregoric, Pavle; Pavle, Gregoric; Sijacki, Ana; Ana, Sijacki; Stankovic, Sanja; Sanja, Stankovic; Radenkovic, Dejan; Dejan, Radenkovic; Ivancevic, Nenad; Nenad, Ivancevic; Karamarkovic, Aleksandar; Aleksandar, Karamarkovic; Popovic, Nada; Nada, Popovic; Karadzic, Borivoje; Borivoje, Karadzic; Stijak, Lazar; Stefanovic, Branislav; Branislav, Stefanovic; Milosevic, Zoran; Zoran, Milosević; Bajec, Djordje; Djordje, Bajec

2010-01-01

Early recognition of severe form of acute pancreatitis is important because these patients need more agressive diagnostic and therapeutical approach an can develope systemic complications such as: sepsis, coagulopathy, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS), Multiple Organ Dysfunction Syndrome (MODS), Multiple Organ Failure (MOF). To determine role of the combination of Systemic Inflammatory Response Syndrome (SIRS) score and serum Interleukin-6 (IL-6) level on admission as predictor of illness severity and outcome of Severe Acute Pancreatitis (SAP). We evaluated 234 patients with first onset of SAP appears in last twenty four hours. A total of 77 (33%) patients died. SIRS score and serum IL-6 concentration were measured in first hour after admission. In 105 patients with SIRS score 3 and higher, initial measured IL-6 levels were significantly higher than in the group of remaining 129 patients (72 +/- 67 pg/mL, vs 18 +/- 15 pg/mL). All nonsurvivals were in the first group, with SIRS score 3 and 4 and initial IL-6 concentration 113 +/- 27 pg/mL. The values of C-reactive Protein (CRP) measured after 48h, Acute Physiology and Chronic Health Evaluation (APACHE II) score on admission and Ranson score showed the similar correlation, but serum amylase level did not correlate significantly with Ranson score, IL-6 concentration and APACHE II score. The combination of SIRS score on admission and IL-6 serum concentration can be early, predictor of illness severity and outcome in SAP.

The urgent need for a harmonized severity scoring system for acute allergic reactions

DEFF Research Database (Denmark)

Muraro, Antonella; Fernandez-Rivas, Montserrat; Beyer, Kirsten

2018-01-01

The accurate assessment and communication of the severity of acute allergic reactions is important to patients, clinicians, researchers, the food industry, public health and regulatory authorities. Severity has different meanings to different stakeholders with patients and clinicians rating...... of different stakeholder groups. We propose a novel approach to develop and then validate a harmonized scoring system for acute allergic reactions, based on a data-driven method that is informed by clinical and patient experience and other stakeholders' perspectives. We envisage two formats: (i) a numerical...... the significance of particular symptoms very differently. Many severity scoring systems have been generated, most focusing on the severity of reactions following exposure to a limited group of allergens. They are heterogeneous in format, none has used an accepted developmental approach and none has been validated...

Cannabis Use Has Negligible Effects Following Severe Traumatic Injury.

Science.gov (United States)

AbdelFattah, Kareem R; Edwards, Courtney R; Cripps, Michael W; Minshall, Christian T; Phelan, Herb A; Minei, Joseph P; Eastman, Alexander L

Nearly half of all states have legalized medical marijuana or recreational-use marijuana. As more states move toward legalization, the effects on injured patients must be evaluated. This study sought to determine effects of cannabis positivity at the time of severe injury on hospital outcomes compared with individuals negative for illicit substances and those who were users of other illicit substances. A Level I trauma center performed a retrospective chart review covering subjects over a 2-year period with toxicology performed and an Injury Severity Score (ISS) of more than 16. These individuals were divided into the negative and positive toxicology groups, further divided into the marijuana-only, other drugs-only, and mixed-use groups. Differences in presenting characteristics, hospital length of stay, intensive care unit (ICU) stays, ventilator days, and death were compared. A total of 8,441 subjects presented during the study period; 2,134 (25%) of these had toxicology performed; 843 (40%) had an ISS of more than 16, with 347 having negative tests (NEG); 70 (8.3%) substance users tested positive only for marijuana (MO), 323 (38.3%) for other drugs-only, excluding marijuana (OD), and 103 (12.2%) subjects showed positivity for mixed-use (MU). The ISS was similar for all groups. No differences were identified in Glasgow Coma Scale (GCS), ventilator days, blood administration, or ICU/hospital length of stay when comparing the MO group with the NEG group. Significant differences occurred between the OD group and the NEG/MO/MU groups for GCS, ICU length of stay, and hospital charges. Cannabis users suffering from severe injury demonstrated no detrimental outcomes in this study compared with nondrug users.

GWOT Vascular Injury Study 2 Supplemental Project: Impact of Prophylactic Fasciotomy

Science.gov (United States)

2016-10-01

1Injury Severity Score 2005: The Injury Severity Score (ISS) is an anatomical scoring system that...iss.html 2Abbreviated Injury Score (Affected Extremity): The Abbreviated Injury Scale (AIS) is an anatomical scoring system first introduced in...documented diagnosis or treatment for one or more of the following: Rhabdomyolysis, Renal Failure, Paralysis, or Pulmonary Embolism 7Extremity

Severity scoring in the critically ill: part 2: maximizing value from outcome prediction scoring systems.

Science.gov (United States)

Breslow, Michael J; Badawi, Omar

2012-02-01

Part 2 of this review of ICU scoring systems examines how scoring system data should be used to assess ICU performance. There often are two different consumers of these data: lCU clinicians and quality leaders who seek to identify opportunities to improve quality of care and operational efficiency, and regulators, payors, and consumers who want to compare performance across facilities. The former need to know how to garner maximal insight into their care practices; this includes understanding how length of stay (LOS) relates to quality, analyzing the behavior of different subpopulations, and following trends over time. Segregating patients into low-, medium-, and high-risk populations is especially helpful, because care issues and outcomes may differ across this severity continuum. Also, LOS behaves paradoxically in high-risk patients (survivors often have longer LOS than nonsurvivors); failure to examine this subgroup separately can penalize ICUs with superior outcomes. Consumers of benchmarking data often focus on a single score, the standardized mortality ratio (SMR). However, simple SMRs are disproportionately affected by outcomes in high-risk patients, and differences in population composition, even when performance is otherwise identical, can result in different SMRs. Future benchmarking must incorporate strategies to adjust for differences in population composition and report performance separately for low-, medium- and high-acuity patients. Moreover, because many ICUs lack the resources to care for high-acuity patients (predicted mortality >50%), decisions about where patients should receive care must consider both ICU performance scores and their capacity to care for different types of patients.

ISS--an electronic syndromic surveillance system for infectious disease in rural China.

Directory of Open Access Journals (Sweden)

Weirong Yan

Full Text Available BACKGROUND: Syndromic surveillance system has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation, and it is especially effective for surveillance in resource poor settings. However, most current syndromic surveillance systems are established in developed countries, and there are very few reports on the development of an electronic syndromic surveillance system in resource-constrained settings. OBJECTIVE: This study describes the design and pilot implementation of an electronic surveillance system (ISS for the early detection of infectious disease epidemics in rural China, complementing the conventional case report surveillance system. METHODS: ISS was developed based on an existing platform 'Crisis Information Sharing Platform' (CRISP, combining with modern communication and GIS technology. ISS has four interconnected functions: 1 work group and communication group; 2 data source and collection; 3 data visualization; and 4 outbreak detection and alerting. RESULTS: As of Jan. 31(st 2012, ISS has been installed and pilot tested for six months in four counties in rural China. 95 health facilities, 14 pharmacies and 24 primary schools participated in the pilot study, entering respectively 74,256, 79,701, and 2330 daily records into the central database. More than 90% of surveillance units at the study sites are able to send daily information into the system. In the paper, we also presented the pilot data from health facilities in the two counties, which showed the ISS system had the potential to identify the change of disease patterns at the community level. CONCLUSIONS: The ISS platform may facilitate the early detection of infectious disease epidemic as it provides near real-time syndromic data collection, interactive visualization, and automated aberration detection. However, several constraints and challenges were encountered during the pilot implementation of ISS in rural China.

Cold Stowage: An ISS Project

Science.gov (United States)

Hartley, Garen

2018-01-01

NASA's vision for humans pursuing deep space flight involves the collection of science in low earth orbit aboard the International Space Station (ISS). As a service to the science community, Johnson Space Center (JSC) has developed hardware and processes to preserve collected science on the ISS and transfer it safely back to the Principal Investigators. This hardware includes an array of freezers, refrigerators, and incubators. The Cold Stowage team is part of the International Space Station (ISS) program. JSC manages the operation, support and integration tasks provided by Jacobs Technology and the University of Alabama Birmingham (UAB). Cold Stowage provides controlled environments to meet temperature requirements during ascent, on-orbit operations and return, in relation to International Space Station Payload Science.

Clinical utility of metabolic syndrome severity scores: considerations for practitioners

Directory of Open Access Journals (Sweden)

DeBoer MD

2017-02-01

Full Text Available Mark D DeBoer,1,2 Matthew J Gurka2 11Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, 2Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA Abstract: The metabolic syndrome (MetS is marked by abnormalities in central obesity, high blood pressure, high triglycerides, low high-density lipoprotein-cholesterol, and high fasting glucose and appears to be produced by underlying processes of inflammation, oxidative stress, and adipocyte dysfunction. MetS has traditionally been classified based on dichotomous criteria that deny that MetS-related risk likely exists as a spectrum. Continuous MetS scores provide a way to track MetS-related risk over time. We generated MetS severity scores that are sex- and race/ethnicity-specific, acknowledging that the way MetS is manifested may be different by sex and racial/ethnic subgroup. These scores are correlated with long-term risk for type 2 diabetes mellitus and cardiovascular disease. Clinical use of scores like these provide a potential opportunity to identify patients at highest risk, motivate patients toward lifestyle change, and follow treatment progress over time. Keywords: metabolic syndrome, insulin resistance, cardiovascular disease, type 2 diabetes, risk prediction

DSMC Simulations of Disturbance Torque to ISS During Airlock Depressurization

Science.gov (United States)

Lumpkin, F. E., III; Stewart, B. S.

2015-01-01

The primary attitude control system on the International Space Station (ISS) is part of the United States On-orbit Segment (USOS) and uses Control Moment Gyroscopes (CMG). The secondary system is part of the Russian On orbit Segment (RSOS) and uses a combination of gyroscopes and thrusters. Historically, events with significant disturbances such as the airlock depressurizations associated with extra-vehicular activity (EVA) have been performed using the RSOS attitude control system. This avoids excessive propulsive "de-saturations" of the CMGs. However, transfer of attitude control is labor intensive and requires significant propellant. Predictions employing NASA's DSMC Analysis Code (DAC) of the disturbance torque to the ISS for depressurization of the Pirs airlock on the RSOS will be presented [1]. These predictions were performed to assess the feasibility of using USOS control during these events. The ISS Pirs airlock is vented using a device known as a "T-vent" as shown in the inset in figure 1. By orienting two equal streams of gas in opposite directions, this device is intended to have no propulsive effect. However, disturbance force and torque to the ISS do occur due to plume impingement. The disturbance torque resulting from the Pirs depressurization during EVAs is estimated by using a loosely coupled CFD/DSMC technique [2]. CFD is used to simulate the flow field in the nozzle and the near field plume. DSMC is used to simulate the remaining flow field using the CFD results to create an in flow boundary to the DSMC simulation. Due to the highly continuum nature of flow field near the T-vent, two loosely coupled DSMC domains are employed. An 88.2 cubic meter inner domain contains the Pirs airlock and the T-vent. Inner domain results are used to create an in flow boundary for an outer domain containing the remaining portions of the ISS. Several orientations of the ISS solar arrays and radiators have been investigated to find cases that result in minimal

Space Flight Resource Management for ISS Operations

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Schmidt, Lacey L.; Slack, Kelley; Holland, Albert; Huning, Therese; O'Keefe, William; Sipes, Walter E.

2010-01-01

Although the astronaut training flow for the International Space Station (ISS) spans 2 years, each astronaut or cosmonaut often spends most of their training alone. Rarely is it operationally feasible for all six ISS crewmembers to train together, even more unlikely that crewmembers can practice living together before launch. Likewise, ISS Flight Controller training spans 18 months of learning to manage incredibly complex systems remotely in plug-and-play ground teams that have little to no exposure to crewmembers before a mission. How then do all of these people quickly become a team - a team that must respond flexibly yet decisively to a variety of situations? The answer implemented at NASA is Space Flight Resource Management (SFRM), the so-called "soft skills" or team performance skills. Based on Crew Resource Management, SFRM was developed first for shuttle astronauts and focused on managing human errors during time-critical events (Rogers, et al. 2002). Given the nature of life on ISS, the scope of SFRM for ISS broadened to include teamwork during prolonged and routine operations (O'Keefe, 2008). The ISS SFRM model resembles a star with one competency for each point: Communication, Cross-Culture, Teamwork, Decision Making, Team Care, Leadership/Followership, Conflict Management, and Situation Awareness. These eight competencies were developed with international participation by the Human Behavior and Performance Training Working Group. Over the last two years, these competencies have been used to build a multi-modal SFRM training flow for astronaut candidates and flight controllers that integrates team performance skills into the practice of technical skills. Preliminary results show trainee skill increases as the flow progresses; and participants find the training invaluable to performing well and staying healthy during ISS operations. Future development of SFRM training will aim to help support indirect handovers as ISS operations evolve further with the

Serial lactate and admission SOFA scores in trauma: an analysis of predictive value in 724 patients with and without traumatic brain injury.

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Dübendorfer, C; Billeter, A T; Seifert, B; Keel, M; Turina, M

2013-02-01

Arterial lactate, base excess (BE), lactate clearance, and Sequential Organ Failure Assessment (SOFA) score have been shown to correlate with outcome in severely injured patients. The goal of the present study was to separately assess their predictive value in patients suffering from traumatic brain injury (TBI) as opposed to patients suffering from injuries not related to the brain. A total of 724 adult trauma patients with an Injury Severity Score (ISS) ≥ 16 were grouped into patients without TBI (non-TBI), patients with isolated TBI (isolated TBI), and patients with a combination of TBI and non-TBI injuries (combined injuries). The predictive value of the above parameters was then analyzed using both uni- and multivariate analyses. The mean age of the patients was 39 years (77 % males), with a mean ISS of 32 (range 16-75). Mortality ranged from 14 % (non-TBI) to 24 % (combined injuries). Admission and serial lactate/BE values were higher in non-survivors of all groups (all p analysis revealed lactate to be the best overall predictor for increased mortality and further septic complications, irrespective of the leading injury. Lactate showed the best performance in predicting sepsis or death in all trauma patients except those with isolated TBI, and the differences were greatest in patients with substantial bleeding. Following isolated TBI, SOFA score was the only parameter which could differentiate survivors from non-survivors on admission, although the SOFA score, too, was not an independent predictor of death following multivariate analysis.

Space Flight Resource Management for ISS Operations

Science.gov (United States)

Schmidt, Larry; Slack, Kelley; O'Keefe, William; Huning, Therese; Sipes, Walter; Holland, Albert

2011-01-01

This slide presentation reviews the International Space Station (ISS) Operations space flight resource management, which was adapted to the ISS from the shuttle processes. It covers crew training and behavior elements.

Attenuated hypocholesterolemia following severe trauma signals risk for late ventilator-associated pneumonia, ventilator dependency, and death: a retrospective study of consecutive patients

Directory of Open Access Journals (Sweden)

Chirichella Thomas J

2011-03-01

Full Text Available Abstract Background Post-traumatic ventilator-associated pneumonia (VAP is a substantial clinical problem that increases hospital costs and typically adds to the duration of mechanical ventilation. We evaluated the impact of VAP on ventilator days. We also assessed 48-hour total blood cholesterol (TC and other potential risk factors for the development of VAP. Methods We performed a retrospective study of consecutive trauma patients requiring emergency tracheal intubation and evaluated TC, age, gender, ethanol status, smoker status, injury mechanism, chest injury, brain injury, Injury Severity Score (ISS, shock, day-one hypoxemia, and RBC transfusion as potential risks for VAP. Results The 152 patients had ISS 28.1, brain injury 68.4%, VAP 50.0%, ventilator days 14.3, and death 9.9%. Ventilator days were increased with late VAP (p Conclusions Severe traumatic injury produced substantial hypocholesterolemia that is greater with chest injury, shock, and RBC transfusion, but less with brain injury. Total blood cholesterol tended to decrease with increasing injury severity. However, attenuated hypocholesterolemia (ISS ≥ 20-&-TC ≥ 90 mg/dL represents a unique response that can occur with critical injury. Attenuated hypocholesterolemia signals early risk for late VAP, ventilator dependency, and death.

Cytogenetic effects of ionizing radiation in peripheral lymphocytes of ISS crew members

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Johannes, Christian; Goedecke, Wolfgang; Antonopoulos, Alexandra; Obe, Günter; Horstmann, Markus

High energy radiation is a major risk factor in manned space missions. Astronauts and cosmonauts are exposed to ionising radiations of cosmic and solar origin, while on the Earth's surface people are well protected by the atmosphere and a deflecting magnetic field. There are now data available describing the dose and the quality of ionising radiation on-board of the International Space Station (ISS). The effect of the increased radiation dose on mutation rates of ISS crew members are hard to predict. Therefore, direct measurements of mutation rates are required.The analysis of chromosomal aberrations in peripheral blood lymphocytes is a well established method to measure radiation-induced mutations. We present data of chromosome aberration analyses from lymphocyte metaphase spreads of ISS crew members participating in short term (10-14 days) or long term (6 months) missions. From each subject we received two blood samples. The first sample was drawn about 10 days before launch and a second sample was drawn within 3 days after return from their flights. From lymphocyte cultures metaphase plates were prepared on glass slides. Metaphases were Giemsa stained or hybridised using multicolour FISH probes. All types of chromosome changes were scored in pre-flight and post-flight blood samples and the mutation rates were compared. Results obtained in chromosomal studies on long-term flight crew members showed pronounced inter-individual differences in the response to cosmic radiation exposure. Overall significant elevations of typical radiation induced aberrations, i.e., dicentric chromosomes and reciprocal translocations have been observed in long-term crew members. Our data indicate no elevation of mutation rates due to short-term stays on-board the ISS.

High velocity missile-related colorectal injuries: In-theatre application of injury scores and their effects on ostomy rates.

Science.gov (United States)

Kaymak, Şahin; Ünlü, Aytekin; Harlak, Ali; Ersöz, Nail; Şenocak, Rahman; Coşkun, Ali Kağan; Zeybek, Nazif; Lapsekili, Emin; Kozak, Orhan

2016-03-01

Treatment of colorectal injuries (CRIs) remains a significant cause of morbidity and mortality. The aim of the present study was to analyze treatment trends of Turkish surgeons and effects of the American Association for the Surgery of Trauma (AAST), Injury Severity (ISS), and Penetrating Abdominal Trauma Index (PATI) scoring systems on decision-making processes and clinical outcomes. Data regarding high velocity missile (HVM)-related CRIs were retrospectively gathered. Four patient groups were included: Group 1 (stoma), Group 2 (no stoma in primary surgery), Group 2a (conversion to stoma in secondary surgery), and Group 2b (remaining Group 2 patients). Groups 1, 2, 2a, and 2b included 39 (66%), 20 (34%), 6 (30%), and 14 (70%) casualties, respectively. Ostomies were performed in casualties with significantly higher AAST scores (pcolon/rectum injury scores.

Neutron production in a spherical phantom aboard ISS

International Nuclear Information System (INIS)

Tasbaz, A.; Machrafi, R.

2012-01-01

As part of an ongoing research program on radiation monitoring on International Space Station (ISS) that was established to analyze the radiation exposure levels onboard the ISS using different radiation instruments and a spherical phantom to simulate human body. Monte Carlo transport code was used to simulate the interaction of high energy protons and neutrons with the spherical phantom currently onboard ISS. The phantom has been exposed to individual proton energies and to a spectrum of neutrons. The internal to external neutron flux ratio was calculated and compared to the experimental data, recently, measured on the ISS. (author)

Acute Radiation Syndrome Severity Score System in Mouse Total-Body Irradiation Model.

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Ossetrova, Natalia I; Ney, Patrick H; Condliffe, Donald P; Krasnopolsky, Katya; Hieber, Kevin P

2016-08-01

Radiation accidents or terrorist attacks can result in serious consequences for the civilian population and for military personnel responding to such emergencies. The early medical management situation requires quantitative indications for early initiation of cytokine therapy in individuals exposed to life-threatening radiation doses and effective triage tools for first responders in mass-casualty radiological incidents. Previously established animal (Mus musculus, Macaca mulatta) total-body irradiation (γ-exposure) models have evaluated a panel of radiation-responsive proteins that, together with peripheral blood cell counts, create a multiparametic dose-predictive algorithm with a threshold for detection of ~1 Gy from 1 to 7 d after exposure as well as demonstrate the acute radiation syndrome severity score systems created similar to the Medical Treatment Protocols for Radiation Accident Victims developed by Fliedner and colleagues. The authors present a further demonstration of the acute radiation sickness severity score system in a mouse (CD2F1, males) TBI model (1-14 Gy, Co γ-rays at 0.6 Gy min) based on multiple biodosimetric endpoints. This includes the acute radiation sickness severity Observational Grading System, survival rate, weight changes, temperature, peripheral blood cell counts and radiation-responsive protein expression profile: Flt-3 ligand, interleukin 6, granulocyte-colony stimulating factor, thrombopoietin, erythropoietin, and serum amyloid A. Results show that use of the multiple-parameter severity score system facilitates identification of animals requiring enhanced monitoring after irradiation and that proteomics are a complementary approach to conventional biodosimetry for early assessment of radiation exposure, enhancing accuracy and discrimination index for acute radiation sickness response categories and early prediction of outcome.

Scapular fracture: lower severity and mortality

Directory of Open Access Journals (Sweden)

Javad Salimi

Full Text Available CONTEXT AND OBJECTIVE: The presence of scapular fracture is believed to be associated with high rates of other injuries and accompanying morbidities. The aim was to study injury patterns and their overall outcomes in patients with scapula fractures. DESIGN AND SETTING: Cross-sectional study of trauma patients treated at six general hospitals in Tehran. METHODS: One-year trauma records were obtained from six general hospitals Among these, forty-one had sustained a scapular fracture and were included in this study. RESULTS: Scapular fracture occurred predominantly among 20 to 50-year-old patients (78%. Road traffic accidents (RTAs were the main cause of injury (73.2%; 30/41. Pedestrians accounted for 46.7% (14/30 of the injuries due to RTAs. Falls were the next most common cause, accounting for seven cases (17.1%. Body fractures were the most common type of scapular fractures (80%. Eighteen patients (43.9% had isolated scapular fractures. Limb fracture was the most common associated injury, detected in 18 cases (43.9%. Three patients (7.3% had severe injuries (injury severity score, ISS > 16 which resulted in one death (2.4%. The majority of the patients were treated conservatively (87.8%. CONCLUSIONS: Patients with scapula fractures have more severe underlying chest injuries and clavicle fractures. However, this did not correlate with higher rates of injury severity score, intensive care unit admission or mortality.

Role of bedside index for severity of acute pancreatitis (bisap score in predicting outcome in acute pancreatitis

Directory of Open Access Journals (Sweden)

Shahnawaz Bashir Bhat

2015-12-01

Full Text Available Objective: To investigate the role of Bedside index for severity of acute pancreatitis (BISAP score in predicting the outcome of acute pancreatitis. Methods: This single hospital based prospective study included fifty patients of acute pancreatitis admitted within 48 hours of onset of symptoms, who were divided into two groups according to admission BISAP score. BISAP score 3 (severe acute pancreatitis. The ability of BISAP score to predict mortality, morbidity and hospital stay in acute pancreatitis patients was analyzed. Results: A BISAP score of >3 was associated with increased risk of development of transient organ failure, persistent organ failure and pancreatic necrosis (Statistically significant. Mortality in group with BISAP and #8805;3 was 23.5% (4 patients which was statistically higher than group with BISAP score and #706;3 (0 patients (p=0.019.The mean duration of hospital stay of patients in group with BISAP score < 3 was 7.58 +/- 4.04 days and in group with BISAP score and #8805;3 was 15.35 +/- 1.66.(p=0.02. Conclusion: Bedside index for severity in acute pancreatitis (BISAP score, at admission is an excellent score in predicting the mortality, morbidity and hospital stay and hence management protocol in patients admitted with acute pancreatitis. [J Contemp Med 2015; 5(4.000: 215-220

Expanding the Description of Spaceflight Effects beyond Bone Mineral Density [BMD]: Trabecular Bone Score [TBS] in ISS Astronauts

Science.gov (United States)

Sibonga, J. D.; Spector, E. R.; King, L. J.; Evans, H. J.; Smith, S. A.

2014-01-01

Dual-energy x-ray absorptiometry [DXA] is the widely-applied bone densitometry method used to diagnose osteoporosis in a terrestrial population known to be at risk for age-related bone loss. This medical test, which measures areal bone mineral density [aBMD] of clinically-relevant skeletal sites (e.g., hip and spine), helps the clinician to identify which persons, among postmenopausal women and men older than 50 years, are at high risk for low trauma or fragility fractures and might require an intervention. The most recognized osteoporotic fragility fracture is the vertebral compression fracture which can lead to kyphosis or hunched backs typically seen in the elderly. DXA measurement of BMD however is recognized to be insufficient as a sole index for assessing fracture risk. DXA's limitation may be related to its inability to monitor changes in structural parameters, such as trabecular vs. cortical bone volumes, bone geometry or trabecular microarchitecture. Hence, in order to understand risks to human health and performance due to space exposure, NASA needs to expand its measurements of bone to include other contributors to skeletal integrity. To this aim, the Bone and Mineral Lab conducted a pilot study for a novel measurement of bone microarchitecture that can be obtained by retrospective analysis of DXA scans. Trabecular Bone Score (TBS) assesses changes to trabecular microarchitecture by measuring the grey color "texture" information extracted from DXA images of the lumbar spine. An analysis of TBS in 51 ISS astronauts was conducted to assess if TBS could detect 1) an effect of spaceflight and 2) a response to countermeasures independent of DXA BMD. In addition, changes in trunk body lean tissue mass and in trunk body fat tissue mass were also evaluated to explore an association between body composition, as impacted by ARED exercise, and bone microarchitecture. The pilot analysis of 51 astronaut scans of the lumbar spine suggests that, following an ISS

ISS Hygiene Activities - Issues and Resolutions

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Prokhorov, Kimberlee S.; Feldman, Brienne; Walker, Stephanie; Bruce, Rebekah

2009-01-01

Hygiene is something that is usually taken for granted by those of us on the Earth. The ability to perform hygiene satisfactorily during long duration space flight is crucial for the crew's ability to function. Besides preserving the basic health of the crew, crew members have expressed that the ability to clean up on-orbit is vital for mental health. Providing this functionality involves more than supplying hygiene items such as soap and toothpaste. On the International Space Station (ISS), the details on where and how to perform hygiene were left to the crew discretion for the first seventeen increments. Without clear guidance, the methods implemented on-orbit have resulted in some unintended consequences to the ISS environment. This paper will outline the issues encountered regarding hygiene activities on-board the ISS, and the lessons that have been learned in addressing those issues. Additionally, the paper will address the resolutions that have been put into place to protect the ISS environment while providing the crew sufficient means to perform hygiene.

Polytrauma Defined by the New Berlin Definition: A Validation Test Based on Propensity-Score Matching Approach.

Science.gov (United States)

Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2017-09-11

Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6.0], coagulopathy [partial thromboplastin time ≥ 40 s or international normalized ratio ≥ 1.4], and age [≥70 years]). Methods: We retrieved detailed data on 369 polytrauma patients and 1260 non-polytrauma patients with an overall Injury Severity Score (ISS) ≥ 18 who were hospitalized between 1 January 2009 and 31 December 2015 for the treatment of all traumatic injuries, from the Trauma Registry System at a level I trauma center. Patients with burn injury or incomplete registered data were excluded. Categorical data were compared with two-sided Fisher exact or Pearson chi-square tests. The unpaired Student t -test and the Mann-Whitney U -test was used to analyze normally distributed continuous data and non-normally distributed data, respectively. Propensity-score matched cohort in a 1:1 ratio was allocated using the NCSS software with logistic regression to evaluate the effect of polytrauma on patient outcomes. Results: The polytrauma patients had a significantly higher ISS than non-polytrauma patients (median (interquartile range Q1-Q3), 29 (22-36) vs. 24 (20-25), respectively; p Polytrauma patients had a 1.9-fold higher odds of mortality than non-polytrauma patients (95% CI 1.38-2.49; p polytrauma patients, polytrauma patients had a substantially longer hospital length of stay (LOS). In addition, a higher proportion of polytrauma patients were admitted to the intensive

[Severity of disease scoring systems and mortality after non-cardiac surgery].

Science.gov (United States)

Reis, Pedro Videira; Sousa, Gabriela; Lopes, Ana Martins; Costa, Ana Vera; Santos, Alice; Abelha, Fernando José

2018-04-05

Mortality after surgery is frequent and severity of disease scoring systems are used for prediction. Our aim was to evaluate predictors for mortality after non-cardiac surgery. Adult patients admitted at our surgical intensive care unit between January 2006 and July 2013 was included. Univariate analysis was carried using Mann-Whitney, Chi-square or Fisher's exact test. Logistic regression was performed to assess independent factors with calculation of odds ratio and 95% confidence interval (95% CI). 4398 patients were included. Mortality was 1.4% in surgical intensive care unit and 7.4% during hospital stay. Independent predictors of mortality in surgical intensive care unit were APACHE II (OR=1.24); emergent surgery (OR=4.10), serum sodium (OR=1.06) and FiO 2 at admission (OR=14.31). Serum bicarbonate at admission (OR=0.89) was considered a protective factor. Independent predictors of hospital mortality were age (OR=1.02), APACHE II (OR=1.09), emergency surgery (OR=1.82), high-risk surgery (OR=1.61), FiO 2 at admission (OR=1.02), postoperative acute renal failure (OR=1.96), heart rate (OR=1.01) and serum sodium (OR=1.04). Dying patients had higher scores in severity of disease scoring systems and longer surgical intensive care unit stay. Some factors influenced both surgical intensive care unit and hospital mortality. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Is paediatric trauma severity overestimated at triage?

DEFF Research Database (Denmark)

DO, H Q; Hesselfeldt, R; Steinmetz, J

2014-01-01

BACKGROUND: Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). METHODS: This is an observational...... follow-up study that involves one level I TC and seven local hospitals. We included paediatric (trauma patients with a driving distance to the TC > 30 minutes. The primary end-point was the proportion of trauma patients arriving in the TC. RESULTS: We included 1934...... trauma patients, 238 children and 1696 adults. A total of 33/238 children (13.9%) vs. 304/1696 adults (17.9%) were transported to the TC post-injury (P = 0.14). Among these, children were significantly less injured than adults [median Injury Severity Score (ISS) 9 vs. 14, P 

Modified poisoning severity score for early prognostic evaluation in acute paraquat poisoning

Directory of Open Access Journals (Sweden)

Feng-lin SONG

2018-04-01

Full Text Available Objective To study the applied value of modified poisoning severity score (PSS for early prognostic evaluation in acute paraquat poisoning. Methods Thirty-seven patients with acute paraquat poisoning from June 2013 to June 2016 were enrolled. The PSS score, the modified PSS score, the acute physiology and the chronic health status Ⅱ score (APACHE Ⅱ of the patients were calculated. The relationship between modified PSS and APACHE Ⅱ was analyzed. Also the factors that affect outcome were analyzed by logistic regression analysis. The work characteristic curve (ROC curve of the PSS, the modified PSS and the APECH Ⅱ were drawn and compared. Results There was a positive correlation between the risk of death and admission time, poisonous dose, the concentration of urine paraquat, and white blood cell count (P<0.05. There was a significant correlation between the modified PSS and the APACHE Ⅱ(P<0.0001. The immediate PSS score, the modified PSS score, and the APACHE Ⅱ score were significant for the prognosis of patients with acute paraquat poisoning. The area under the curve (AUC was in turn 0.774, 0.788, 0.799. Among them, the best bound of the modified PSS score was 6.5 (when the score is greater than 6.5, the risk of death is higher. Further comparison of the area under the three curves showed that there was no significant difference in the area under the ROC curve between the three scores in predicting the prognosis of death [P=0.7633(PSS-DPSS, P=0.7791(PSS-APACHE Ⅱ, P=0.8918(DPSS-APACHE Ⅱ]. Conclusion Modified PSS is helpful in early predicting the prognosis of acute paraquat poisoning. DOI: 10.11855/j.issn.0577-7402.2018.04.13

Space Weather Monitoring for ISS Geomagnetic Storm Studies

Science.gov (United States)

Minow, Joseph I.; Parker, Linda Neergaard

2013-01-01

The International Space Station (ISS) space environments community utilizes near real time space weather data to support a variety of ISS engineering and science activities. The team has operated the Floating Potential Measurement Unit (FPMU) suite of plasma instruments (two Langmuir probes, a floating potential probe, and a plasma impedance probe) on ISS since 2006 to obtain in-situ measurements of plasma density and temperature along the ISS orbit and variations in ISS frame potential due to electrostatic current collection from the plasma environment (spacecraft charging) and inductive (vxB) effects from the vehicle motion across the Earth s magnetic field. An ongoing effort is to use FPMU for measuring the ionospheric response to geomagnetic storms at ISS altitudes and investigate auroral charging of the vehicle as it passes through regions of precipitating auroral electrons. This work is challenged by restrictions on FPMU operations that limit observation time to less than about a third of a year. As a result, FPMU campaigns ranging in length from a few days to a few weeks are typically scheduled weeks in advance for ISS engineering and payload science activities. In order to capture geomagnetic storm data under these terms, we monitor near real time space weather data from NASA, NOAA, and ESA sources to determine solar wind disturbance arrival times at Earth likely to be geoeffective (including coronal mass ejections and high speed streams associated with coronal holes) and activate the FPMU ahead of the storm onset. Using this technique we have successfully captured FPMU data during a number of geomagnetic storm periods including periods with ISS auroral charging. This presentation will describe the strategies and challenges in capturing FPMU data during geomagnetic storms, the near real time space weather resources utilized for monitoring the space weather environment, and provide examples of auroral charging data obtained during storm operations.

CALET docked on the ISS

CERN Multimedia

Antonella Del Rosso

2015-01-01

On 19 August, with a spectacular launch on board the Japanese H2-B rocket operated by the Japan Aerospace Exploration Agency (JAXA), the CALorimetric Electron Telescope (CALET) left the Tanegashima Space Center to reach the International Space Station five days later.   After berthing with the ISS, CALET was extracted by a robotic arm from the Japanese HTV-5 transfer vehicle and installed on the Japanese Exposure Facility (right) where it will start its first data-taking. (Image: NASA/JAXA.)   CALET is a space mission led by JAXA with the participation of the Italian Space Agency (ASI) and NASA. It is a CERN-recognised experiment and the second high-energy astroparticle experiment to be installed on the International Space Station (ISS) after AMS-02, which has been taking data since 2011. Designed to be a space observatory for long-term observations of cosmic radiation aboard the external platform JEM-EF of the Japanese module (KIBO) on the ISS, CALET aims to identify elect...

ISS Asset Tracking Using SAW RFID Technology

Science.gov (United States)

Schellhase, Amy; Powers, Annie

2004-01-01

A team at the NASA Johnson Space Center (JSC) is undergoing final preparations to test Surface Acoustic Wave (SAW) Radio Frequency Identification (RFID) technology to track assets aboard the International Space Station (ISS). Currently, almost 10,000 U.S. items onboard the ISS are tracked within a database maintained by both the JSC ground teams and crew onboard the ISS. This barcode-based inventory management system has successfully tracked the location of 97% of the items onboard, but its accuracy is dependant on the crew to report hardware movements, taking valuable time away from science and other activities. With the addition of future modules, the volume of inventory to be tracked is expected to increase significantly. The first test of RFID technology on ISS, which will be conducted by the Expedition 16 crew later this year, will evaluate the ability of RFID technology to track consumable items. These consumables, which include office supplies and clothing, are regularly supplied to ISS and can be tagged on the ground. Automation will eliminate line-of-sight auditing requirements, directly saving crew time. This first step in automating an inventory tracking system will pave the way for future uses of RFID for inventory tracking in space. Not only are there immediate benefits for ISS applications, it is a crucial step to ensure efficient logistics support for future vehicles and exploration missions where resupplies are not readily available. Following a successful initial test, the team plans to execute additional tests for new technology, expanded operations concepts, and increased automation.

Ordinal convolutional neural networks for predicting RDoC positive valence psychiatric symptom severity scores.

Science.gov (United States)

Rios, Anthony; Kavuluru, Ramakanth

2017-11-01

The CEGS N-GRID 2016 Shared Task in Clinical Natural Language Processing (NLP) provided a set of 1000 neuropsychiatric notes to participants as part of a competition to predict psychiatric symptom severity scores. This paper summarizes our methods, results, and experiences based on our participation in the second track of the shared task. Classical methods of text classification usually fall into one of three problem types: binary, multi-class, and multi-label classification. In this effort, we study ordinal regression problems with text data where misclassifications are penalized differently based on how far apart the ground truth and model predictions are on the ordinal scale. Specifically, we present our entries (methods and results) in the N-GRID shared task in predicting research domain criteria (RDoC) positive valence ordinal symptom severity scores (absent, mild, moderate, and severe) from psychiatric notes. We propose a novel convolutional neural network (CNN) model designed to handle ordinal regression tasks on psychiatric notes. Broadly speaking, our model combines an ordinal loss function, a CNN, and conventional feature engineering (wide features) into a single model which is learned end-to-end. Given interpretability is an important concern with nonlinear models, we apply a recent approach called locally interpretable model-agnostic explanation (LIME) to identify important words that lead to instance specific predictions. Our best model entered into the shared task placed third among 24 teams and scored a macro mean absolute error (MMAE) based normalized score (100·(1-MMAE)) of 83.86. Since the competition, we improved our score (using basic ensembling) to 85.55, comparable with the winning shared task entry. Applying LIME to model predictions, we demonstrate the feasibility of instance specific prediction interpretation by identifying words that led to a particular decision. In this paper, we present a method that successfully uses wide features and

Association between the Osteoporosis Self-Assessment Tool for Asians Score and Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: A Propensity Score-Matched Analysis.

Science.gov (United States)

Rau, Cheng-Shyuan; Kuo, Pao-Jen; Wu, Shao-Chun; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2016-12-03

Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014. Patients were categorized as high-risk (OSTA score -1; n = 5359). Two-sided Pearson's chi-squared, or Fisher's exact tests were used to compare categorical data. Unpaired Student's t -test and Mann-Whitney U test were performed to analyze normally and non-normally distributed continuous data, respectively. Propensity score-matching in a 1:1 ratio was performed using NCSS software, with adjustment for covariates. Results: Compared to low-risk patients, high- and medium-risk patients were significantly older and injured more severely. The high- and medium-risk patients had significantly higher mortality rates, longer hospital length of stay, and a higher proportion of admission to the intensive care unit than low-risk patients. Analysis of propensity score-matched patients with adjusted covariates, including gender, co-morbidity, blood alcohol concentration level, Glasgow Coma Scale score, and Injury Severity Score revealed that high- and medium-risk patients still had a 2.4-fold (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.39-4.15; p = 0.001) and 1.8-fold (OR, 1.8; 95% CI, 1.19-2.86; p = 0.005) higher mortality, respectively, than low-risk patients. However, further addition of age as a covariate for the propensity score-matching demonstrated that there was no significant difference between high-risk and low-risk patients or between medium-risk and low-risk patients, implying that older age

ISS Robotic Student Programming

Science.gov (United States)

Barlow, J.; Benavides, J.; Hanson, R.; Cortez, J.; Le Vasseur, D.; Soloway, D.; Oyadomari, K.

2016-01-01

The SPHERES facility is a set of three free-flying satellites launched in 2006. In addition to scientists and engineering, middle- and high-school students program the SPHERES during the annual Zero Robotics programming competition. Zero Robotics conducts virtual competitions via simulator and on SPHERES aboard the ISS, with students doing the programming. A web interface allows teams to submit code, receive results, collaborate, and compete in simulator-based initial rounds and semi-final rounds. The final round of each competition is conducted with SPHERES aboard the ISS. At the end of 2017 a new robotic platform called Astrobee will launch, providing new game elements and new ground support for even more student interaction.

Thermally-Constrained Fuel-Optimal ISS Maneuvers

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Bhatt, Sagar; Svecz, Andrew; Alaniz, Abran; Jang, Jiann-Woei; Nguyen, Louis; Spanos, Pol

2015-01-01

Optimal Propellant Maneuvers (OPMs) are now being used to rotate the International Space Station (ISS) and have saved hundreds of kilograms of propellant over the last two years. The savings are achieved by commanding the ISS to follow a pre-planned attitude trajectory optimized to take advantage of environmental torques. The trajectory is obtained by solving an optimal control problem. Prior to use on orbit, OPM trajectories are screened to ensure a static sun vector (SSV) does not occur during the maneuver. The SSV is an indicator that the ISS hardware temperatures may exceed thermal limits, causing damage to the components. In this paper, thermally-constrained fuel-optimal trajectories are presented that avoid an SSV and can be used throughout the year while still reducing propellant consumption significantly.

Objective Assessment of the Severity of Patients Suffering from Fall from Height with Combined Injuries of the Abdominal Parenchymal Organs

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Abdukhakim Khadjibaev

2015-06-01

Full Text Available In recent years, fall from a height (FFH has been a relatively frequent cause of injury and death in the urban environment. The purpose of this study was to optimize the risk stratification of FFH victims with combined injuries of the abdominal organs by using Injury Severity Score (ISS scale. The study included 111 patients (aged between 15 and 80 years injured by FFH. All the falls were accidental and occurred mainly among males (82%. The height of the fall ranged from 2 to 5 meters. Combined injuries were found in 98 patients and isolated injuries in 13 patients. The combination of the 6 injured body regions was identified in 5 patients, 5 regions in 17, 4 in 35, 3 in 23, and 2 in 18. The abdomen trauma was most commonly associated with the following injured body regions: head and neck-chest-extremities and pelvis (13.3%, head and neck-chest-extremities (12.2%, and head and neck-chest-pelvis (9.2%. Among the combined injuries of the abdomen, ruptures of parenchymal organs (liver, spleen and kidneys were predominant. To assess the severity of the injury, the ISS scale was applied. The injuries of abdominal parenchymal organs were evaluated according to the AAST (American Association for the Surgery of Trauma classification. Comparative analysis of the assessment of the severity of a patient's condition according to the traditional scale and the ISS scale showed that the ISS scale promotes the active and timely detection of the extremely severe and terminal condition in patients with injuries due to FFH with combined trauma of the abdominal organs. Objective assessment of the severity of trauma and the dominant injury region allows determining the optimal treatment algorithm and predicting the outcome of the injury.

Validating severity of illness scoring systems in the prediction of outcomes in Staphylococcus aureus bacteremia.

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Sharma, Mamta; Szpunar, Susan; Khatib, Riad

2013-08-01

Severity of illness scores are helpful in predicting mortality; however, no standardized scoring system has been validated in patients with Staphylococcus aureus bacteremia (SAB). The modified Rapid Emergency Medicine Score (REMS), the CURB-65 (confusion, urea, respiratory rate, blood pressure and age 65) and the Charlson weighted index of comorbidity (CWIC) were compared in predicting outcomes at the onset of SAB. All adult inpatients with SAB from July 15, 2008, to December 31, 2009, were prospectively assessed. The 3 scoring systems were applied: REMS, CURB-65 and CWIC. The end points were attributable and overall mortality. A total of 241 patients with SAB were reviewed during the study period. The all-cause mortality rate was 22.8% and attributable mortality 14.1%. Patients who died had higher mean CURB-65 score and REMS than those who lived, whereas the difference in the CWIC score was not significant. Two logistic regression models based on CURB-65 score or REMS, after controlling for CWIC, revealed that both scores were independent predictors of mortality, with an odds ratio of 3.38 (P < 0.0001) and 1.45 (P < 0.0001) for CURB-65 and REMS, respectively. Receiver operating characteristic analysis revealed that a cutoff point of 3.0 (CURB-65) and 6.0 (REMS) provided the highest sensitivity and specificity. The area under the curves for all-cause mortality were 0.832 and 0.806, and for attributable mortality 0.845 and 0.819, for CURB-65 and REMS, respectively. REMS and CURB-65 scores outperformed CWIC as predictors of mortality in SAB and may be effective in predicting the severity of illness at the onset of bacteremia.

Orion Handling Qualities During ISS Rendezvous and Docking

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Hart, Jeremy J.; Stephens, J. P.; Spehar, P.; Bilimoria, K.; Foster, C.; Gonzalex, R.; Sullivan, K.; Jackson, B.; Brazzel, J.; Hart, J.

2011-01-01

The Orion spacecraft was designed to rendezvous with multiple vehicles in low earth orbit (LEO) and beyond. To perform the required rendezvous and docking task, Orion must provide enough control authority to perform coarse translational maneuvers while maintaining precision to perform the delicate docking corrections. While Orion has autonomous docking capabilities, it is expected that final approach and docking operations with the International Space Station (ISS) will initially be performed in a manual mode. A series of evaluations was conducted by NASA and Lockheed Martin at the Johnson Space Center to determine the handling qualities (HQ) of the Orion spacecraft during different docking and rendezvous conditions using the Cooper-Harper scale. This paper will address the specifics of the handling qualities methodology, vehicle configuration, scenarios flown, data collection tools, and subject ratings and comments. The initial Orion HQ assessment examined Orion docking to the ISS. This scenario demonstrates the Translational Hand Controller (THC) handling qualities of Orion. During this initial assessment, two different scenarios were evaluated. The first was a nominal docking approach to a stable ISS, with Orion initializing with relative position dispersions and a closing rate of approximately 0.1 ft/sec. The second docking scenario was identical to the first, except the attitude motion of the ISS was modeled to simulate a stress case ( 1 degree deadband per axis and 0.01 deg/sec rate deadband per axis). For both scenarios, subjects started each run on final approach at a docking port-to-port range of 20 ft. Subjects used the THC in pulse mode with cues from the docking camera image, window views, and range and range rate data displayed on the Orion display units. As in the actual design, the attitude of the Orion vehicle was held by the automated flight control system at 0.5 degree deadband per axis. Several error sources were modeled including Reaction

Status of ISS Water Management and Recovery

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Carter, Layne; Takada, Kevin; Gazda, Daniel; Brown, Christopher; Bazley, Jesse; Schaezler, Ryan; Bankers, Lyndsey

2017-01-01

Water management on ISS is responsible for the provision of water to the crew for drinking water, food preparation, and hygiene, to the Oxygen Generation System (OGS) for oxygen production via electrolysis, to the Waste & Hygiene Compartment (WHC) for flush water, and for experiments on ISS. This paper summarizes water management activities on the ISS US Segment and provides a status of the performance and issues related to the operation of the Water Processor Assembly (WPA) and Urine Processor Assembly (UPA). This paper summarizes the on-orbit status as of June 2017 and describes the technical challenges encountered and lessons learned over the past year.

Status of ISS Water Management and Recovery

Science.gov (United States)

Carter, Layne; Brown, Christopher; Orozco, Nicole

2014-01-01

Water management on ISS is responsible for the provision of water to the crew for drinking water, food preparation, and hygiene, to the Oxygen Generation System (OGS) for oxygen production via electrolysis, to the Waste & Hygiene Compartment (WHC) for flush water, and for experiments on ISS. This paper summarizes water management activities on the ISS US Segment, and provides a status of the performance and issues related to the operation of the Water Processor Assembly (WPA) and Urine Processor Assembly (UPA). This paper summarizes the on-orbit status as of June 2013, and describes the technical challenges encountered and lessons learned over the past year.

ISS Ammonia Leak Detection Through X-Ray Fluorescence

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Camp, Jordan; Barthelmy, Scott; Skinner, Gerry

2013-01-01

Ammonia leaks are a significant concern for the International Space Station (ISS). The ISS has external transport lines that direct liquid ammonia to radiator panels where the ammonia is cooled and then brought back to thermal control units. These transport lines and radiator panels are subject to stress from micrometeorites and temperature variations, and have developed small leaks. The ISS can accommodate these leaks at their present rate, but if the rate increased by a factor of ten, it could potentially deplete the ammonia supply and impact the proper functioning of the ISS thermal control system, causing a serious safety risk. A proposed ISS astrophysics instrument, the Lobster X-Ray Monitor, can be used to detect and localize ISS ammonia leaks. Based on the optical design of the eye of its namesake crustacean, the Lobster detector gives simultaneously large field of view and good position resolution. The leak detection principle is that the nitrogen in the leaking ammonia will be ionized by X-rays from the Sun, and then emit its own characteristic Xray signal. The Lobster instrument, nominally facing zenith for its astrophysics observations, can be periodically pointed towards the ISS radiator panels and some sections of the transport lines to detect and localize the characteristic X-rays from the ammonia leaks. Another possibility is to use the ISS robot arm to grab the Lobster instrument and scan it across the transport lines and radiator panels. In this case the leak detection can be made more sensitive by including a focused 100-microampere electron beam to stimulate X-ray emission from the leaking nitrogen. Laboratory studies have shown that either approach can be used to locate ammonia leaks at the level of 0.1 kg/day, a threshold rate of concern for the ISS. The Lobster instrument uses two main components: (1) a microchannel plate optic (also known as a Lobster optic) that focuses the X-rays and directs them to the focal plane, and (2) a CCD (charge

Estimation of Symptom Severity Scores for Patients with Schizophrenia Using ERP Source Activations during a Facial Affect Discrimination Task.

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Kim, Do-Won; Lee, Seung-Hwan; Shim, Miseon; Im, Chang-Hwan

2017-01-01

Precise diagnosis of psychiatric diseases and a comprehensive assessment of a patient's symptom severity are important in order to establish a successful treatment strategy for each patient. Although great efforts have been devoted to searching for diagnostic biomarkers of schizophrenia over the past several decades, no study has yet investigated how accurately these biomarkers are able to estimate an individual patient's symptom severity. In this study, we applied electrophysiological biomarkers obtained from electroencephalography (EEG) analyses to an estimation of symptom severity scores of patients with schizophrenia. EEG signals were recorded from 23 patients while they performed a facial affect discrimination task. Based on the source current density analysis results, we extracted voxels that showed a strong correlation between source activity and symptom scores. We then built a prediction model to estimate the symptom severity scores of each patient using the source activations of the selected voxels. The symptom scores of the Positive and Negative Syndrome Scale (PANSS) were estimated using the linear prediction model. The results of leave-one-out cross validation (LOOCV) showed that the mean errors of the estimated symptom scores were 3.34 ± 2.40 and 3.90 ± 3.01 for the Positive and Negative PANSS scores, respectively. The current pilot study is the first attempt to estimate symptom severity scores in schizophrenia using quantitative EEG features. It is expected that the present method can be extended to other cognitive paradigms or other psychological illnesses.

Estimation of Symptom Severity Scores for Patients with Schizophrenia Using ERP Source Activations during a Facial Affect Discrimination Task

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Do-Won Kim

2017-08-01

Full Text Available Precise diagnosis of psychiatric diseases and a comprehensive assessment of a patient's symptom severity are important in order to establish a successful treatment strategy for each patient. Although great efforts have been devoted to searching for diagnostic biomarkers of schizophrenia over the past several decades, no study has yet investigated how accurately these biomarkers are able to estimate an individual patient's symptom severity. In this study, we applied electrophysiological biomarkers obtained from electroencephalography (EEG analyses to an estimation of symptom severity scores of patients with schizophrenia. EEG signals were recorded from 23 patients while they performed a facial affect discrimination task. Based on the source current density analysis results, we extracted voxels that showed a strong correlation between source activity and symptom scores. We then built a prediction model to estimate the symptom severity scores of each patient using the source activations of the selected voxels. The symptom scores of the Positive and Negative Syndrome Scale (PANSS were estimated using the linear prediction model. The results of leave-one-out cross validation (LOOCV showed that the mean errors of the estimated symptom scores were 3.34 ± 2.40 and 3.90 ± 3.01 for the Positive and Negative PANSS scores, respectively. The current pilot study is the first attempt to estimate symptom severity scores in schizophrenia using quantitative EEG features. It is expected that the present method can be extended to other cognitive paradigms or other psychological illnesses.

Association between Global Assessment of Functioning scores and indicators of functioning, severity, and prognosis in first-time schizophrenia

DEFF Research Database (Denmark)

Köhler-Forsberg, Ole; Horsdal, Henriette Thisted; Baandrup, Lone

2016-01-01

are associated with other indicators of functioning, severity, and hospitalization. METHODS: A Danish population-based cohort study of adults (≥18 years) with a recorded GAF-F score at first-time schizophrenia diagnosis during 2004-2011 was performed. The internal validity of GAF-F was evaluated by assessing its...... of schizophrenia with a GAF-F score at first-time diagnosis (73.0% inpatients; 62.6% males). GAF-F was associated with several baseline measures of functioning and illness severity, such as female sex, being in work, and a longer baseline hospitalization. Lower GAF-F scores were associated with higher.......36-3.90), fitting a dose-response relationship (P=0.031). This association was not found in females. CONCLUSION: GAF-F at first-time schizophrenia diagnosis showed good internal validity against other measures of functionality in a Danish hospital setting. Severe impairment (as measured by the GAF-F score) at first...

Assessment of asthma severity in adults with ever asthma: A continuous score.

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Lucia Calciano

Full Text Available In epidemiological studies, continuous measures of asthma severity should be used to catch the heterogeneity of phenotypes. This study aimed at developing and validating continuous measures of asthma severity in adult patients with ever asthma from the general population, to be used in epidemiological studies.Respiratory symptoms, anti-asthmatic treatment and lung function were measured on 520 patients with ever asthma aged 20-64 years from the general Italian population (GEIRD study; 2007/2010. The variables that represent the same dimension of asthma severity were identified through an exploratory factor analysis and were summarized through a multiple factor analysis.Only respiratory symptoms and anti-asthmatic treatment were summarized in a continuous score (STS. STS ranges from 0 (no symptoms/treatment to 10 (maximum symptom frequency and treatment intensity. STS was positively correlated with the Global Initiative for Asthma classification of asthma severity computed on the 137 cases with a doctor's diagnosis (Spearman's coefficient = 0.61, p-value<0.0001 (concurrent validity. Furthermore, using a cohort of 1,097 European asthmatics (ECRHS II study; 1999/2002, increasing STS levels at baseline (1991/1993 were positively associated with long-term outcomes (hospitalization and lost workdays for breathing problems, asthma attack frequency and use of asthma controllers (predictive validity. Finally, the STS scores computed from the GEIRD and ECRHS II data were comparable (Lin's coefficient = 0.95, p-value<0.0001 (replication analysis.STS is a valid and replicable measure of asthma severity in adults, which could be used in association studies.

NASA ISS Portable Fan Assembly Acoustics

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Boone, Andrew; Allen, Christopher S.; Hess, Linda F.

2018-01-01

The Portable Fan Assembly (PFA) is a variable speed fan that can be used to provide additional ventilation inside International Space Station (ISS) modules as needed for crew comfort or for enhanced mixing of the ISS atmosphere. This fan can also be configured with a Shuttle era lithium hydroxide (LiOH) canister for CO2 removal in confined areas partially of fully isolated from the primary Environmental Control and Life Support System (ECLSS) on ISS which is responsible for CO2 removal. This report documents noise emission levels of the PFA at various speed settings and configurations. It also documents the acoustic attenuation effects realized when circulating air through the PFA inlet and outlet mufflers and when operating in its CO2 removal configuration (CRK) with a LiOH canister (sorbent bed) installed over the fan outlet.

Innovative Sea Surface Monitoring with GNSS-Reflectometry aboard ISS: Overview and Recent Results from GEROS-ISS

DEFF Research Database (Denmark)

Wickert, Jens; Andersen, Ole Baltazar; Bandeiras, J.

GEROS-ISS (GEROS hereafter) stands for GNSS REflectometry, Radio Occultation and Scatterometry onboard the International Space Station. It is a scientific experiment, proposed to the European Space Agency (ESA)in 2011 for installation aboard the ISS. The main focus of GEROS is the dedicated use o...... of signals from the currently available Global Navigation Satellite Systems (GNSS) for remote sensing of the System Earth with focus to Climate Change characterisation. The GEROS mission idea and the current status are briefly reviewed....

Effect of dextran-70 on outcome in severe sepsis; a propensity-score matching study.

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Bentzer, Peter; Broman, Marcus; Kander, Thomas

2017-07-06

Albumin may be beneficial in patients with septic shock but availability is limited and cost is high. The objective of the present study was to investigate if the use of dextran-70 in addition to albumin and crystalloids influences organ failure or mortality in patients with severe sepsis or septic shock. Patients with severe sepsis or septic shock (n = 778) admitted to a university hospital intensive care unit (ICU) between 2007 and 2015 that received dextran-70 during resuscitation were propensity score matched to controls at a 1 to 1 ratio. Outcomes were highest acute kidney injury network (AKIN) score the first 10 days in the ICU, use of renal replacement therapy, days alive and free of organ support the first 28 days after admission to ICU, mortality and events of severe bleeding. Outcomes were assessed using paired hypothesis testing. Propensity score matching resulted in two groups of patients with 245 patients in each group. The dextran group received a median volume of 1483 ml (interquartile range, 1000-2000 ml) of dextran-70 during the ICU stay. Highest AKIN score did not differ between the control- and dextran groups (1 (0-3) versus 2 (0-3), p = 0.06). Incidence of renal replacement therapy in the control- and dextran groups was similar (19% versus 22%, p = 0.42, absolute risk reduction -2.9% [95% CI: -9.9 to 4.2]). Days alive and free of renal replacement, vasopressors and mechanical ventilation did not differ between the control- and dextran groups. The 180-day mortality was 50.2% in the control group and 41.6% in the dextran group (p = 0.046, absolute risk reduction 8.6% [-0.2 to 17.4]). Fraction of patients experiencing a severe bleeding in the first 10 days in the ICU did not differ between the control and dextran groups (14% versus 18%, p = 0.21). There is a paucity of high quality data regarding effects of dextran solutions on outcome in sepsis. In the present study, propensity score matching was used in attempt to reduce bias. No

ISS Has an Attitude! Determining ISS Attitude at the ISS Window Observational Research Facility (WORF) Using Landmarks

Science.gov (United States)

Runco, Susan K.; Pickard,Henry; Kowtha, Vijayanand; Jackson, Dan

2011-01-01

Universities and secondary schools can help solve a real issue for remote sensing from the ISS WORF through hands-on engineering and activities. Remote sensing technology is providing scientists with higher resolution, higher sensitivity sensors. Where is it pointing? - To take full advantage of these improved sensors, space platforms must provide commensurate improvements in attitude determination

Predictive value of the Status Epilepticus Severity Score (STESS) and its components for long-term survival

DEFF Research Database (Denmark)

Aukland, Preben; Lando, Martin; Vilholm, Ole

2016-01-01

BACKGROUND: The "Status Epilepticus Severity Score" (STESS) is the most important clinical score to predict in-hospital mortality of patients with status epilepticus (SE), but its prognostic relevance for long-term survival is unknown. This study therefore examined if STESS and its components...

A clinical severity scoring system for visceral leishmaniasis in immunocompetent patients in South Sudan.

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Suzette S Kämink

2017-10-01

Full Text Available South Sudan is one of the most endemic countries for visceral leishmaniasis (VL, and is frequently affected by large epidemics. In resource-limited settings, clinicians require a simple clinical tool to identify VL patients who are at increased risk of dying, and who need specialised treatment with liposomal amphotericin B and other supportive care. The aim of this study was to develop and validate a clinical severity scoring system based on risk factors for death in VL patients in South Sudan.A retrospective analysis was conducted of data from a cohort of 6,633 VL patients who were treated in the Médecins Sans Frontières (MSF hospital in Lankien between July 2013 and June 2015. Risk factors for death during treatment were identified using multivariable logistic regression models, and the regression coefficients were used to develop a severity scoring system. Sensitivity and specificity of score cut-offs were assessed by receiver operating characteristic (ROC analysis.In multivariable models, risk factors for death in adult VL patients were: anaemia (odds ratio (OR 4.46 (95% CI 1.58-12.6 for Hb <6g/dL compared with ≥9g/dL, nutritional status (OR 4.84 (2.09-11.2 for BMI <13 kg/m2 compared with ≥16 kg/m2, weakness (OR 4.20 (1.82-9.73 for collapsed compared with normal weakness, jaundice (OR 3.41 (1.17-9.95, and oedema/ascites (OR 4.86 (1.67-14.1. For children and adolescents the risk factors were: age (OR 10.7 (6.3-18.3 for age <2 years compared with 6-18 years, anaemia (OR 7.76 (4.15-14.5 for Hb <6g/dL compared with ≥9g/dL, weakness (OR 3.13 (22.8-105.2 for collapsed compared with normal weakness, and jaundice (OR 12.8 (4.06-40.2. Severity scoring predictive ability was 74.4% in adults and 83.4% in children and adolescents.Our evidenced-based severity scoring system demonstrated sufficient predictive ability to be operationalised as a clinical tool for rational allocation of treatment to VL patients at MSF centres in South Sudan.

Long-Term International Space Station (ISS) Risk Reduction Activities

Science.gov (United States)

Fodroci, M. P.; Gafka, G. K.; Lutomski, M. G.; Maher, J. S.

2012-01-01

As the assembly of the ISS nears completion, it is worthwhile to step back and review some of the actions pursued by the Program in recent years to reduce risk and enhance the safety and health of ISS crewmembers, visitors, and space flight participants. While the initial ISS requirements and design were intended to provide the best practicable levels of safety, it is always possible to further reduce risk - given the determination, commitment, and resources to do so. The following is a summary of some of the steps taken by the ISS Program Manager, by our International Partners, by hardware and software designers, by operational specialists, and by safety personnel to continuously enhance the safety of the ISS, and to reduce risk to all crewmembers. While years of work went into the development of ISS requirements, there are many things associated with risk reduction in a Program like the ISS that can only be learned through actual operational experience. These risk reduction activities can be divided into roughly three categories: Areas that were initially noncompliant which have subsequently been brought into compliance or near compliance (i.e., Micrometeoroid and Orbital Debris [MMOD] protection, acoustics) Areas where initial design requirements were eventually considered inadequate and were subsequently augmented (i.e., Toxicity Hazard Level- 4 [THL] materials, emergency procedures, emergency equipment, control of drag-throughs) Areas where risks were initially underestimated, and have subsequently been addressed through additional mitigation (i.e., Extravehicular Activity [EVA] sharp edges, plasma shock hazards) Due to the hard work and cooperation of many parties working together across the span of more than a decade, the ISS is now a safer and healthier environment for our crew, in many cases exceeding the risk reduction targets inherent in the intent of the original design. It will provide a safe and stable platform for utilization and discovery for years

Trochantric severity score a useful tool to assess outcomes after intertrochantric fractures

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Sandeep Thomas George

2017-01-01

CONCLUSION: Trochantric severity score is a useful tool to assess the outcome of management of intertrochanteric fractures. Sliding hip screw may not be an ideal implant for, trochantric fractures with inadequate lateral wall thickness (failure rate of 63%, reverse oblique type of trochanter fractures (failure rates of 50%, and displaced comminuted fractures (failure rate of 13%.

Retrospective review of injury severity, interventions and outcomes among helicopter and nonhelicopter transport patients at a Level 1 urban trauma centre.

Science.gov (United States)

Hannay, R Scott; Wyrzykowski, Amy D; Ball, Chad G; Laupland, Kevin; Feliciano, David V

2014-02-01

Air ambulance transport for injured patients is vitally important given increasing patient volumes, the limited number of trauma centres and inadequate subspecialty coverage in nontrauma hospitals. Air ambulance services have been shown to improve patient outcomes compared with ground transport in select circumstances. Our primary goal was to compare injuries, interventions and outcomes in patients transported by helicopter versus nonhelicopter transport. We performed a retrospective 10-year review of 14 440 patients transported to an urban Level 1 trauma centre by helicopter or by other means. We compared injury severity, interventions and mortality between the groups. Patients transported by helicopter had higher median injury severity scores (ISS), regardless of penetrating or blunt injury, and were more likely to have Glasgow Coma Scale scores less than 8, require airway control, receive blood transfusions and require admission to the intensive care unit or operating room than patients transported by other means. Helicopter transport was associated with reduced overall mortality (odds ratio 0.41, 95% confidence interval 0.33-0.39). Patients transported by other methods were more likely to die in the emergency department. The mean ISS, regardless of transport method, rose from 12.3 to 15.1 (p = 0.011) during our study period. Patients transported by helicopter to an urban trauma centre were more severely injured, required more interventions and had improved survival than those arriving by other means of transport.

A score model for the continuous grading of early allograft dysfunction severity.

Science.gov (United States)

Pareja, Eugenia; Cortes, Miriam; Hervás, David; Mir, José; Valdivieso, Andrés; Castell, José V; Lahoz, Agustín

2015-01-01

Early allograft dysfunction (EAD) dramatically influences graft and patient outcomes. A lack of consensus on an EAD definition hinders comparisons of liver transplant outcomes and management of recipients among and within centers. We sought to develop a model for the quantitative assessment of early allograft function [Model for Early Allograft Function Scoring (MEAF)] after transplantation. A retrospective study including 1026 consecutive liver transplants was performed for MEAF score development. Multivariate data analysis was used to select a small number of postoperative variables that adequately describe EAD. Then, the distribution of these variables was mathematically modeled to assign a score for each actual variable value. A model, based on easily obtainable clinical parameters (ie, alanine aminotransferase, international normalized ratio, and bilirubin) and scoring liver function from 0 to 10, was built. The MEAF score showed a significant association with patient and graft survival at 3-, 6- and 12-month follow-ups. Hepatic steatosis and age for donors; cold/warm ischemia times and postreperfusion syndrome for surgery; and intensive care unit and hospital stays, Model for End-Stage Liver Disease and Child-Pugh scores, body mass index, and fresh frozen plasma transfusions for recipients were factors associated significantly with EAD. The model was satisfactorily validated by its application to an independent set of 200 patients who underwent liver transplantation at a different center. In conclusion, a model for the quantitative assessment of EAD severity has been developed and validated for the first time. The MEAF provides a more accurate graft function assessment than current categorical classifications and may help clinicians to make early enough decisions on retransplantation benefits. Furthermore, the MEAF score is a predictor of recipient and graft survival. The standardization of the criteria used to define EAD may allow reliable comparisons of

Return to work and quality of life in severely injured patients

NARCIS (Netherlands)

Post, R. B.; Van der Sluis, C. K.; Ten Duis, H. J.

2006-01-01

Background. Little is known about the long-term consequences of severe injuries in terms of return to productivity and quality of life. Methods. In this study we focused on the return to work status and quality of life in 53 severely injured patients (AIS/ISS >= 16, mean ISS 24, range 16 - 54), mean

Return to work and quality of life in severely injured patients

NARCIS (Netherlands)

Post, R. B.; Van der Sluis, C. K.; Ten Duis, H. J.

Background. Little is known about the long-term consequences of severe injuries in terms of return to productivity and quality of life. Methods. In this study we focused on the return to work status and quality of life in 53 severely injured patients (AIS/ISS >= 16, mean ISS 24, range 16 - 54), mean

The International Space Station (ISS) Education Accomplishments and Opportunities

Science.gov (United States)

Alleyne, Camille W.; Blue, Regina; Mayo, Susan

2012-01-01

The International Space Station (ISS) has the unique ability to capture the imaginations of both students and teachers worldwide and thus stands as an invaluable learning platform for the advancement of proficiency in research and development and education. The presence of humans on board ISS for the past ten years has provided a foundation for numerous educational activities aimed at capturing that interest and motivating study in the sciences, technology, engineering and mathematics (STEM) disciplines which will lead to an increase in quality of teachers, advancements in research and development, an increase in the global reputation for intellectual achievement, and an expanded ability to pursue unchartered avenues towards a brighter future. Over 41 million students around the world have participated in ISS-related activities since the year 2000. Projects such as the Amateur Radio on International Space Station (ARISS) and Earth Knowledge Acquired by Middle School Students (EarthKAM), among others, have allowed for global student, teacher, and public access to space through radio contacts with crewmembers and student image acquisition respectively. . With planned ISS operations at least until 2020, projects like the aforementioned and their accompanying educational materials will be available to enable increased STEM literacy around the world. Since the launch of the first ISS element, a wide range of student experiments and educational activities have been performed by each of the international partner agencies: National Aeronautics and Space Administration (NASA), Canadian Space Agency (CSA), European Space Agency (ESA), Japan Aerospace Exploration Agency (JAXA) and Russian Federal Space Agency (Roscosmos). Additionally, a number of non-participating countries, some under commercial agreements, have also participated in Station-related activities. Many of these programs still continue while others are being developed and added to the station crewmembers tasks

Cardiovascular Risk Stratification in Patients with Metabolic Syndrome Without Diabetes or Cardiovascular Disease: Usefulness of Metabolic Syndrome Severity Score.

Science.gov (United States)

Masson, Walter; Epstein, Teo; Huerín, Melina; Lobo, Lorenzo Martín; Molinero, Graciela; Angel, Adriana; Masson, Gerardo; Millán, Diana; De Francesca, Salvador; Vitagliano, Laura; Cafferata, Alberto; Losada, Pablo

2017-09-01

The estimated cardiovascular risk determined by the different risk scores, could be heterogeneous in patients with metabolic syndrome without diabetes or vascular disease. This risk stratification could be improved by detecting subclinical carotid atheromatosis. To estimate the cardiovascular risk measured by different scores in patients with metabolic syndrome and analyze its association with the presence of carotid plaque. Non-diabetic patients with metabolic syndrome (Adult Treatment Panel III definition) without cardiovascular disease were enrolled. The Framingham score, the Reynolds score, the new score proposed by the 2013 ACC/AHA Guidelines and the Metabolic Syndrome Severity Calculator were calculated. Prevalence of carotid plaque was determined by ultrasound examination. A Receiver Operating Characteristic analysis was performed. A total of 238 patients were enrolled. Most patients were stratified as "low risk" by Framingham score (64%) and Reynolds score (70.1%). Using the 2013 ACC/AHA score, 45.3% of the population had a risk ≥7.5%. A significant correlation was found between classic scores but the agreement (concordance) was moderate. The correlation between classical scores and the Metabolic Syndrome Severity Calculator was poor. Overall, the prevalence of carotid plaque was 28.2%. The continuous metabolic syndrome score used in our study showed a good predictive power to detect carotid plaque (area under the curve 0.752). In this population, the calculated cardiovascular risk was heterogenic. The prevalence of carotid plaque was high. The Metabolic Syndrome Severity Calculator showed a good predictive power to detect carotid plaque.

Report by the International Space Station (ISS) Management and Cost Evaluation (IMCE) Task Force

Science.gov (United States)

Young, A. Thomas; Kellogg, Yvonne (Technical Monitor)

2001-01-01

The International Space Station (ISS) Management and Cost Evaluation Task Force (IMCE) was chartered to conduct an independent external review and assessment of the ISS cost, budget, and management. In addition, the Task Force was asked to provide recommendations that could provide maximum benefit to the U.S. taxpayers and the International Partners within the President's budget request. The Task Force has made the following principal findings: (1) The ISS Program's technical achievements to date, as represented by on-orbit capability, are extraordinary; (2) The Existing ISS Program Plan for executing the FY 02-06 budget is not credible; (3) The existing deficiencies in management structure, institutional culture, cost estimating, and program control must be acknowledged and corrected for the Program to move forward in a credible fashion; (4) Additional budget flexibility, from within the Office of Space Flight (OSF) must be provided for a credible core complete program; (5) The research support program is proceeding assuming the budget that was in place before the FY02 budget runout reduction of $1B; (6) There are opportunities to maximize research on the core station program with modest cost impact; (7) The U.S. Core Complete configuration (three person crew) as an end-state will not achieve the unique research potential of the ISS; (8) The cost estimates for the U.S.-funded enhancement options (e.g., permanent seven person crew) are not sufficiently developed to assess credibility. After these findings, the Task Force has formulated several primary recommendations which are published here and include: (1) Major changes must be made in how the ISS program is managed; (2) Additional cost reductions are required within the baseline program; (3) Additional funds must be identified and applied from the Human Space Flight budget; (4) A clearly defined program with a credible end-state, agreed to by all stakeholders, must be developed and implemented.

A Persian-version of the stuttering severity instrument-version four (SSI-4): How the new additions to SSI-4 complement its stuttering severity score?

Science.gov (United States)

Tahmasebi, Neda; Shafie, Bijan; Karimi, Hamid; Mazaheri, Masood

The fourth version of the Stuttering Severity Instrument (SSI-4) has been available since 2009. It has some modifications and new features which make it more appropriate at least for clinical practice, although further documentation is needed. The objective of the current research was to translate SSI-4 into Persian language and to discuss its relative and absolute reliability as well as its criterion validity for Persian adults who stutter (PWS). We also aimed to study how the new subjective self-reports of the SSI-4 complement the stuttering severity score obtained from the SSI-3 or the SSI-4. The cross-cultural guideline recommended by the International Quality of Life Assessment project was used to translate the SSI-4 into Persian language. Thirty five PWS from ages 17 to 42 were recruited and 10 speech and language pathologists assessed their stuttering severity using either the SSI-4 or stuttering severity ratings (SR) to test validity and reliability of the Persian translated version. A very high inter-judge relative reliability along with a poor absolute inter-judge reliability was found for the SSI-4 scores. The results were more promising for the intra-judge absolute reliability. Test-retest reliability of the complementary questions to the SSI-4 was also found acceptable. However, no strong relationship was found between the SSI-4 scores and its complementary questions. The Persian version of the SSI-4 can be used reliably by trained SLPs for research and clinical purposes, but not to document small changes in stuttering severity. We argue that the response of participants to the complementary self-report questions should also be considered in calculating their stuttering severity score. Copyright © 2018 Elsevier Inc. All rights reserved.

A chest radiograph scoring system in patients with severe acute respiratory infection: a validation study

International Nuclear Information System (INIS)

Taylor, Emma; Haven, Kathryn; Reed, Peter; Bissielo, Ange; Harvey, Dave; McArthur, Colin; Bringans, Cameron; Freundlich, Simone; Ingram, R. Joan H.; Perry, David; Wilson, Francessa; Milne, David; Modahl, Lucy; Huang, Q. Sue; Gross, Diane; Widdowson, Marc-Alain; Grant, Cameron C.

2015-01-01

The term severe acute respiratory infection (SARI) encompasses a heterogeneous group of respiratory illnesses. Grading the severity of SARI is currently reliant on indirect disease severity measures such as respiratory and heart rate, and the need for oxygen or intensive care. With the lungs being the primary organ system involved in SARI, chest radiographs (CXRs) are potentially useful for describing disease severity. Our objective was to develop and validate a SARI CXR severity scoring system. We completed validation within an active SARI surveillance project, with SARI defined using the World Health Organization case definition of an acute respiratory infection with a history of fever, or measured fever of ≥ 38 °C; and cough; and with onset within the last 10 days; and requiring hospital admission. We randomly selected 250 SARI cases. Admission CXR findings were categorized as: 1 = normal; 2 = patchy atelectasis and/or hyperinflation and/or bronchial wall thickening; 3 = focal consolidation; 4 = multifocal consolidation; and 5 = diffuse alveolar changes. Initially, four radiologists scored CXRs independently. Subsequently, a pediatrician, physician, two residents, two medical students, and a research nurse independently scored CXR reports. Inter-observer reliability was determined using a weighted Kappa (κ) for comparisons between radiologists; radiologists and clinicians; and clinicians. Agreement was defined as moderate (κ > 0.4–0.6), good (κ > 0.6–0.8) and very good (κ > 0.8–1.0). Agreement between the two pediatric radiologists was very good (κ = 0.83, 95 % CI 0.65–1.00) and between the two adult radiologists was good (κ = 0.75, 95 % CI 0.57–0. 93). Agreement of the clinicians with the radiologists was moderate-to-good (pediatrician:κ = 0.65; pediatric resident:κ = 0.69; physician:κ = 0.68; resident:κ = 0.67; research nurse:κ = 0.49, medical students: κ = 0.53 and κ = 0.56). Agreement between clinicians was good-to-very good

Sequential Organ Failure Assessment Score for Evaluating Organ Failure and Outcome of Severe Maternal Morbidity in Obstetric Intensive Care

Directory of Open Access Journals (Sweden)

Antonio Oliveira-Neto

2012-01-01

Full Text Available Objective. To evaluate the performance of Sequential Organ Failure Assessment (SOFA score in cases of severe maternal morbidity (SMM. Design. Retrospective study of diagnostic validation. Setting. An obstetric intensive care unit (ICU in Brazil. Population. 673 women with SMM. Main Outcome Measures. mortality and SOFA score. Methods. Organ failure was evaluated according to maximum score for each one of its six components. The total maximum SOFA score was calculated using the poorest result of each component, reflecting the maximum degree of alteration in systemic organ function. Results. highest total maximum SOFA score was associated with mortality, 12.06 ± 5.47 for women who died and 1.87 ± 2.56 for survivors. There was also a significant correlation between the number of failing organs and maternal mortality, ranging from 0.2% (no failure to 85.7% (≥3 organs. Analysis of the area under the receiver operating characteristic (ROC curve (AUC confirmed the excellent performance of total maximum SOFA score for cases of SMM (AUC = 0.958. Conclusions. Total maximum SOFA score proved to be an effective tool for evaluating severity and estimating prognosis in cases of SMM. Maximum SOFA score may be used to conceptually define and stratify the degree of severity in cases of SMM.

Unusual ISS Rate Signature

Science.gov (United States)

Laible, Michael R.

2011-01-01

On November 23, 2011 International Space Station Guidance, Navigation, and Control reported unusual pitch rate disturbance. These disturbances were an order of magnitude greater than nominal rates. The Loads and Dynamics team was asked to review and analyze current accelerometer data to investigate this disturbance. This paper will cover the investigation process under taken by the Loads and Dynamics group. It will detail the accelerometers used and analysis performed. The analysis included performing Frequency Fourier Transform of the data to identify the mode of interest. This frequency data is then reviewed with modal analysis of the ISS system model. Once this analysis is complete and the disturbance quantified, a forcing function was produced to replicate the disturbance. This allows the Loads and Dynamics team to report the load limit values for the 100's of interfaces on the ISS.

SPHERES: From Ground Development to Operations on ISS

Science.gov (United States)

Katterhagen, A.

2015-01-01

SPHERES (Synchronized Position Hold Engage and Reorient Experimental Satellites) is an internal International Space Station (ISS) Facility that supports multiple investigations for the development of multi-spacecraft and robotic control algorithms. The SPHERES Facility on ISS is managed and operated by the SPHERES National Lab Facility at NASA Ames Research Center (ARC) at Moffett Field California. The SPHERES Facility on ISS consists of three self-contained eight-inch diameter free-floating satellites which perform the various flight algorithms and serve as a platform to support the integration of experimental hardware. To help make science a reality on the ISS, the SPHERES ARC team supports a Guest Scientist Program (GSP). This program allows anyone with new science the possibility to interface with the SPHERES team and hardware. In addition to highlighting the available SPHERES hardware on ISS and on the ground, this presentation will also highlight ground support, facilities, and resources available to guest researchers. Investigations on the ISS evolve through four main phases: Strategic, Tactical, Operations, and Post Operations. The Strategic Phase encompasses early planning beginning with initial contact by the Principle Investigator (PI) and the SPHERES program who may work with the PI to assess what assistance the PI may need. Once the basic parameters are understood, the investigation moves to the Tactical Phase which involves more detailed planning, development, and testing. Depending on the nature of the investigation, the tactical phase may be split into the Lab Tactical Phase or the ISS Tactical Phase due to the difference in requirements for the two destinations. The Operations Phase is when the actual science is performed; this can be either in the lab, or on the ISS. The Post Operations Phase encompasses data analysis and distribution, and generation of summary status and reports. The SPHERES Operations and Engineering teams at ARC is composed of

Reimbursement of care for severe trauma under SwissDRG.

Science.gov (United States)

Moos, Rudolf M; Sprengel, Kai; Jensen, Kai Oliver; Jentzsch, Thorsten; Simmen, Hans-Peter; Seifert, Burkhardt; Ciritsis, Bernhard; Neuhaus, Valentin; Volbracht, Jörk; Mehra, Tarun

2016-01-01

Treatment of patients with severe injuries is costly, with best results achieved in specialised care centres. However, diagnosis-related group (DRG)-based prospective payment systems have difficulties in depicting treatment costs for specialised care. We analysed reimbursement of care for severe trauma in the first 3 years after the introduction of the Swiss DRG reimbursement system (2012-2014). The study included all patients with solely basic insurance, hospital admission after 01.01.2011 and discharge in 2011 or 2012, who were admitted to the resuscitation room of the University Hospital of Zurich, aged ≥16 years and with an injury severity score (ISS) ≥16 (n = 364). Clinical, financial and administrative data were extracted from the electronic medical records. All cases were grouped into DRGs according to different SwissDRG versions. We considered results to be significant if p ≤0.002. The mean deficit decreased from 12 065 CHF under SwissDRG 1.0 (2012) to 2 902 CHF under SwissDRG 3.0 (2014). The main reason for the reduction of average deficits was a refinement of the DRG algorithm with a regrouping of 23 cases with an ISS ≥16 from MDC 01 to DRGs within MDC21A. Predictors of an increased total loss per case could be identified: for example, high total number of surgical interventions, surgeries on multiple anatomical regions or operations on the pelvis (p ≤0.002). Psychiatric diagnoses in general were also significant predictors of deficit per case (p<0.001). The reimbursement for care of severely injured patients needs further improvement. Cost neutral treatment was not possible under the first three versions of SwissDRG.

Portsmouth physiological and operative severity score for the Enumeration of Mortality and morbidity scoring system in general surgical practice and identifying risk factors for poor outcome

Science.gov (United States)

Tyagi, Ashish; Nagpal, Nitin; Sidhu, D. S.; Singh, Amandeep; Tyagi, Anjali

2017-01-01

Background: Estimation of the outcome is paramount in disease stratification and subsequent management in severely ill surgical patients. Risk scoring helps us quantify the prospects of adverse outcome in a patient. Portsmouth-Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) the world over has proved itself as a worthy scoring system and the present study was done to evaluate the feasibility of P-POSSUM as a risk scoring system as a tool in efficacious prediction of mortality and morbidity in our demographic profile. Materials and Methods: Validity of P-POSSUM was assessed prospectively in fifty major general surgeries performed at our hospital from May 2011 to October 2012. Data were collected to obtain P-POSSUM score, and statistical analysis was performed. Results: Majority (72%) of patients was male and mean age was 40.24 ± 18.6 years. Seventy-eight percentage procedures were emergency laparotomies commonly performed for perforation peritonitis. Mean physiological score was 17.56 ± 7.6, and operative score was 17.76 ± 4.5 (total score = 35.3 ± 10.4). The ratio of observed to expected mortality rate was 0.86 and morbidity rate was 0.78. Discussion: P-POSSUM accurately predicted both mortality and morbidity in patients who underwent major surgical procedures in our setup. Thus, it helped us in identifying patients who required preferential attention and aggressive management. Widespread application of this tool can result in better distribution of care among high-risk surgical patients. PMID:28250670

Endothelial glycocalyx shedding and vascular permeability in severely injured trauma patients

DEFF Research Database (Denmark)

Rahbar, Elaheh; Cardenas, Jessica C; Baimukanova, Gyulnar

2015-01-01

of trauma patients. METHODS: Plasma samples were collected from 5 healthy consented volunteers and 22 severely injured trauma patients upon admission to the emergency department. ELISA assays were performed to quantify shed HA, HS, CS and syndecan-1 in plasma. A colloid osmometer and Electric Cell......-substrate Impedance Sensing (ECIS) system were used to measure plasma colloid osmotic pressure (COP) and cell permeability, respectively. Thrombin generation was measured using a calibrated automated thrombogram (CAT). Initial vital signs, routine laboratory values, and injury severity scores (ISS) were recorded. Non......COP (≤16 mmHg) had significantly increased syndecan-1 and HA compared to those with normal COP, which corresponded to increased cell permeability via ECIS. CS and HS did not vary between COP groups. Lastly, patients with low COP displayed reduced peak thrombin...

Serum high sensitivity C-reactive protein levels and the severity of coronary atherosclerosis assessed by angiographic gensini score

International Nuclear Information System (INIS)

Masood, A.; Jafar, S.S.; Akram, Z.

2011-01-01

Objective: To assess the relationship between plasma high sensitivity C-reactive protein levels with severity of coronary atherosclerosis. Materials and Methods: The study included 80 patients subjected to coronary angiography. The extent of Coronary Artery Disease (CAD) was assessed using Gensini score. Patients were divided into three risk groups according to hs-CRP levels ( 3mg/L- as high risk). Mean Angiographic Gensini scores were compared among the risk groups. Correlation between serum hs-CRP levels and angiographic Gensini scores was also assessed. Results: The 26 (32.5%) patients belonging to hs-CRP low-risk group had a mean angiographic Gensini score of 11.8 +- 5.8, 18 (22.5%) belonging to moderate-risk group had a mean score of 28.9 +- 7.9 and 36 (45%) belonging to high- risk group had a mean score of 78.7 +- 41.0. By applying ANOVA the mean angiographic Gensini scores showed increasing trend from lower to higher hs-CRP risk groups (p < 0.001). Serum hs-CRP levels showed significant correlation with respective angiographic Gensini scores by Pearson's correlation (p < 0.001). Conclusion: Serum hs-CRP levels show significant correlation with the severity of Coronary Artery Disease as assessed by angiographic Gensini score. (author)

Predictive score of sarcopenia occurrence one year after bariatric surgery in severely obese patients.

Science.gov (United States)

Voican, Cosmin Sebastian; Lebrun, Amandine; Maitre, Sophie; Lainas, Panagiotis; Lamouri, Karima; Njike-Nakseu, Micheline; Gaillard, Martin; Tranchart, Hadrien; Balian, Axel; Dagher, Ibrahim; Perlemuter, Gabriel; Naveau, Sylvie

2018-01-01

Sarcopenic obesity is a risk factor of morbidity and mortality. The aim of this study was to generate a predictive score of sarcopenia occurrence one year after bariatric surgery. We conducted an observational prospective cohort study on a total of 184 severely obese patients admitted to our institution to undergo sleeve gastrectomy. Skeletal muscle cross-sectional area at the third lumbar vertebrae (SMA, cm2) was measured from the routinely performed computed tomography. The skeletal muscle index (SMI) was calculated as follows: SMA/height2 (cm2/m2). Sarcopenia was defined as an SMI predictive sarcopenia occurrence scores were constructed using SMA and gender (SS1 score) or SMI and gender (SS2 score). The area under receiver operating characteristic (AUROC) curve of the SS2 score was significantly greater than that of the SS1 score for the diagnosis of postoperative sarcopenia occurrence (0.95±0.02 versus 0.90±0.02; ppredictive value of 83%, and a negative predictive value of 95%. In the group of patients without baseline sarcopenia, the SS2 score had still an excellent AUROC of 0.92±0.02. A cut-off of 0.55 predicted development of sarcopenia one year after sleeve gastrectomy in these patients with a sensitivity of 87%, a specificity of 88%, and negative predictive value of 95%. The SS2 score has excellent predictive value for the occurrence of sarcopenia one year after sleeve gastrectomy. This score can be used to target early intensification of nutritional and dietetic follow-up to the predicted high-risk population.

The ISS as a platform for a fully simulated mars voyage

Science.gov (United States)

Narici, Livio; Reitz, Guenther

2016-07-01

The ISS can mimic the impact of microgravity, radiation, living and psychological conditions that astronauts will face during a deep space cruise, for example to Mars. This suggests the ISS as the most valuable "analogue" for deep space exploration. NASA has indeed suggested a 'full-up deep space simulation on last available ISS Mission: 6/7 crew for one year duration; full simulation of time delays & autonomous operations'. This idea should be pushed further. It is indeed conceivable to use the ISS as the final "analogue", performing a real 'dry-run' of a deep space mission (such as a mission to Mars), as close as reasonably possible to what will be the real voyage. This Mars ISS dry run (ISS4Mars) would last 500-800 days, mimicking most of the challenges which will be undertaken such as length, isolation, food provision, decision making, time delays, health monitoring diagnostic and therapeutic actions and more: not a collection of "single experiments", but a complete exploration simulation were all the pieces will come together for the first in space simulated Mars voyage. Most of these challenges are the same that those that will be encountered during a Moon voyage, with the most evident exceptions being the duration and the communication delay. At the time of the Mars ISS dry run all the science and technological challenges will have to be mostly solved by dedicated works. These solutions will be synergistically deployed in the dry run which will simulate all the different aspects of the voyage, the trip to Mars, the permanence on the planet and the return to Earth. During the dry run i) There will be no arrivals/departure of spacecrafts; 2) Proper communications delay with ground will be simulated; 3) Decision processes will migrate from Ground to ISS; 4) Permanence on Mars will be simulated. Mars ISS dry run will use just a portion of the ISS which will be totally isolated from the rest of the ISS, leaving to the other ISS portions the task to provide the

Prestroke CHA2DS2-VASc Score and Severity of Acute Stroke in Patients with Atrial Fibrillation: Findings from RAF Study.

Science.gov (United States)

Acciarresi, Monica; Paciaroni, Maurizio; Agnelli, Giancarlo; Falocci, Nicola; Caso, Valeria; Becattini, Cecilia; Marcheselli, Simona; Rueckert, Christina; Pezzini, Alessandro; Morotti, Andrea; Costa, Paolo; Padovani, Alessandro; Csiba, Laszló; Szabó, Lilla; Sohn, Sung-Il; Tassinari, Tiziana; Abdul-Rahim, Azmil H; Michel, Patrik; Cordier, Maria; Vanacker, Peter; Remillard, Suzette; Alberti, Andrea; Venti, Michele; D'Amore, Cataldo; Scoditti, Umberto; Denti, Licia; Orlandi, Giovanni; Chiti, Alberto; Gialdini, Gino; Bovi, Paolo; Carletti, Monica; Rigatelli, Alberto; Putaala, Jukka; Tatlisumak, Turgut; Masotti, Luca; Lorenzini, Gianni; Tassi, Rossana; Guideri, Francesca; Martini, Giuseppe; Tsivgoulis, Georgios; Vadikolias, Kostantinos; Liantinioti, Chrissoula; Corea, Francesco; Del Sette, Massimo; Ageno, Walter; De Lodovici, Maria Luisa; Bono, Giorgio; Baldi, Antonio; D'Anna, Sebastiano; Sacco, Simona; Carolei, Antonio; Tiseo, Cindy; Imberti, Davide; Zabzuni, Dorjan; Doronin, Boris; Volodina, Vera; Consoli, Domenico; Galati, Franco; Pieroni, Alessio; Toni, Danilo; Monaco, Serena; Baronello, Mario Maimone; Barlinn, Kristian; Pallesen, Lars-Peder; Kepplinger, Jessica; Bodechtel, Ulf; Gerber, Johannes; Deleu, Dirk; Melikyan, Gayane; Ibrahim, Faisal; Akhtar, Naveed; Mosconi, Maria Giulia; Lees, Kennedy R

2017-06-01

The aim of this study was to investigate for a possible association between both prestroke CHA 2 DS 2 -VASc score and the severity of stroke at presentation, as well as disability and mortality at 90 days, in patients with acute stroke and atrial fibrillation (AF). This prospective study enrolled consecutive patients with acute ischemic stroke, AF, and assessment of prestroke CHA 2 DS 2 -VASc score. Severity of stroke was assessed on admission using the National Institutes of Health Stroke Scale (NIHSS) score (severe stroke: NIHSS ≥10). Disability and mortality at 90 days were assessed by the modified Rankin Scale (mRS <3 or ≥3). Multiple logistic regression was used to correlate prestroke CHA 2 DS 2 -VASc and severity of stroke, as well as disability and mortality at 90 days. Of the 1020 patients included in the analysis, 606 patients had an admission NIHSS score lower and 414 patients higher than 10. At 90 days, 510 patients had mRS ≥3. A linear correlation was found between the prestroke CHA 2 DS 2 -VASc score and severity of stroke (P = .001). On multivariate analysis, CHA 2 DS 2 -VASc score correlated with severity of stroke (P = .041) and adverse functional outcome (mRS ≥3) (P = .001). A logistic regression with the receiver operating characteristic graph procedure (C-statistics) evidenced an area under the curve of .60 (P = .0001) for severe stroke. Furthermore, a correlation was found between prestroke CHA 2 DS 2 -VASc score and lesion size. In patients with AF, in addition to the risk of stroke, a high CHA 2 DS 2 -VASc score was independently associated with both stroke severity at onset and disability and mortality at 90 days. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

ISS and Space Environment Interactions in Event of Plasma Contactor Failure

Science.gov (United States)

Carruth, M. R., Jr.; Munafo, Paul M. (Technical Monitor)

2000-01-01

The International Space Station (ISS), illustrated in Figure 1, will be the largest, highest power spacecraft placed in orbit. Because of this the design of the electrical power system diverged markedly from previous systems. The solar arrays will operate at 160 V and the power distribution voltage will be 120 V. The structure is grounded to the negative side of the solar arrays so under the right circumstances it is possible to drive the ISS potential very negative. A plasma contactor has been added to the ISS to provide control of the ISS structure potential relative to the ambient plasma. The ISS requirement is that the ISS structure not be greater than 40 V positive or negative of local plasma. What are the ramifications of operating large structures with such high voltage power systems? The application of a plasma contactor on ISS controls the potential between the structure and the local plasma, preventing degrading effects. It is conceivable that there can be situations where the plasma contactor might be non-functional. This might be due to lack of power, the need to turn it off during some of the build-up sequences, the loss of functionality for both plasma contactors before a replacement can be installed, and similar circumstances. A study was undertaken to understand how important it is to have the contactor functioning and how long it might be off before unacceptable degradation to ISS could occur.

International Space Station (ISS) Plasma Contactor Unit (PCU) Utilization Plan Assessment Update

Science.gov (United States)

Hernandez-Pellerano, Amri; Iannello, Christopher J.; Garrett, Henry B.; Ging, Andrew T.; Katz, Ira; Keith, R. Lloyd; Minow, Joseph I.; Willis, Emily M.; Schneider, Todd A.; Whittlesey, Edward J.;

Propensity scores-potential outcomes framework to incorporate severity probabilities in the highway safety manual crash prediction algorithm.

Science.gov (United States)

Sasidharan, Lekshmi; Donnell, Eric T

2014-10-01

Accurate estimation of the expected number of crashes at different severity levels for entities with and without countermeasures plays a vital role in selecting countermeasures in the framework of the safety management process. The current practice is to use the American Association of State Highway and Transportation Officials' Highway Safety Manual crash prediction algorithms, which combine safety performance functions and crash modification factors, to estimate the effects of safety countermeasures on different highway and street facility types. Many of these crash prediction algorithms are based solely on crash frequency, or assume that severity outcomes are unchanged when planning for, or implementing, safety countermeasures. Failing to account for the uncertainty associated with crash severity outcomes, and assuming crash severity distributions remain unchanged in safety performance evaluations, limits the utility of the Highway Safety Manual crash prediction algorithms in assessing the effect of safety countermeasures on crash severity. This study demonstrates the application of a propensity scores-potential outcomes framework to estimate the probability distribution for the occurrence of different crash severity levels by accounting for the uncertainties associated with them. The probability of fatal and severe injury crash occurrence at lighted and unlighted intersections is estimated in this paper using data from Minnesota. The results show that the expected probability of occurrence of fatal and severe injury crashes at a lighted intersection was 1 in 35 crashes and the estimated risk ratio indicates that the respective probabilities at an unlighted intersection was 1.14 times higher compared to lighted intersections. The results from the potential outcomes-propensity scores framework are compared to results obtained from traditional binary logit models, without application of propensity scores matching. Traditional binary logit analysis suggests that

Development of a Simple Clinical Risk Score for Early Prediction of Severe Dengue in Adult Patients.

Directory of Open Access Journals (Sweden)

Ing-Kit Lee

Full Text Available We aimed to develop and validate a risk score to aid in the early identification of laboratory-confirmed dengue patients at high risk of severe dengue (SD (i.e. severe plasma leakage with shock or respiratory distress, or severe bleeding or organ impairment. We retrospectively analyzed data of 1184 non-SD patients at hospital presentation and 69 SD patients before SD onset. We fit a logistic regression model using 85% of the population and converted the model coefficients to a numeric risk score. Subsequently, we validated the score using the remaining 15% of patients. Using the derivation cohort, two scoring algorithms for predicting SD were developed: models 1 (dengue illness ≤4 days and 2 (dengue illness >4 days. In model 1, we identified four variables: age ≥65 years, minor gastrointestinal bleeding, leukocytosis, and platelet count ≥100×109 cells/L. Model 1 (ranging from -2 to +6 points showed good discrimination between SD and non-SD, with an area under the receiver operating characteristic curve (AUC of 0.848 (95% confidence interval [CI], 0.771-0.924. The optimal cutoff value for model 1 was 1 point, with a sensitivity and specificity for predicting SD of 70.3% and 90.6%, respectively. In model 2 (ranging from 0 to +3 points, significant predictors were age ≥65 years and leukocytosis. Model 2 showed an AUC of 0.859 (95% CI, 0.756-0.963, with an optimal cutoff value of 1 point (sensitivity, 80.3%; specificity, 85.8%. The median interval from hospital presentation to SD was 1 day. This finding underscores the importance of close monitoring, timely resuscitation of shock including intravenous fluid adjustment and early correction of dengue-related complications to prevent the progressive dengue severity. In the validation data, AUCs of 0.904 (95% CI, 0.825-0.983 and 0.917 (95% CI, 0.833-1.0 in models 1 and 2, respectively, were achieved. The observed SD rates (in both cohorts were 50% for those with a score of ≥2 points

Determination of a Quantitative Job Severity Score Value for Health Hazards in Industry

Directory of Open Access Journals (Sweden)

A. Nayebzadeh

2007-09-01

Full Text Available Background and aims   There are numerous types of health hazards in every workplace which threaten the health and well-being of employees. Therefore, various types of engineering and  administrative control approaches have been developed in industry. Control of hazardous agents can be difficult in most conditions due to economical and technical limitations. However, certain types of administrative control methods can be implemented in these cases instead of engineering or process controls. Since creating a safe environment with zero chance of occupational exposures to hazardous agents is practically impossible, it can be expected that every employee may have a certain level of exposure to one or more of hazardous agents. The probability and extent of these  exposures will depend on job's demands or work environment's conditions. Under this condition,  a "job severity score" as a quantitative value can be determined in order to choose and employ the  best possible control methodology and also to create a long-term occupational health plan.   Methods   In this study, the main goal is to develop a questionnaire as a model for assessment of job severity and tasks harmfulness. This questionnaire has five sections in which there are numbers  of questions each with a specified quantitative score.  These scores have been identified according to the brainstorming among the some experienced  experts in the fields safety, occupational health, and industrial psychology. When the final  questionnaire was completed, two well-known industrial sectors were selected as pilot plants for final verification of questionnaire in order to obtain valid questions.    Results & Conclusion   The result of this study was providing a questionnaire which might be used in similar studies for determination of job severity level at any industrial plants.

Establishing the cut-off score for remission and severity-ranges on the Psychotic Depression Assessment Scale (PDAS)

DEFF Research Database (Denmark)

Østergaard, Søren D; Rothschild, Anthony J; Flint, Alastair J

2016-01-01

BACKGROUND: The Psychotic Depression Assessment Scale (PDAS) is a rating scale dedicated to the measurement of severity in psychotic depression (PD). The aim of this study was to establish the PDAS cut-off for remission of PD as well as PDAS score-ranges for mild, moderate, and severe PD...... on the PDAS and the severity-ranges for mild, moderate, and severe PD were defined using the Clinical Global Impression - Severity scale (CGI-S) as reference by means of pair-wise receiver operating characteristic (ROC) analyses. Subsequently, it was tested whether remission on the PDAS could separate...... the effects of Olanzapine+Sertraline vs. Olanzapine+Placebo through an intention-to-treat, mixed-effects logistic regression of the data from STOP-PD. RESULTS: According to the ROC analyses, the ideal cut-off for remission of PD was a PDAS total score moderate...

Tipprežissöör Leni / Tiit Tuumalu

Index Scriptorium Estoniae

Tuumalu, Tiit, 1971-

2004-01-01

Eesti Televisioon näitab kaht legendaarse Leni Riefenstahli (1902-2003) osalusega dokumentaalfilmi - "Leni Riefenstahl : Unistus Aafrikast" : režissöör Ray Müller : Saksamaa 2000 ja "Vetesügavuste lummus" : režissöör Leni Riefenstahl : Saksamaa 2002

Service on demand for ISS users

Science.gov (United States)

Hüser, Detlev; Berg, Marco; Körtge, Nicole; Mildner, Wolfgang; Salmen, Frank; Strauch, Karsten

2002-07-01

Since the ISS started its operational phase, the need of logistics scenarios and solutions, supporting the utilisation of the station and its facilities, becomes increasingly important. Our contribution to this challenge is a SERVICE On DEMAND for ISS users, which offers a business friendly engineering and logistics support for the resupply of the station. Especially the utilisation by commercial and industrial users is supported and simplified by this service. Our industrial team, consisting of OHB-System and BEOS, provides experience and development support for space dedicated hard- and software elements, their transportation and operation. Furthermore, we operate as the interface between customer and the envisaged space authorities. Due to a variety of tailored service elements and the ongoing servicing, customers can concentrate on their payload content or mission objectives and don't have to deal with space-specific techniques and regulations. The SERVICE On DEMAND includes the following elements: ITR is our in-orbit platform service. ITR is a transport rack, used in the SPACEHAB logistics double module, for active and passive payloads on subrack- and drawer level of different standards. Due to its unique late access and early retrieval capability, ITR increases the flexibility concerning transport capabilities to and from the ISS. RIST is our multi-functional test facility for ISPR-based experiment drawer and locker payloads. The test program concentrates on physical and functional interface and performance testing at the payload developers site prior to the shipment to the integration and launch. The RIST service program comprises consulting, planning and engineering as well. The RIST test suitcase is planned to be available for lease or rent to users, too. AMTSS is an advanced multimedia terminal consulting service for communication with the space station scientific facilities, as part of the user home-base. This unique ISS multimedia kit combines

Finite temperature behaviour of the ISS-uplifted KKLT model

International Nuclear Information System (INIS)

Papineau, Chloe

2008-01-01

We study the static phase structure of the ISS-KKLT model for moduli stabilisation and uplifting to a zero cosmological constant. Since the supersymmetry breaking sector and the moduli sector are only gravitationally coupled, we expect negligible quantum effects of the modulus upon the ISS sector, and the other way around. Under this assumption, we show that the ISS fields end up in the metastable vacua. The reason is not only that it is thermally favoured (second order phase transition) compared to the phase transition towards the supersymmetric vacua, but rather that the metastable vacua form before the supersymmetric ones. This nice feature is exclusively due to the presence of the KKLT sector. We also show that supergravity effects are negligible around the origin of the field space. Finally, we turn to the modulus sector and show that there is no destabilisation effect coming from the ISS sector.

Proposed configuration for ITER hydrogen isotope separation system (ISS)

International Nuclear Information System (INIS)

Lazar, A.; Brad, S.; Sofalca, N.; Vijulie, M.; Cristescu, I.; Doer, L; Wurster, W.

2008-01-01

Full text: The isotope separation system utilizes cryogenic distillation and catalytic reaction for isotope exchange to separate elemental hydrogen isotope gas mixtures. The ISS shall separate hydrogen isotope mixtures from two sources to produce up to five different products. These are: protium, effluent for discharge to the atmosphere, deuterium for fuelling, deuterium for NB injector (NBI) source gas, 50 % and 90% T fuelling streams. The concept of equipment 3D layout for the ISS main components were developed using the Part Design, Assembly Design, Piping Design, Equipment Arrangement and Plant Layout application from CATIA V5. The 3D conceptual layouts for ISS system were created having as reference the DDD -32-B report, the drawings 0028.0001.2D. 0100. R 'Process Flow Diagram'; 0029.0001.2D. 0200.R 'Process Instrumentation Diagram -1' (in the cold box); 0030.0001.2D. 0100. R 'Process Instrumentation Diagram -2' (in the hard shell confinement) and imputes from TLK team. The main components designed for ISS are: ISS cold box system (CB) with cryogenic distillation columns (CD) and recovery heat exchangers (HX), ISS hard shell containment (HSC) system with metals bellow pumps (MB) and chemical equilibrators (RC), valve box system, instrumentation box system, vacuum system and hydrogen expansion vessels. Work related to these topics belongs to the contract FU06-CT-2006-00508 (EFDA 06-1511) from the EFDA Technology Workprogramm 2006 and was done in collaboration with FZK Association team during the period January 2007 - September 2008. (authors)

System Interface for an Integrated Intelligent Safety System (ISS for Vehicle Applications

Directory of Open Access Journals (Sweden)

Mahammad A. Hannan

2010-01-01

Full Text Available This paper deals with the interface-relevant activity of a vehicle integrated intelligent safety system (ISS that includes an airbag deployment decision system (ADDS and a tire pressure monitoring system (TPMS. A program is developed in LabWindows/CVI, using C for prototype implementation. The prototype is primarily concerned with the interconnection between hardware objects such as a load cell, web camera, accelerometer, TPM tire module and receiver module, DAQ card, CPU card and a touch screen. Several safety subsystems, including image processing, weight sensing and crash detection systems, are integrated, and their outputs are combined to yield intelligent decisions regarding airbag deployment. The integrated safety system also monitors tire pressure and temperature. Testing and experimentation with this ISS suggests that the system is unique, robust, intelligent, and appropriate for in-vehicle applications.

ISS And Space Environment Interactions Without Operating Plasma Contactor

Science.gov (United States)

Carruth, M. R., Jr.; Ferguson, Dale; Suggs,Rob; McCollum, Matt

2001-01-01

The International Space Station (ISS) will be the largest, highest power spacecraft placed in orbit. Because of this the design of the electrical power system diverged markedly from previous systems. The solar arrays will operate at 160 V and the power distribution voltage will be 120 V. The structure is grounded to the negative side of the solar arrays so under the right circumstances it is possible to drive the ISS potential very negative. A plasma contactor has been added to the ISS to provide control of the ISS structure potential relative to the ambient plasma. The ISS requirement is that the ISS structure not be greater than 40 V positive or negative of local plasma. What are the ramifications of operating large structures with such high voltage power systems? The application of a plasma contactor on ISS controls the potential between the structure and the local plasma, preventing degrading effects. It is conceivable that there can be situations where the plasma contactor might be non-functional. This might be due to lack of power, the need to turn it off during some of the build-up sequences, the loss of functionality for both plasma contactors before a replacement can be installed, similar circumstances. A study was undertaken to understand how important it is to have the contactor functioning and how long it might be off before unacceptable degradation to ISS could occur. The details of interaction effects on spacecraft have not been addressed until driven by design. This was true for ISS. If the structure is allowed to float highly negative impinging ions can sputter exposed conductors which can degrade the primary surface and also generate contamination due to the sputtered material. Arcing has been known to occur on solar arrays that float negative of the ambient plasma. This can also generate electromagnetic interference and voltage transients. Much of the ISS structure and pressure module surfaces exposed to space is anodized aluminum. The anodization

Gene expression variations during Drosophila metamorphosis in space: The GENE experiment in the Spanish cervantes missions to the ISS

Science.gov (United States)

Herranz, Raul; Benguria, Alberto; Medina, Javier; Gasset, Gilbert; van Loon, Jack J.; Zaballos, Angel; Marco, Roberto

2005-08-01

The ISS expedition 8, a Soyuz Mission, flew to the International Space Station (ISS) to replace the two- member ISS crew during October 2003. During this crew exchanging flight, the Spanish Cervantes Scientific Mission took place. In it some biological experiments were performed among them three proposed by our Team. The third member of the expedition, the Spanish born ESA astronaut Pedro Duque, returned within the Soyuz 7 capsule carrying the experiment containing transport box after almost 11 days in microgravity. In one of the three experiments, the GENE experiment, we intended to determine how microgravity affects the gene expression pattern of Drosophila with one of the current more powerful technologies , a complete Drosophila melanogaster genome microarray (AffymetrixTM, version 1.0). Due to the constrains in the current ISS experiments, we decided to limit our experiment to the organism rebuilding processes that occurs during Drosophila metamorphosis. In addition to the ISS samples, several control experiments have been performed including a 1g Ground control parallel to the ISS flight samples, a Random Position Machine microgravity simulated control and a parallel Hypergravity (10g) experiment. Extracted RNA from the samples was used to test the differences in gene expression during Drosophila development. A preliminary analysis of the results indicates that around five hundred genes change their expression profiles, many of them belonging to particular ontology classification groups.

ISS Expedition 08 Press Kit

Data.gov (United States)

National Aeronautics and Space Administration — Press kit for ISS mission Expedition 08 from 10/2003-04/2004. Press kits contain information about each mission overview, crew, mission timeline, benefits, and media...

Innovations for ISS Plug-In Plan (IPiP) Operations

Science.gov (United States)

Moore, Kevin D.

2013-01-01

Limited resources and increasing requirements will continue to influence decisions on ISS. The ISS Plug-In Plan (IPiP) supports power and data for utilization, systems, and daily operations through the Electrical Power System (EPS) Secondary Power/Data Subsystem. Given the fluid launch schedule, the focus of the Plug-In Plan has evolved to anticipate future requirements by judicious development and delivery of power supplies, power strips, Alternating Current (AC) power inverters, along with innovative deployment strategies. A partnership of ISS Program Office, Engineering Directorate, Mission Operations, and International Partners poses unique solutions with existing on-board equipment and resources.

Severity score system for progressive myelopathy: development and validation of a new clinical scale

Directory of Open Access Journals (Sweden)

R.M. Castilhos

2012-07-01

Full Text Available Progressive myelopathies can be secondary to inborn errors of metabolism (IEM such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM, covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS, the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001 and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001 were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.

Preventing Precipitation in the ISS Urine Processor

Science.gov (United States)

Muirhead, Dean; Carter, Layne; Williamson, Jill; Chambers, Antja

2017-01-01

The ISS Urine Processor Assembly (UPA) was initially designed to achieve 85% recovery of water from pretreated urine on ISS. Pretreated urine is comprised of crew urine treated with flush water, an oxidant (chromium trioxide), and an inorganic acid (sulfuric acid) to control microbial growth and inhibit precipitation. Unfortunately, initial operation of the UPA on ISS resulted in the precipitation of calcium sulfate at 85% recovery. This occurred because the calcium concentration in the crew urine was elevated in microgravity due to bone loss. The higher calcium concentration precipitated with sulfate from the pretreatment acid, resulting in a failure of the UPA due to the accumulation of solids in the Distillation Assembly. Since this failure, the UPA has been limited to a reduced recovery of water from urine to prevent calcium sulfate from reaching the solubility limit. NASA personnel have worked to identify a solution that would allow the UPA to return to a nominal recovery rate of 85%. This effort has culminated with the development of a pretreatment based on phosphoric acid instead of sulfuric acid. By eliminating the sulfate associated with the pretreatment, the brine can be concentrated to a much higher concentration before calcium sulfate reach the solubility limit. This paper summarizes the development of this pretreatment and the testing performed to verify its implementation on ISS.

A prospective, multisite, international validation of the Complex Regional Pain Syndrome Severity Score.

Science.gov (United States)

Harden, R Norman; Maihofner, Christian; Abousaad, Elias; Vatine, Jean-Jacques; Kirsling, Amy; Perez, Roberto S G M; Kuroda, Maxine; Brunner, Florian; Stanton-Hicks, Michael; Marinus, Johan; van Hilten, Jacobus J; Mackey, Sean; Birklein, Frank; Schlereth, Tanja; Mailis-Gagnon, Angela; Graciosa, Joe; Connoly, Sara B; Dayanim, David; Massey, Michael; Frank, Hadas; Livshitz, Anatoly; Bruehl, Stephen

2017-08-01

Clinical diagnosis of complex regional pain syndrome (CRPS) is a dichotomous (yes/no) categorization, a format necessary for clinical decision making. Such dichotomous diagnostic categories do not convey an individual's subtle gradations in the severity of the condition over time and have poor statistical power when used as an outcome measure in research. This prospective, international, multicenter study slightly modified and further evaluated the validity of the CRPS Severity Score (CSS), a continuous index of CRPS severity. Using a prospective design, medical evaluations were conducted in 156 patients with CRPS to compare changes over time in CSS scores between patients initiating a new treatment program and patients on stable treatment regimens. New vs stable categorizations were supported by greater changes in pain and function in the former. Results indicated that CSS values in the stable CRPS treatment group exhibited much less change over time relative to the new treatment group, with intraclass correlations nearly twice as large in the former. A calculated smallest real difference value revealed that a change in the CSS of ≥4.9 scale points would indicate real differences in CRPS symptomatology (with 95% confidence). Across groups, larger changes in CRPS features on the CSS over time were associated in the expected direction with greater changes in pain intensity, fatigue, social functioning, ability to engage in physical roles, and general well-being. The overall pattern of findings further supports the validity of the CSS as a measure of CRPS severity and suggests it may prove useful in clinical monitoring and outcomes research.

Automated ISS Flight Utilities

Science.gov (United States)

Offermann, Jan Tuzlic

2016-01-01

During my internship at NASA Johnson Space Center, I worked in the Space Radiation Analysis Group (SRAG), where I was tasked with a number of projects focused on the automation of tasks and activities related to the operation of the International Space Station (ISS). As I worked on a number of projects, I have written short sections below to give a description for each, followed by more general remarks on the internship experience. My first project is titled "General Exposure Representation EVADOSE", also known as "GEnEVADOSE". This project involved the design and development of a C++/ ROOT framework focused on radiation exposure for extravehicular activity (EVA) planning for the ISS. The utility helps mission managers plan EVAs by displaying information on the cumulative radiation doses that crew will receive during an EVA as a function of the egress time and duration of the activity. SRAG uses a utility called EVADOSE, employing a model of the space radiation environment in low Earth orbit to predict these doses, as while outside the ISS the astronauts will have less shielding from charged particles such as electrons and protons. However, EVADOSE output is cumbersome to work with, and prior to GEnEVADOSE, querying data and producing graphs of ISS trajectories and cumulative doses versus egress time required manual work in Microsoft Excel. GEnEVADOSE automates all this work, reading in EVADOSE output file(s) along with a plaintext file input by the user providing input parameters. GEnEVADOSE will output a text file containing all the necessary dosimetry for each proposed EVA egress time, for each specified EVADOSE file. It also plots cumulative dose versus egress time and the ISS trajectory, and displays all of this information in an auto-generated presentation made in LaTeX. New features have also been added, such as best-case scenarios (egress times corresponding to the least dose), interpolated curves for trajectories, and the ability to query any time in the

Organization and Management of the International Space Station (ISS) Multilateral Medical Operations

Science.gov (United States)

Duncan, J. M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

2007-01-01

The goal of this work is to review the principles, design, and function of the ISS multilateral medical authority and the medical support system of the ISS Program. Multilateral boards and panels provide operational framework, direct, and supervise the ISS joint medical operational activities. The Integrated Medical Group (IMG) provides front-line medical support of the crews. Results of ongoing activities are reviewed weekly by physician managers. A broader status review is conducted monthly to project the state of crew health and medical support for the following month. All boards, panels, and groups function effectively and without interruptions. Consensus prevails as the primary nature of decisions made by all ISS medical groups, including the ISS medical certification board. The sustained efforts of all partners have resulted in favorable medical outcomes of the initial fourteen long-duration expeditions. The medical support system appears to be mature and ready for further expansion of the roles of all Partners, and for the anticipated increase in the size of ISS crews.

Are severely injured trauma victims in Norway offered advanced pre-hospital care? National, retrospective, observational cohort.

Science.gov (United States)

Wisborg, T; Ellensen, E N; Svege, I; Dehli, T

2017-08-01

Studies of severely injured patients suggest that advanced pre-hospital care and/or rapid transportation provides a survival benefit. This benefit depends on the disposition of resources to patients with the greatest need. Norway has 19 Emergency Helicopters (HEMS) staffed by anaesthesiologists on duty 24/7/365. National regulations describe indications for their use, and the use of the national emergency medical dispatch guideline is recommended. We assessed whether severely injured patients had been treated or transported by advanced resources on a national scale. A national survey was conducted collecting data for 2013 from local trauma registries at all hospitals caring for severely injured patients. Patients were analysed according to hospital level; trauma centres or acute care hospitals with trauma functions. Patients with an Injury Severity Score (ISS) > 15 were considered severely injured. Three trauma centres (75%) and 17 acute care hospitals (53%) had data for trauma patients from 2013, a total of 3535 trauma registry entries (primary admissions only), including 604 victims with an ISS > 15. Of these 604 victims, advanced resources were treating and/or transporting 51%. Sixty percent of the severely injured admitted directly to trauma centres received advanced services, while only 37% of the severely injured admitted primarily to acute care hospitals received these services. A highly developed and widely distributed HEMS system reached only half of severely injured trauma victims in Norway in 2013. © 2017 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

A new system for severity scoring of facial fractures: development and validation.

Science.gov (United States)

Catapano, Joseph; Fialkov, Jeffrey A; Binhammer, Paul A; McMillan, Catherine; Antonyshyn, Oleh M

2010-07-01

Facial fractures are often the result of high-velocity trauma, causing skeletal disruption affecting multiple anatomic sites to varying degrees. Although several widely accepted classification systems exist, these are mostly region-specific and differ in the classification criteria used, making it impossible to uniformly and comprehensively document facial fracture patterns. Furthermore, a widely accepted system that is able to provide a final summary measure of fracture severity does not exist, making it difficult to investigate the epidemiologic data surrounding facial fracture severity. In this study, a comprehensive method for panfacial fracture documentation and severity measurement is proposed and validated through a retrospective analysis of 63 patients operated on for acute facial fracture. The severity scale was validated through statistical analysis of correlation with surrogate markers of severity (operating room procedure time and number of implants). Spearman correlation coefficients were calculated, and a statistically significant correlation was found between severity score and both number of implants and operating room procedure time (R = 0.92790 and R = 0.68157, respectively). Intraclass correlation coefficients were calculated to assess intrarater and interrater reliabilities of the severity scale and were found to be high (0.97 and 0.99, respectively). This severity scale provides a valuable, validated research tool for the investigation of facial fracture severity across patient populations, allowing for systematic evaluation of facial fracture outcomes, cost-benefit analysis, and objective analysis of the effect of specific interventions.

Pediatric patients with severe head injury in Japan Neurotrauma Data Bank. Analysis of the prognostic factors

International Nuclear Information System (INIS)

Miki, Tamotsu; Haraoka, Jo

2009-01-01

The purpose of this study is to evaluate the clinical characteristics of the pediatric patients in the Japan Neurotrauma Data Bank: Project 2004. Project 2004 consisted of severe head injury patients with a Glasgow Coma Scale (GCS) score of 8 or less on admission or during course and patients who were operated for traumatic intracranial lesion between 2004-2006. The subjects were 101 pediatric patients aged 15 years old or less (mean: 7.8 y/o). We retrospectively examined the patients' age, GCS, cause of injury, duration and time of patient transfer, pupillary abnormality, body temperature, serum glucose level, Injury Severity Score (ISS) excluding cranio-cervical score, skull fracture, CT classification of the Traumatic Coma Data Bank (TCDB), main lesion of focal brain injury on CT, and traumatic subarachnoid hemorrhage (SAH) on CT. The mortality rate in children is lower than in adults: 18.8% vs. 39.7%. The factors that correlated to the poor outcome in pediatric patients are lower GCS score on admission, pupillary abnormality, hyperglycemia (more than 200 mg/dl), complications of severe other organ injury, diffuse injury III according to classification of CT, acute subdural hematoma and SAH. Pathophysiologically pediatric patients are not miniatures of adult patients. The data of Project 2004 is extremely significant and indicates the profile of one general view of pediatric patients with severe head injury in Japan. However, further collection of data and careful analysis are necessary for standardizing pediatric head trauma care. (author)

Optimization of MRI-based scoring scales of brain injury severity in children with unilateral cerebral palsy

International Nuclear Information System (INIS)

Pagnozzi, Alex M.; Fiori, Simona; Boyd, Roslyn N.; Guzzetta, Andrea; Doecke, James; Rose, Stephen; Dowson, Nicholas; Gal, Yaniv

2016-01-01

Several scoring systems for measuring brain injury severity have been developed to standardize the classification of MRI results, which allows for the prediction of functional outcomes to help plan effective interventions for children with cerebral palsy. The aim of this study is to use statistical techniques to optimize the clinical utility of a recently proposed template-based scoring method by weighting individual anatomical scores of injury, while maintaining its simplicity by retaining only a subset of scored anatomical regions. Seventy-six children with unilateral cerebral palsy were evaluated in terms of upper limb motor function using the Assisting Hand Assessment measure and injuries visible on MRI using a semiquantitative approach. This cohort included 52 children with periventricular white matter injury and 24 with cortical and deep gray matter injuries. A subset of the template-derived cerebral regions was selected using a data-driven region selection algorithm. Linear regression was performed using this subset, with interaction effects excluded. Linear regression improved multiple correlations between MRI-based and Assisting Hand Assessment scores for both periventricular white matter (R squared increased to 0.45 from 0, P < 0.0001) and cortical and deep gray matter (0.84 from 0.44, P < 0.0001) cohorts. In both cohorts, the data-driven approach retained fewer than 8 of the 40 template-derived anatomical regions. The equal or better prediction of the clinically meaningful Assisting Hand Assessment measure using fewer anatomical regions highlights the potential of these developments to enable enhanced quantification of injury and prediction of patient motor outcome, while maintaining the clinical expediency of the scoring approach. (orig.)

Optimization of MRI-based scoring scales of brain injury severity in children with unilateral cerebral palsy.

Science.gov (United States)

Pagnozzi, Alex M; Fiori, Simona; Boyd, Roslyn N; Guzzetta, Andrea; Doecke, James; Gal, Yaniv; Rose, Stephen; Dowson, Nicholas

2016-02-01

Several scoring systems for measuring brain injury severity have been developed to standardize the classification of MRI results, which allows for the prediction of functional outcomes to help plan effective interventions for children with cerebral palsy. The aim of this study is to use statistical techniques to optimize the clinical utility of a recently proposed template-based scoring method by weighting individual anatomical scores of injury, while maintaining its simplicity by retaining only a subset of scored anatomical regions. Seventy-six children with unilateral cerebral palsy were evaluated in terms of upper limb motor function using the Assisting Hand Assessment measure and injuries visible on MRI using a semiquantitative approach. This cohort included 52 children with periventricular white matter injury and 24 with cortical and deep gray matter injuries. A subset of the template-derived cerebral regions was selected using a data-driven region selection algorithm. Linear regression was performed using this subset, with interaction effects excluded. Linear regression improved multiple correlations between MRI-based and Assisting Hand Assessment scores for both periventricular white matter (R squared increased to 0.45 from 0, P < 0.0001) and cortical and deep gray matter (0.84 from 0.44, P < 0.0001) cohorts. In both cohorts, the data-driven approach retained fewer than 8 of the 40 template-derived anatomical regions. The equal or better prediction of the clinically meaningful Assisting Hand Assessment measure using fewer anatomical regions highlights the potential of these developments to enable enhanced quantification of injury and prediction of patient motor outcome, while maintaining the clinical expediency of the scoring approach.

Optimization of MRI-based scoring scales of brain injury severity in children with unilateral cerebral palsy

Energy Technology Data Exchange (ETDEWEB)

Pagnozzi, Alex M. [Royal Brisbane and Women' s Hospital, CSIRO Digital Productivity and Services Flagship, The Australian e-Health Research Centre, Herston, QLD (Australia); The University of Queensland, School of Medicine, Brisbane (Australia); Fiori, Simona [Stella Maris Scientific Institute, Pisa (Italy); Boyd, Roslyn N. [The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Brisbane (Australia); Guzzetta, Andrea [Stella Maris Scientific Institute, Pisa (Italy); University of Pisa, Department of Clinical and Experimental Medicine, Pisa (Italy); Doecke, James; Rose, Stephen; Dowson, Nicholas [Royal Brisbane and Women' s Hospital, CSIRO Digital Productivity and Services Flagship, The Australian e-Health Research Centre, Herston, QLD (Australia); Gal, Yaniv [The University of Queensland, Centre for Medical Diagnostic Technologies in Queensland, Brisbane (Australia)

2016-02-15

Several scoring systems for measuring brain injury severity have been developed to standardize the classification of MRI results, which allows for the prediction of functional outcomes to help plan effective interventions for children with cerebral palsy. The aim of this study is to use statistical techniques to optimize the clinical utility of a recently proposed template-based scoring method by weighting individual anatomical scores of injury, while maintaining its simplicity by retaining only a subset of scored anatomical regions. Seventy-six children with unilateral cerebral palsy were evaluated in terms of upper limb motor function using the Assisting Hand Assessment measure and injuries visible on MRI using a semiquantitative approach. This cohort included 52 children with periventricular white matter injury and 24 with cortical and deep gray matter injuries. A subset of the template-derived cerebral regions was selected using a data-driven region selection algorithm. Linear regression was performed using this subset, with interaction effects excluded. Linear regression improved multiple correlations between MRI-based and Assisting Hand Assessment scores for both periventricular white matter (R squared increased to 0.45 from 0, P < 0.0001) and cortical and deep gray matter (0.84 from 0.44, P < 0.0001) cohorts. In both cohorts, the data-driven approach retained fewer than 8 of the 40 template-derived anatomical regions. The equal or better prediction of the clinically meaningful Assisting Hand Assessment measure using fewer anatomical regions highlights the potential of these developments to enable enhanced quantification of injury and prediction of patient motor outcome, while maintaining the clinical expediency of the scoring approach. (orig.)

Paralytic Ectropion Treatment with Lateral Periosteal Flap Canthoplasty and Introduction of the Ectropion Severity Score

Directory of Open Access Journals (Sweden)

Steven F. S. Korteweg, MD

2014-05-01

Conclusions: The ESS is a useful instrument to score the severity of paralytic ectropion. The periosteal flap canthoplasty is an effective procedure, with durable results in paralytic ectropion patients. The same periosteal flap can be used in a revision procedure.

Status epilepticus severity score (STESS): A useful tool to predict outcome of status epilepticus.

Science.gov (United States)

Goyal, Manoj Kumar; Chakravarthi, Sudheer; Modi, Manish; Bhalla, Ashish; Lal, Vivek

2015-12-01

The treatment protocols for status epilepticus (SE) range from small doses of intravenous benzodiazepines to induction of coma. The pros and cons of more aggressive treatment regimen remain debatable. The importance of an index need not be overemphasized which can predict outcome of SE and guide the intensity of treatment. We tried to evaluate utility of one such index Status epilepticus severity score (STESS). 44 consecutive patients of SE were enrolled in the study. STESS results were compared with various outcome measures: (a) mortality, (b) final neurological outcome at discharge as defined by functional independence measure (FIM) (good outcome: FIM score 5-7; bad outcome: FIM score 1-4), (c) control of SE within 1h of start of treatment and (d) need for coma induction. A higher STESS score correlated significantly with poor neurological outcome at discharge (p=0.0001), need for coma induction (p=0.0001) and lack of response to treatment within 1h (p=0.001). A STESS of status epilepticus. Further studies on STESS based treatment approach may help in designing better therapeutic regimens for SE. Copyright © 2015 Elsevier B.V. All rights reserved.

Respiratory severity score and extubation readiness in very low birth weight infants

Directory of Open Access Journals (Sweden)

Maroun J. Mhanna

2017-12-01

Full Text Available Background: The respiratory severity score (RSS is a byproduct of mean airway pressure (MAP and fraction of inspired oxygen (FiO2. We sought to determine whether RSS could be used as a screening tool to predict extubation readiness in very low birth weight (VLBW infants. Methods: In a retrospective cohort study, medical records of all VLBW infants admitted to our unit (6/1/09–2/28/12 were reviewed for infants' demographics, prenatal characteristics, and medication use. Also, records were reviewed for unplanned vs. planned extubation, blood gas, ventilator parameters and signs of severe respiratory failure [RF, defined as partial pressure of carbon dioxide (pCO2 > 65, pH  50%, and MAP > 10 cm] on the day of extubation. Results: During the study period 31% (45/147 failed extubation. Overall, infants who failed extubation had a lower birth weight (BW and gestational age (GA, and on the day of extubation had a higher RSS and percentage of having one or more signs of severe RF. In a logistic regression model, adjusting for BW, GA, RSS and RF, RSS remained the only risk factor associated with extubation failure [adjusted OR 1.63 (95% CI: 1.10–2.40; p = 0.01]. RSS had a sensitivity of 0.86 (95% CI: 0.72–0.94 at a cutoff of 1.26 and a specificity of 0.88 (95% CI: 0.80–0.94 at a cutoff of 2.5. There was no difference in extubation failure between unplanned vs. planned extubation [41% (9/22 vs. 29% (36/125; p = 0.25]. Conclusion: An elevated RSS is associated with extubation failure. Successful unplanned extubation is common in VLBW infants. Key Words: very low birth weight, extubation, mechanical ventilation, respiratory severity score

Rapid Monitoring of Bacteria and Fungi aboard the International Space Station (ISS)

Science.gov (United States)

Gunter, D.; Flores, G.; Effinger, M.; Maule, J.; Wainwright, N.; Steele, A.; Damon, M.; Wells, M.; Williams, S.; Morris, H.;

Evaluation of the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) scoring system in elderly patients with pressure sores undergoing fasciocutaneous flap-reconstruction.

Science.gov (United States)

Mizumoto, Kazuo; Morita, Eishin

2009-01-01

The aim of the present study was to predict operative morbidity in elderly patients with deep pressure sores by using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) scoring system. Fifteen patients over 70 years old were retrospectively reviewed who had undergone gluteus maximus fasciocutaneous flap-reconstruction for pressure sores of the sacral region from 1 April 2005 to 31 March 2007. Complications were seen in six cases (40%) after operation. Four were wound infection, one was chest infection and another was septicemia. The subjects were divided into two groups by the presence (complicated group) or absence (non-complicated group) of postoperative complications. Each item of physiological scores, physiological score (PS), operative severity score (OS) and predicted morbidity rate (R) were calculated and compared between two groups. As a result, hemoglobin (P = 0.0276), PS (P = 0.0023) and R (P = 0.0078) differed significantly between the two groups. It is noteworthy that the PS were over 25 in all of the complicated group, but in only one of nine in the non-complicated group (P = 0.0014). Our study suggests that, for pressure sores in the sacral region in elderly patients, gluteus maximus fasciocutaneous flap-reconstruction can be employed in patients whose PS are under 24 in the POSSUM scoring system.

An Onboard ISS Virtual Reality Trainer

Science.gov (United States)

Miralles, Evelyn

2013-01-01

Prior to the retirement of the Space Shuttle, many exterior repairs on the International Space Station (ISS) were carried out by shuttle astronauts, trained on the ground and flown to the Station to perform these specific repairs. With the retirement of the shuttle, this is no longer an available option. As such, the need for ISS crew members to review scenarios while on flight, either for tasks they already trained for on the ground or for contingency operations has become a very critical issue. NASA astronauts prepare for Extra-Vehicular Activities (EVA) or Spacewalks through numerous training media, such as: self-study, part task training, underwater training in the Neutral Buoyancy Laboratory (NBL), hands-on hardware reviews and training at the Virtual Reality Laboratory (VRLab). In many situations, the time between the last session of a training and an EVA task might be 6 to 8 months. EVA tasks are critical for a mission and as time passes the crew members may lose proficiency on previously trained tasks and their options to refresh or learn a new skill while on flight are limited to reading training materials and watching videos. In addition, there is an increased need for unplanned contingency repairs to fix problems arising as the Station ages. In order to help the ISS crew members maintain EVA proficiency or train for contingency repairs during their mission, the Johnson Space Center's VRLab designed an immersive ISS Virtual Reality Trainer (VRT). The VRT incorporates a unique optical system that makes use of the already successful Dynamic On-board Ubiquitous Graphics (DOUG) software to assist crew members with procedure reviews and contingency EVAs while on board the Station. The need to train and re-train crew members for EVAs and contingency scenarios is crucial and extremely demanding. ISS crew members are now asked to perform EVA tasks for which they have not been trained and potentially have never seen before. The Virtual Reality Trainer (VRT

Organization, Management and Function of International Space Station (ISS) Multilateral Medical Operations

Science.gov (United States)

Duncan, James M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

2007-01-01

Long duration crews have inhabited the ISS since November of 2000. The favorable medical outcomes of its missions can be largely attributed to sustained collective efforts of all ISS Partners medical organizations. In-flight medical monitoring and support, although crucial, is just a component of the ISS system of Joint Medical Operations. The goal of this work is to review the principles, design, and function of the multilateral medical support of the ISS Program. The governing documents, which describe the relationships among all ISS partner medical organizations, were evaluated, followed by analysis of the roles, responsibilities, and decision-making processes of the ISS medical boards, panels, and working groups. The degree of integration of the medical support system was evaluated by reviewing the multiple levels of the status reviews and mission assurance activities carried out throughout the last six years. The Integrated Medical Group, consisting of physicians and other essential personnel in the mission control centers represents the front-line medical support of the ISS. Data from their day-to-day activities are presented weekly at the Space Medicine Operations Team (SMOT), where known or potential concerns are addressed by an international group of physicians. A broader status review is conducted monthly to project the state of crew health and medical support for the following month, and to determine measures to return to nominal state. Finally, a comprehensive readiness review is conducted during preparations for each ISS mission. The Multilateral Medical Policy Board (MMPB) issues medical policy decisions and oversees all health and medical matters. The Multilateral Space Medicine Board (MSMB) certifies crewmembers and visitors for training and space flight to the Station, and physicians to practice space medicine for the ISS. The Multilateral Medical Operations Panel (MMOP) develops medical requirements, defines and supervises implementation of

Evaluating the Medical Kit System for the International Space Station(ISS) - A Paradigm Revisited

Science.gov (United States)

Hailey, Melinda J.; Urbina, Michelle C.; Hughlett, Jessica L.; Gilmore, Stevan; Locke, James; Reyna, Baraquiel; Smith, Gwyn E.

2010-01-01

Medical capabilities aboard the International Space Station (ISS) have been packaged to help astronaut crew medical officers (CMO) mitigate both urgent and non-urgent medical issues during their 6-month expeditions. Two ISS crewmembers are designated as CMOs for each 3-crewmember mission and are typically not physicians. In addition, the ISS may have communication gaps of up to 45 minutes during each orbit, necessitating medical equipment that can be reliably operated autonomously during flight. The retirement of the space shuttle combined with ten years of manned ISS expeditions led the Space Medicine Division at the NASA Johnson Space Center to reassess the current ISS Medical Kit System. This reassessment led to the system being streamlined to meet future logistical considerations with current Russian space vehicles and future NASA/commercial space vehicle systems. Methods The JSC Space Medicine Division coordinated the development of requirements, fabrication of prototypes, and conducted usability testing for the new ISS Medical Kit System in concert with implementing updated versions of the ISS Medical Check List and associated in-flight software applications. The teams constructed a medical kit system with the flexibility for use on the ISS, and resupply on the Russian Progress space vehicle and future NASA/commercial space vehicles. Results Prototype systems were developed, reviewed, and tested for implementation. Completion of Preliminary and Critical Design Reviews resulted in a streamlined ISS Medical Kit System that is being used for training by ISS crews starting with Expedition 27 (June 2011). Conclusions The team will present the process for designing, developing, , implementing, and training with this new ISS Medical Kit System.

Severe Spontaneous Echo Contrast/Auricolar Thrombosis in "Nonvalvular" AF: Value of Thromboembolic Risk Scores.

Science.gov (United States)

Mascioli, Giosuè; Lucca, Elena; Michelotti, Federica; Alioto, Giusy; Santoro, Franco; Belli, Guido; Rota, Cristina; Ornago, Ombretta; Sirianni, Giovanni; Pulcini, Emanuela; Pennesi, Matteo; Savasta, Carlo; Russo, Rosario; Pitì, Antonino

2017-01-01

Patients with atrial fibrillation (AF) have an increased thromboembolic risk that can be estimated with risk scores and sometimes require oral anticoagulation therapy (OAT). Despite correct anticoagulation, some patients still develop left atrial spontaneous echo contrast (SEC) or thrombosis. The value of traditional risk scores (R 2 CHADS 2 , CHADS 2 , and CHA 2 DS 2 -VASc) in predicting such events remains controversial. The aim of our study was to explore variables linked to severe SEC or atrial thrombosis and evaluate the performance of traditional risk scores in identifying these patients. In order to do this, we retrospectively analyzed 568 patients with nonvalvular nonparoxysmal AF who underwent electrical cardioversion from January 2011 to December 2016 after OAT for a minimum of 4 weeks. A transesophageal echocardiogram was performed in 265 patients for various indications, and 24 exhibited left atrial SEC or thrombosis. Female gender, history of heart failure or left ventricular ejection fraction 1 mg/dL) of C-reactive protein (CRP) were independently associated with left atrial SEC/thrombosis. A score composed by these factors (denominated HIS [Heart Failure, Inflammation, and female Sex]) showed a sensitivity of 79% and a specificity of 60% (area under receiver operating characteristic curve 0.695, P = 0.002) in identifying patients with a positive transesophageal echo; traditional risk scores did not perform as well. In patients with persistent AF and suboptimal anticoagulation, a risk score composed by history of heart failure, high CRP, and female gender identifies patients at high risk of left atrial SEC/thrombosis when its value is >1. © 2016 Wiley Periodicals, Inc.

Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.

LENUS (Irish Health Repository)

Miletin, J

2012-02-01

OBJECTIVE: Recent evidence suggests that high cortisol concentrations are associated with increased morbidity and mortality in very low birth weight (VLBW) infants. Neonatal illness severity and mortality risk scores are reliable in predicting morbidity and mortality. The objectives were (i) to assess the correlation between serum cortisol levels and clinical assessment of multi-organ dysfunction\\/illness severity scores (CRIB II, SNAPPE-II and neonatal multiple organ dysfunction score (NEOMOD)) in first 24 h in VLBW infants and (ii) to assess the relationship between surrogates of end organ blood flow and serum cortisol levels. STUDY DESIGN: A prospective observational cohort study. Neonates with birth weight <1500 g were eligible for enrollment. Echocardiography evaluation of superior vena cava (SVC) flow was carried out in the first 24 h life. Cortisol levels were measured simultaneously and appropriate clinical scores were calculated. RESULT: A total of 54 VLBW neonates were enrolled following parental consent. Two patients were excluded because of congenital malformations. In 14 babies the cortisol value was not simultaneously obtained. The mean birth weight was 1.08 kg, mean gestational age was 27.8 weeks. There was a significant correlation between cortisol and NEOMOD score (P=0.006). There was no correlation between cortisol and CRIB II score (P=0.34), SVC flow (P=0.49) and mean arterial blood pressure respectively (P=0.35). CONCLUSION: There was no correlation between SVC flow and cortisol values or between cortisol and mean blood pressure values. There was a significant correlation between cortisol levels and neonatal organ dysfunction score evaluated suggesting that stressed VLBW infants do mount a cortisol response.

Association of Osteoporosis Self-Assessment Tool for Asians (OSTA) Score with Clinical Presentation and Expenditure in Hospitalized Trauma Patients with Femoral Fractures.

Science.gov (United States)

Chen, Chien-Chang; Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2016-10-10

Background : A cross-sectional study to investigate the association of Osteoporosis Self-Assessment Tool for Asians (OSTA) score with clinical presentation and expenditure of hospitalized adult trauma patients with femoral fractures. Methods : According to the data retrieved from the Trauma Registry System between 1 January 2009 and 31 December 2015, a total of 2086 patients aged ≥40 years and hospitalized for treatment of traumatic femoral bone fracture were categorized as high-risk patients (OSTA -1, n = 638). Two-sided Pearson's, chi-squared, or Fisher's exact tests were used to compare categorical data. Unpaired Student's t -test and Mann-Whitney U -test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed using Number Crunching Statistical Software (NCSS) software (NCSS 10; NCSS Statistical Software, Kaysville, UT, USA), with adjusted covariates including mechanism and Glasgow Coma Scale (GCS); injuries were assessed based on the Abbreviated Injury Scale (AIS), and Injury Severity Score (ISS) was used to evaluate the effect of OSTA-related grouping on a patient's outcome. Results : High-risk and medium-risk patients were predominantly female, presented with significantly older age and higher incidences of co-morbidity, and were injured in a fall accident more frequently than low-risk patients. High-risk patients and medium-risk patients had a different pattern of femoral fracture and a significantly lower ISS. Although high-risk and medium-risk patients had significantly shorter lengths hospital of stay (LOS) and less total expenditure than low-risk patients did, similar results were not found in the selected propensity score-matched patients, implying that the difference may be attributed to the associated injury severity of the patients with femoral fracture. However, the charge of surgery is significantly lower in high-risk and medium-risk patients than in low

The New York Sepsis Severity Score: Development of a Risk-Adjusted Severity Model for Sepsis.

Science.gov (United States)

Phillips, Gary S; Osborn, Tiffany M; Terry, Kathleen M; Gesten, Foster; Levy, Mitchell M; Lemeshow, Stanley

2018-05-01

In accordance with Rory's Regulations, hospitals across New York State developed and implemented protocols for sepsis recognition and treatment to reduce variations in evidence informed care and preventable mortality. The New York Department of Health sought to develop a risk assessment model for accurate and standardized hospital mortality comparisons of adult septic patients across institutions using case-mix adjustment. Retrospective evaluation of prospectively collected data. Data from 43,204 severe sepsis and septic shock patients from 179 hospitals across New York State were evaluated. Prospective data were submitted to a database from January 1, 2015, to December 31, 2015. None. Maximum likelihood logistic regression was used to estimate model coefficients used in the New York State risk model. The mortality probability was estimated using a logistic regression model. Variables to be included in the model were determined as part of the model-building process. Interactions between variables were included if they made clinical sense and if their p values were less than 0.05. Model development used a random sample of 90% of available patients and was validated using the remaining 10%. Hosmer-Lemeshow goodness of fit p values were considerably greater than 0.05, suggesting good calibration. Areas under the receiver operator curve in the developmental and validation subsets were 0.770 (95% CI, 0.765-0.775) and 0.773 (95% CI, 0.758-0.787), respectively, indicating good discrimination. Development and validation datasets had similar distributions of estimated mortality probabilities. Mortality increased with rising age, comorbidities, and lactate. The New York Sepsis Severity Score accurately estimated the probability of hospital mortality in severe sepsis and septic shock patients. It performed well with respect to calibration and discrimination. This sepsis-specific model provides an accurate, comprehensive method for standardized mortality comparison of adult

Mortality is predicted by Comorbidity Polypharmacy score but not Charlson Comorbidity Index in geriatric trauma patients.

Science.gov (United States)

Nossaman, Vaughn E; Larsen, Brett E; DiGiacomo, Jody C; Manuelyan, Zara; Afram, Renee; Shukry, Sally; Kang, Amiee Luan; Munnangi, Swapna; Angus, L D George

2017-09-19

Increased life expectancy has resulted in more older patients at trauma centers. Traditional assessments of injuries alone may not be sufficient; age, comorbidities, and medications should be considered. 446 older trauma patients were analyzed in two groups, 45-65 years and <65, using Injury Severity Score (ISS), the Charlson Comorbidity Index (CCI), and Comorbidity-Polypharmacy Score (CPS). CCI and CPS were associated with HLOS in patients <65. In patients aged 45-65, only CPS was associated with HLOS. CPS was inversely associated with in-hospital mortality in patients <65, but not patients aged 45-65. CCI score was not associated with in-hospital mortality in either group. Increased CCI and CPS were associated with increased HLOS. In patients over 65, increased CPS was associated with decreased mortality. This could be due to return toward physiologic normalcy in treated patients not seen in their peers with undiagnosed or untreated comorbidities. TABLE OF CONTENTS SUMMARY: In an analysis of 446 older trauma patients, the Charlson Comorbidity Index (CCI) and Comorbidity-Polypharmacy Score (CPS) were associated with increased hospital length of stay. In patients ≥65, increased CPS had a lower mortality, possibly due to a greater return toward physiologic normalcy not present in their untreated peers. Published by Elsevier Inc.

Severity of pulmonary emphysema and lung cancer: analysis using quantitative lobar emphysema scoring.

Science.gov (United States)

Bae, Kyungsoo; Jeon, Kyung Nyeo; Lee, Seung Jun; Kim, Ho Cheol; Ha, Ji Young; Park, Sung Eun; Baek, Hye Jin; Choi, Bo Hwa; Cho, Soo Buem; Moon, Jin Il

2016-11-01

The aim of this study was to determine the relationship between lobar severity of emphysema and lung cancer using automated lobe segmentation and emphysema quantification methods.This study included 78 patients (74 males and 4 females; mean age of 72 years) with the following conditions: pathologically proven lung cancer, available chest computed tomographic (CT) scans for lobe segmentation, and quantitative scoring of emphysema. The relationship between emphysema and lung cancer was analyzed using quantitative emphysema scoring of each pulmonary lobe.The most common location of cancer was the left upper lobe (LUL) (n = 28), followed by the right upper lobe (RUL) (n = 27), left lower lobe (LLL) (n = 13), right lower lobe (RLL) (n = 9), and right middle lobe (RML) (n = 1). Emphysema ratio was the highest in LUL, followed by that in RUL, LLL, RML, and RLL. Multivariate logistic regression analysis revealed that upper lobes (odds ratio: 1.77; 95% confidence interval: 1.01-3.11, P = 0.048) and lobes with emphysema ratio ranked the 1st or the 2nd (odds ratio: 2.48; 95% confidence interval: 1.48-4.15, P emphysema patients, lung cancer has a tendency to develop in lobes with more severe emphysema.

Amplitude-integrated electroencephalographic activity is suppressed in preterm infants with high scores on illness severity

NARCIS (Netherlands)

ter Horst, Hendrik J.; Jongbloed-Pereboom, Marjolein; van Eykern, Leo A.; Bos, Arend F.

Background: The neonatal acute physiology score. SNAP-II, reflects the severity of illness in newborns. In term newborns, amplitude integrated EEG (aEEG), is depressed following asphyxia. In preterm infants aEEG is discontinuous, and therefore more difficult to assess compared to term infants. Aims:

Evaluation of Revised International Staging System (R-ISS) for transplant-eligible multiple myeloma patients.

Science.gov (United States)

González-Calle, Verónica; Slack, Abigail; Keane, Niamh; Luft, Susan; Pearce, Kathryn E; Ketterling, Rhett P; Jain, Tania; Chirackal, Sintosebastian; Reeder, Craig; Mikhael, Joseph; Noel, Pierre; Mayo, Angela; Adams, Roberta H; Ahmann, Gregory; Braggio, Esteban; Stewart, A Keith; Bergsagel, P Leif; Van Wier, Scott A; Fonseca, Rafael

2018-04-06

The International Myeloma Working Group has proposed the Revised International Staging System (R-ISS) for risk stratification of multiple myeloma (MM) patients. There are a limited number of studies that have validated this risk model in the autologous stem cell transplant (ASCT) setting. In this retrospective study, we evaluated the applicability and value for predicting survival of the R-ISS model in 134 MM patients treated with new agents and ASCT at the Mayo Clinic in Arizona and the University Hospital of Salamanca in Spain. The patients were reclassified at diagnosis according to the R-ISS: 44 patients (33%) had stage I, 75 (56%) had stage II, and 15 (11%) had stage III. After a median follow-up of 60 months, R-ISS assessed at diagnosis was an independent predictor for overall survival (OS) after ASCT, with median OS not reached, 111 and 37 months for R-ISS I, II and III, respectively (P R-ISS II and having high-risk chromosomal abnormalities (CA) had a significant shorter median OS than those with R-ISS II without CA: 70 vs. 111 months, respectively. Therefore, this study lends further support for the R-ISS as a reliable prognostic tool for estimating survival in transplant myeloma patients and suggests the importance of high-risk CA in the R-ISS II group.

Magnetic resonance imaging versus Acute Physiology And Chronic Healthy Evaluation II score in predicting the severity of acute pancreatitis

International Nuclear Information System (INIS)

Tang Wei; Zhang Xiaoming; Xiao Bo; Zeng Nanlin; Pan Huashan; Feng Zhisong; Xu Xiaoxue

2011-01-01

Objective: To study the correlation between established magnetic resonance (MR) imaging criteria of disease severity in acute pancreatitis and the Acute Physiology And Chronic Healthy Evaluation II (APACHE II) score, and to assess the utility of each prognostic indicators in acute pancreatitis. Materials and methods: In this study there were 94 patients with acute pancreatitis (AP), all had abdominal MR imaging. MR findings were categorized into edematous and necrotizing AP and graded according to the MR severity index (MRSI). The APACHE II score was calculated within 24 h of admission, and local complications, death, duration of hospitalization and ICU were recorded. Statistical analysis was performed to determine their correlation. Results: In patients with pancreatitis, no significant correlation can be found between the APACHE II score and the MRSI score (P = 0.196). The MRSI score correlated well with morbidity (P = 0.006) but not with mortality (P = 0.137). The APACHE II score correlated well with mortality (P = 0.002) but not with the morbidity (P = 0.112). The MRSI score was superior to the APACHE II score as a predictor of the length of hospitalization (r = 0.52 vs. r = 0.35). A high MRSI and APACHE II score correlated with the need for being in the intensive care unit (ICU) (P = 0.000 and P = 0.000, respectively). Conclusion: In patients with pancreatitis, MRSI is superior to APACHE II in assessing local complications from pancreatitis but has a limited role in determining systemic complications in which the APACHE II score excels.

Potteri filmi režissöör murdis needuse

Index Scriptorium Estoniae

2007-01-01

Harry Potteri viienda filmi "Harry Potter ja Fööniksi ordu" režissöör David Yates on andnud oma nõusoleku jätkata režissöörina ka järgmise, "Harry Potter ja segavereline prints" filmi juures. Esilinastus 21. nov. 2008

The burden of infection in severely injured trauma patients and the relationship with admission shock severity.

Science.gov (United States)

Cole, Elaine; Davenport, Ross; Willett, Keith; Brohi, Karim

2014-03-01

Infection following severe injury is common and has a major impact on patient outcomes. The relationship between patient, injury, and physiologic characteristics with subsequent infections is not clearly defined. The objective of this study was to characterize the drivers and burden of all-cause infection in critical care trauma patients. A prospective cohort study of severely injured adult patients admitted to critical care was conducted. Data were collected prospectively on patient and injury characteristics, baseline physiology, coagulation profiles, and blood product use. Patients were followed up daily for infectious episodes and other adverse outcomes while in the hospital. Three hundred patients (Injury Severity Score [ISS] >15) were recruited. In 48 hours or less, 29 patients (10%) died, leaving a cohort of 271. One hundred forty-one patients (52%) developed at least one infection. Three hundred four infections were diagnosed overall. Infection and noninfection groups were matched for age, sex, mechanism, and ISS. Infection rates were greater with any degree of admission shock and threefold higher in the most severely shocked cohort (p < 0.01). In multivariate analysis, base deficit (odds ratio [OR], 1.78, 95% confidence interval [CI], 1.48-1.94; p < 0.001) and lactate (OR, 1.36; 95% CI, 1.10-1.69; p = 0.05) were independently associated with the development of infection. Outcomes were significantly worse for the patients with infection. In multivariate logistic regression, infection was the only factor independently associated with multiple-organ failure (p < 0.001; OR, 15.4; 95% CI, 8.2-28.9; r = 0.402), ventilator-free days (p < 0.001; β, -4.48; 95% CI, -6.7 to -2.1; r = 0.245), critical care length of stay (p < 0.001; β, 13.2; 95% CI, 10.0-16.4; r = 0.466), and hospital length of stay (p < 0.001; β, 31.1; 95% CI, 24.0-38.2; r = 0.492). Infectious complications are a burden for severely injured patients and occur early in the critical care stay

Cloning, expression and sequence diversity of iss gene from avian pathogenic Escherichia coli (APEC isolated in Brazil / Clonagem, expressão e diversidade na seqüência do gene iss de Escherichia coli patogênica para aves (APEC, isolada no Brasil

Directory of Open Access Journals (Sweden)

Marilda Carlos Vidotto

2010-09-01

Full Text Available A proteína Iss (increased serum survival é uma importante característica de resistência ao sistema complemento da Escherichia coli patogênica para aves (APEC. Os objetivos deste trabalho foram clonar e verificar a diversidade da seqüência do gene iss de APEC e caracterizar a proteína Iss recombinante. O gene iss de 309 bp foi amplificado por PCR, clonado e expresso na E. coli BL21 (DE3 utilizando o vetor pET SUMO. O gene iss da APEC9 foi classificado como iss tipo 1 pela diferenciação entre 3 tipos de iss alelos. A proteína Iss foi expressa pela indução com IPTG, purificada em coluna com resina ligada ao íon níquel e utilizada na imunização de galinhas poedeiras. Anticorpos da classe IgY anti rIss reagiram com a proteina rIss, a qual apresentou massa molecular de 22 kDa, correspondendo 11kDa da Iss e 11 kDa da proteína SUMO. The Iss (Increased serum survival protein is an important characteristic of resistance to complement system of avian pathogenic Escherichia coli (APEC. The objectives of this work were to cloning and verify the sequence diversity of iss gene from APEC and characterize the recombinant Iss protein. The iss gene of 309 bp was amplified by PCR, cloned and expressed in E. coli BL21 (DE3 using the pET SUMO vector. The iss gene from APEC9 strain was classified as iss type 1 by differentiation of the three iss gene allele types. The protein was expressed by induction of IPTG and purified in resin charged with the nickel ion. Antibodies IgY anti rIss reacted with rIss showing a molecular mass of 22 kDa, corresponding 11KDa of Iss protein and 11 KDa SUMO protein.

Somatic involvement assessed through a cumulative score of clinical severity in patients with eating disorders.

Science.gov (United States)

Scanelli, Giovanni; Gualandi, Malvina; Simoni, Marzia; Manzato, Emilia

2014-03-01

To evaluate the overall somatic involvement in patients with eating disorders (EDs). The medical records of 206 patients (age 15-56 years, 96.1% females) with diagnosis of anorexia nervosa (AN, n = 63, 30.6%), bulimia nervosa (BN, n = 78, 37.9%), or eating disorder not otherwise specified (EDNOS, n = 65, 31.6 %) were analyzed. A cumulative score of clinical severity (SCS) was computed according to the presence of physical, instrumental, and laboratory abnormalities, as well as to their prognostic impact. Based on the tertile distribution of SCS, three levels of severity were defined: low, medium, and high. A medium/high level of severity was found in 63% of the whole sample, 89% of AN, 49% of BN, and 55% of EDNOS. In the whole sample, the risk of medium/high SCS was significantly and inversely related to the body mass index (BMI) and to the lifetime minimum BMI. The severity level was significantly and positively associated with diagnosis of AN, duration of amenorrhea C1 year, and presence of ED-related symptoms. EDNOS patients showed a higher risk for increased SCS than BN patients, although not significantly. The non-negligible frequency of a relevant somatic involvement in patients with EDNOS suggests that a transdiagnostic scoring system might be helpful to identify ED cases at risk of medical complications.

GEROS-ISS: GNSS REflectometry, Radio Occultation and Scatterometry onboard the International Space Station

DEFF Research Database (Denmark)

Wickert, Jens; Cardellach, Estel; Bandeiras, Jorge

2016-01-01

GEROS-ISS stands for GNSS REflectometry, radio occultation, and scatterometry onboard the International Space Station (ISS). It is a scientific experiment, successfully proposed to the European Space Agency in 2011. The experiment as the name indicates will be conducted on the ISS. The main focus...... of GEROS-ISS is the dedicated use of signals from the currently available Global Navigation Satellite Systems (GNSS) in L-band for remote sensing of the Earth with a focus to study climate change. Prime mission objectives are the determination of the altimetric sea surface height of the oceans...

Should the IDC-9 Trauma Mortality Prediction Model become the new paradigm for benchmarking trauma outcomes?

Science.gov (United States)

Haider, Adil H; Villegas, Cassandra V; Saleem, Taimur; Efron, David T; Stevens, Kent A; Oyetunji, Tolulope A; Cornwell, Edward E; Bowman, Stephen; Haack, Sara; Baker, Susan P; Schneider, Eric B

2012-06-01

Optimum quantification of injury severity remains an imprecise science with a need for improvement. The accuracy of the criterion standard Injury Severity Score (ISS) worsens as a patient's injury severity increases, especially among patients with penetrating trauma. The objective of this study was to comprehensively compare the mortality prediction ability of three anatomic injury severity indices: the ISS, the New ISS (NISS), and the DRG International Classification of Diseases-9th Rev.-Trauma Mortality Prediction Model (TMPM-ICD-9), a recently developed contemporary injury assessment model. Retrospective analysis of patients in the National Trauma Data Bank from 2007 to 2008. The TMPM-ICD-9 values were computed and compared with the ISS and NISS for each patient using in-hospital mortality after trauma as the outcome measure. Discrimination and calibration were compared using the area under the receiver operator characteristic curve. Subgroup analysis was performed to compare each score across varying ranges of injury severity and across different types of injury. A total of 533,898 patients were identified with a crude mortality rate of 4.7%. The ISS and NISS performed equally in the groups with minor (ISS, 1-8) and moderate (ISS, 9-15) injuries, regardless of the injury type. However, in the populations with severe (ISS, 16-24) and very severe (ISS, ≥ 25) injuries for all injury types, the NISS predicted mortality better than the ISS did. The TMPM-ICD-9 outperformed both the NISS and ISS almost consistently. The NISS and TMPM-ICD-9 are both superior predictors of mortality as compared with the ISS. The immediate adoption of NISS for evaluating trauma outcomes using trauma registry data is recommended. The TMPM-ICD-9 may be an even better measure of human injury, and its use in administrative or nonregistry data is suggested. Further research on its attributes is recommended because it has the potential to become the basis for benchmarking trauma outcomes

Productivity of Mizuna Cultivated in the Space Greenhouse Onboard the Russian Module of the Iss

Science.gov (United States)

Levinskikh, Margarita; Sychev, Vladimir; Podolsky, Igor; Bingham, Gail; Moukhamedieva, Lana

As stipulated by the science program of research into the processes of growth, development, metabolism and reproduction of higher plants in microgravity in view of their potential use in advanced life support systems, five experiments on Mizuna plants (Brassica rapa var. nipponisica) were performed using the Lada space greenhouse onboard the ISS Russian Module (RM) during Expeditions ISS-5, 17 and 20-22. One of the goals of the experiments was to evaluate the productivity of Mizuna plants grown at different levels of ISS RM air contamination. Mizuna plants were cultivated for 31 - 36 days when exposed to continuous illumination. The root growing medium was made of Turface enriched with a controlled release fertilizer Osmocote. In the course of the flight experiments major parameters of plant cultivation, total level of ISS RM air contamination and plant microbiological status were measured. The grown plants were returned to Earth as fresh or frozen samples. After the three last vegetation cycles the plants were harvested, packed and frozen at -80 0C in the MELFI freezer on the ISS U.S. Module and later returned to Earth onboard Space Shuttle. It was found that the productivity and morphometric (e.g., plant height and mass, number of leaves) parameters of the plants grown in space did not differ from those seen in ground controls. The T coefficient, which represents the total contamination level of ISS air), was 4 (ISS-5), 22 (ISS-17), 55 (ISS-20), 22 (ISS-21) and 28 (ISS-22) versus the norm of no more than 5. In summary, a significant increase in the total contamination level of the ISS RM air did not reduce the productivity of the leaf vegetable plant used in the flight experiments.

Funding Medical Research Projects: Taking into Account Referees' Severity and Consistency through Many-Faceted Rasch Modeling of Projects' Scores.

Science.gov (United States)

Tesio, Luigi; Simone, Anna; Grzeda, Mariuzs T; Ponzio, Michela; Dati, Gabriele; Zaratin, Paola; Perucca, Laura; Battaglia, Mario A

2015-01-01

The funding policy of research projects often relies on scores assigned by a panel of experts (referees). The non-linear nature of raw scores and the severity and inconsistency of individual raters may generate unfair numeric project rankings. Rasch measurement (many-facets version, MFRM) provides a valid alternative to scoring. MFRM was applied to the scores achieved by 75 research projects on multiple sclerosis sent in response to a previous annual call by FISM-Italian Foundation for Multiple Sclerosis. This allowed to simulate, a posteriori, the impact of MFRM on the funding scenario. The applications were each scored by 2 to 4 independent referees (total = 131) on a 10-item, 0-3 rating scale called FISM-ProQual-P. The rotation plan assured "connection" of all pairs of projects through at least 1 shared referee.The questionnaire fulfilled satisfactorily the stringent criteria of Rasch measurement for psychometric quality (unidimensionality, reliability and data-model fit). Arbitrarily, 2 acceptability thresholds were set at a raw score of 21/30 and at the equivalent Rasch measure of 61.5/100, respectively. When the cut-off was switched from score to measure 8 out of 18 acceptable projects had to be rejected, while 15 rejected projects became eligible for funding. Some referees, of various severity, were grossly inconsistent (z-std fit indexes less than -1.9 or greater than 1.9). The FISM-ProQual-P questionnaire seems a valid and reliable scale. MFRM may help the decision-making process for allocating funds to MS research projects but also in other fields. In repeated assessment exercises it can help the selection of reliable referees. Their severity can be steadily calibrated, thus obviating the need to connect them with other referees assessing the same projects.

Simpler ISS Flight Control Communications and Log Keeping via Social Tools and Techniques

Science.gov (United States)

Scott, David W.; Cowart, Hugh; Stevens, Dan

2012-01-01

The heart of flight operations control involves a) communicating effectively in real time with other controllers in the room and/or in remote locations and b) tracking significant events, decisions, and rationale to support the next set of decisions, provide a thorough shift handover, and troubleshoot/improve operations. International Space Station (ISS) flight controllers speak with each other via multiple voice circuits or loops, each with a particular purpose and constituency. Controllers monitor and/or respond to several loops concurrently. The primary tracking tools are console logs, typically kept by a single operator and not visible to others in real-time. Information from telemetry, commanding, and planning systems also plays into decision-making. Email is very secondary/tertiary due to timing and archival considerations. Voice communications and log entries supporting ISS operations have increased by orders of magnitude because the number of control centers, flight crew, and payload operations have grown. This paper explores three developmental ground system concepts under development at Johnson Space Center s (JSC) Mission Control Center Houston (MCC-H) and Marshall Space Flight Center s (MSFC) Payload Operations Integration Center (POIC). These concepts could reduce ISS control center voice traffic and console logging yet increase the efficiency and effectiveness of both. The goal of this paper is to kindle further discussion, exploration, and tool development.

An Evidence-Based Approach To Exercise Prescriptions on ISS

Science.gov (United States)

Ploutz-Snyder, Lori

2009-01-01

This presentation describes current exercise countermeasures and exercise equipment for astronauts onboard the ISS. Additionally, a strategy for evaluating evidence supporting spaceflight exercise is described and a new exercise prescription is proposed. The current exercise regimen is not fully effective as the ISS exercise hardware does not allow for sufficient exercise intensity, the exercise prescription is adequate and crew members are noncompliant with the prescription. New ISS hardware is proposed, Advanced Resistance Exercise Device (ARED), which allows additional exercises, is instrumented for data acquisition and offers improved loading. The new T2 hardware offers a better harness and subject loading system, is instrumented to allow ground reaction force data, and offers improved speed. A strategy for developing a spaceflight exercise prescription is described and involves identifying exercise training programs that have been shown to maximize adaptive benefits of people exercising in both 0 and 1 g environments. Exercise intensity emerged as an important factor in maintaining physiologic adaptations in the spaceflight environment and interval training is suggested. New ISS exercise hardware should allow for exercise at intensities high enough to elicit adaptive responses. Additionally, new exercise prescriptions should incorporate higher intensity exercises and seek to optimize intensity, duration and frequency for greater efficiency.

The relationship between physical and psychological complaints and quality of life in severely injured patients.

Science.gov (United States)

van Delft-Schreurs, C C H M; van Son, M A C; de Jongh, M A C; Lansink, K W W; de Vries, J; Verhofstad, M H J

2017-09-01

The purpose of this study was two-fold. The first goal was to investigate which variables were associated with the remaining physical limitations of severely injured patients after the initial rehabilitation phase. Second, we investigated whether physical limitations were attributable to the association between psychological complaints and quality of life in this patient group. Patients who were 18 years or older and who had an injury severity score (ISS)>15 completed a set of questionnaires at one time-point after their rehabilitation phase (15-53 months after their trauma). The Short Musculoskeletal Function Assessment (SMFA) questionnaire was used to determine physical limitations. The Hospital Anxiety and Depression Scale, the Dutch Impact of Event Scale and the Cognitive Failure Questionnaire were used to determine psychological complaints, and the World Health Organization Quality of Life assessment instrument-BREF was used to measure general Quality of Life (QOL). Differences in physical limitations were investigated for several trauma- and patient-related variables using non-parametric independent-sample Mann-Whitney U tests. Multiple linear regression was performed to investigate whether the decreased QOL of severely injured patients with psychological complaints could be explained by their physical limitations. Older patients, patients with physical complaints before the injury, patients with higher ISS scores, and patients who had an injury of the spine or of the lower extremities reported significantly more physical problems. Additionally, patients with a low education level, patients who were living alone, and those who were unemployed reported significantly more long-term physical problems. Severely injured patients without psychological complaints reported significantly less physical limitations than those with psychological complaints. The SMFA factor of Lower extremity dysfunction was a confounder of the association between psychological complaints

An overview of NASA ISS human engineering and habitability: past, present, and future.

Science.gov (United States)

Fitts, D; Architecture, B

2000-09-01

The International Space Station (ISS) is the first major NASA project to provide human engineering an equal system engineering an equal system engineering status to other disciplines. The incorporation and verification of hundreds of human engineering requirements applied across-the-board to the ISS has provided for a notably more habitable environment to support long duration spaceflight missions than might otherwise have been the case. As the ISS begins to be inhabited and become operational, much work remains in monitoring the effectiveness of the Station's built environment in supporting the range of activities required of a long-duration vehicle. With international partner participation, NASA's ISS Operational Habitability Assessment intends to carry human engineering and habitability considerations into the next phase of the ISS Program with constant attention to opportunities for cost-effective improvements that need to be and can be made to the on-orbit facility. Too, during its operations the ISS must be effectively used as an on-orbit laboratory to promote and expand human engineering/habitability awareness and knowledge to support the international space faring community with the data needed to develop future space vehicles for long-duration missions. As future space mission duration increases, the rise in importance of habitation issues make it imperative that lessons are captured from the experience of human engineering's incorporation into the ISS Program and applied to future NASA programmatic processes.

ISS Material Science Research Rack HWIL Interface Simulation

Science.gov (United States)

Williams, Philip J.; Ballard, Gary H.; Crumbley, Robert T. (Technical Monitor)

2002-01-01

In this paper, the first Material Science Research Rack (MSRR-1) hardware-in-the-loop (HWIL) interface simulation is described. Dynamic Concepts developed this HWIL simulation system with funding and management provided by the Flight Software group (ED14) of NASA-MSFC's Avionics Department. The HWIL system has been used both as a flight software development environment and as a software qualification tool. To fulfill these roles, the HWIL simulator accurately models the system dynamics of many MSRR-1 subsystems and emulates most of the internal interface signals. The modeled subsystems include the Experiment Modules, the Thermal Environment Control System, the Vacuum Access System, the Solid State Power Controller Module, and the Active Rack Isolation Systems. The emulated signals reside on three separate MIL-STD-1553B digital communication buses, the ISS Medium Rate Data Link, and several analog controller and sensor signals. To enhance the range of testing, it was necessary to simulate several off-nominal conditions that may occur in the interfacing subsystems.

Mediterranean Diet in patients with acute ischemic stroke: Relationships between Mediterranean Diet score, diagnostic subtype, and stroke severity index.

Science.gov (United States)

Tuttolomondo, Antonino; Casuccio, Alessandra; Buttà, Carmelo; Pecoraro, Rosaria; Di Raimondo, Domenico; Della Corte, Vittoriano; Arnao, Valentina; Clemente, Giuseppe; Maida, Carlo; Simonetta, Irene; Miceli, Giuseppe; Lucifora, Benedetto; Cirrincione, Anna; Di Bona, Danilo; Corpora, Francesca; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio

2015-11-01

Adherence to a Mediterranean Diet appears to reduce the risk of cardiovascular disease, cancer, Alzheimer's disease, and Parkinson's disease, as well as the risk of death due to cardiovascular disease. No study has addressed the association between diagnostic subtype of stroke and its severity and adherence to a Mediterranean Diet in subjects with acute ischemic stroke. To evaluate the association between Mediterranean Diet adherence, TOAST subtype, and stroke severity by means of a retrospective study. The type of acute ischemic stroke was classified according to the TOAST criteria. All patients admitted to our ward with acute ischemic stroke completed a 137-item validated food-frequency questionnaire adapted to the Sicilian population. A scale indicating the degree of adherence to the traditional Mediterranean Diet was used (Me-Di score: range 0-9). 198 subjects with acute ischemic stroke and 100 control subjects without stroke. Stroke subjects had a lower mean Mediterranean Diet score compared to 100 controls without stroke. We observed a significant positive correlation between Me-Di score and SSS score, whereas we observed a negative relationship between Me-Di score and NIHSS and Rankin scores. Subjects with atherosclerotic (LAAS) stroke subtype had a lower mean Me-Di score compared to subjects with other subtypes. Multinomial logistic regression analysis in a simple model showed a negative relationship between MeDi score and LAAS subtype vs. lacunar subtype (and LAAS vs. cardio-embolic subtype). Patients with lower adherence to a Mediterranean Diet are more likely to have an atherosclerotic (LAAS) stroke, a worse clinical presentation of ischemic stroke at admission and a higher Rankin score at discharge. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system

Energy Technology Data Exchange (ETDEWEB)

Hiremath, Rudresh; Gowda, Goutham; Ibrahim, Jebin; Reddy, Harish T.; Chodiboina, Haritha; Shah, Rushit [Radiodiagnosis and Imaging, KVG Medical College and Hospital, Sullia (India)

2017-07-15

The aim of this study was to validate the diagnostic feasibility of a novel scoring system of peripheral arterial disease (PAD) in smokers and patients with diabetes depending on duplex Doppler sonographic features. Patients presenting with the symptomatology of PAD were divided into three groups: diabetes only, smoking only, and smokers with diabetes. The patients were clinically examined, a clinical severity score was obtained, and the subjects were categorized into the three extrapolated categories of mild, moderate, and severe. All 106 subjects also underwent a thorough duplex Doppler examination, and various aspects of PAD were assessed and tabulated. These components were used to create a novel duplex Doppler scoring system. Depending on the scores obtained, each individual was categorized as having mild, moderate, or severe illness. The Cohen kappa value was used to assess interobserver agreement between the two scoring systems. Interobserver agreement between the traditional Rutherford clinical scoring system and the newly invented duplex Doppler scoring system showed a kappa value of 0.83, indicating significant agreement between the two scoring systems (P<0.001). Duplex Doppler imaging is an effective screening investigation for lower extremity arterial disease, as it not only helps in its diagnosis, but also in the staging and grading of the disease, providing information that can be utilized for future management and treatment planning.

Comparison of the severity of lower extremity arterial disease in smokers and patients with diabetes using a novel duplex Doppler scoring system.

Science.gov (United States)

Hiremath, Rudresh; Gowda, Goutham; Ibrahim, Jebin; Reddy, Harish T; Chodiboina, Haritha; Shah, Rushit

2017-07-01

The aim of this study was to validate the diagnostic feasibility of a novel scoring system of peripheral arterial disease (PAD) in smokers and patients with diabetes depending on duplex Doppler sonographic features. Patients presenting with the symptomatology of PAD were divided into three groups: diabetes only, smoking only, and smokers with diabetes. The patients were clinically examined, a clinical severity score was obtained, and the subjects were categorized into the three extrapolated categories of mild, moderate, and severe. All 106 subjects also underwent a thorough duplex Doppler examination, and various aspects of PAD were assessed and tabulated. These components were used to create a novel duplex Doppler scoring system. Depending on the scores obtained, each individual was categorized as having mild, moderate, or severe illness. The Cohen kappa value was used to assess interobserver agreement between the two scoring systems. Interobserver agreement between the traditional Rutherford clinical scoring system and the newly invented duplex Doppler scoring system showed a kappa value of 0.83, indicating significant agreement between the two scoring systems (PDuplex Doppler imaging is an effective screening investigation for lower extremity arterial disease, as it not only helps in its diagnosis, but also in the staging and grading of the disease, providing information that can be utilized for future management and treatment planning.

Lightning Observations from the International Space Station (ISS) for Science Research and Operational Applications

Science.gov (United States)

Blakeslee, R. J.; Christian, H. J.; Mach, D. M.; Buechler, D. E.; Koshak, W. J.; Walker, T. D.; Bateman, M.; Stewart, M. F.; O'Brien, S.; Wilson, T.;

Trauma indices for prediction of acute respiratory distress syndrome.

Science.gov (United States)

Afshar, Majid; Smith, Gordon S; Cooper, Richard S; Murthi, Sarah; Netzer, Giora

2016-04-01

A myriad of trauma indices has been validated to predict probability of trauma survival. We aimed to compare the performance of commonly used indices for the development of the acute respiratory distress syndrome (ARDS). Historic, observational cohort study of 27,385 consecutive patients admitted to a statewide referral trauma center between July 11, 2003 and October 31, 2011. A validated algorithm was adapted to identify patients with ARDS. Each trauma index was evaluated in logistic regression using the area under the receiver operating characteristic curve. The case rate for ARDS development was 5.8% (1594). The receiver operating characteristics for injury severity score (ISS) had the best discrimination and had an area under the curve of 0.88 (95% confidence interval [CI] = 0.87-0.89). Glasgow coma score (0.71, 95% CI = 0.70-0.73), A Severity Characterization of Trauma (0.86, 95% CI = 0.85-0.87), Revised Trauma Score (0.71, 95% CI = 0.70-0.72) and thorax Abbreviated Injury Score (0.73, 95% CI = 0.72-0.74) performed worse (P < 0.001) and Trauma and Injury Severity Score (0.88, 95% CI = 0.87-0.88) performed equivocally (P = 0.51) in comparison to ISS. Using a cutoff point ISS ≥16, sensitivity and specificity were 84.9% (95% CI = 83.0%-86.6%) and 75.6% (95% CI = 75.1%-76.2%), respectively. Among commonly used trauma indices, ISS has superior or equivocal discriminative ability for development of ARDS. A cutoff point of ISS ≥16 provided good sensitivity and specificity. The use of ISS ≥16 is a simple method to evaluate ARDS in trauma epidemiology and outcomes research. Copyright © 2016 Elsevier Inc. All rights reserved.

Dose Calibration of the ISS-RAD Fast Neutron Detector

Science.gov (United States)

Zeitlin, C.

2015-01-01

The ISS-RAD instrument has been fabricated by Southwest Research Institute and delivered to NASA for flight to the ISS in late 2015 or early 2016. ISS-RAD is essentially two instruments that share a common interface to ISS. The two instruments are the Charged Particle Detector (CPD), which is very similar to the MSL-RAD detector on Mars, and the Fast Neutron Detector (FND), which is a boron-loaded plastic scintillator with readout optimized for the 0.5 to 10 MeV energy range. As the FND is completely new, it has been necessary to develop methodology to allow it to be used to measure the neutron dose and dose equivalent. This talk will focus on the methods developed and their implementation using calibration data obtained in quasi-monoenergetic (QMN) neutron fields at the PTB facility in Braunschweig, Germany. The QMN data allow us to determine an approximate response function, from which we estimate dose and dose equivalent contributions per detected neutron as a function of the pulse height. We refer to these as the "pSv per count" curves for dose equivalent and the "pGy per count" curves for dose. The FND is required to provide a dose equivalent measurement with an accuracy of ?10% of the known value in a calibrated AmBe field. Four variants of the analysis method were developed, corresponding to two different approximations of the pSv per count curve, and two different implementations, one for real-time analysis onboard ISS and one for ground analysis. We will show that the preferred method, when applied in either real-time or ground analysis, yields good accuracy for the AmBe field. We find that the real-time algorithm is more susceptible to chance-coincidence background than is the algorithm used in ground analysis, so that the best estimates will come from the latter.

Lessons Learned from ISS Cooperation

Science.gov (United States)

Jolly, C.

2002-01-01

Forty years of human spaceflight activities are now culminating in the International Space Station program (ISS). The ISS involves fifteen nations, working together to create a permanently occupied orbital facility that will support scientific and potentially, commercial endeavours. The assembly of the ISS is scheduled to be completed later in this decade, after which it will be operated for at least ten years. At the strategic level, such a complex international project is highly dependent on the fifteen Partners' respective internal politics and foreign policies. On the operational level, Partners still have certain difficulties in issuing and agreeing to common technical procedures. As with almost all aspects of International Space Station cooperation, the Partners are going through a constant learning process, where they have to deal with complex political, legal and operational differences. Intergovernmental Agreement and the Memoranda of Understanding, the instruments forming the legal backbone of the International Space Station cooperation, are still lacking a fair number of arrangements that need to be created for completing and operating the Station. The whole endeavour is also a constant learning process at the operational level, as astronauts, cosmonauts, engineers and technicians on the ground with different cultural and educational backgrounds, learn to work together. One recent Space Shuttle mission to the Station showed the importance of standardising even trivial system components such as packaging labels, as it took the astronauts half a day more than planned to correctly unpack the equipment. This paper will provide a synthesis of some of the main lessons learned during the first few years of International Space Station's lifetime. Important political, legal and operational issues will be addressed and combined. This analysis will provide some guidelines and recommendations for future international space projects, such as an international human

Microbial Observatory (ISS-MO): Antimicrobial resistance genes

Data.gov (United States)

National Aeronautics and Space Administration — The environmental samples were collected with the polyester wipes from eight different locations in the International Space Station (ISS) during two consecutive...

APACHE II SCORING SYSTEM AND ITS MODIFICATION FOR THE ASSESSMENT OF DISEASE SEVERITY IN CHILDREN WHO UNDERWENT POLYCHEMOTHERAPY

Directory of Open Access Journals (Sweden)

А. V. Sotnikov

2014-01-01

Full Text Available Short-term disease prognosis should be considered for the appropriate treatment policy based on the assessment of disease severity in patients with acute disease. The adequate assessment of disease severity and prognosis allows the indications for transferring patients to the resuscitation and intensive care department to be defined more precisely. Disease severity of patients who underwent polychemotherapy was assessed using APACHE II scoring system.

Emir Kusturica - maailmakuulus režissöör või lihtne bändi bassimees?

Index Scriptorium Estoniae

2008-01-01

26. aprillil esineb Tallinnas Serbia filmirežissöör Emir Kusturica koos Balkani ansambliga No Smoking Orchestra. Esitlusele tuleb muusika, mis kirjutatud režissööri filmile "Lubadus" ("Zavet"). Muusika autoriteks on ansambli juht Nele Karajlic ja režissöör ise. Režissöörist

ISS Ambient Air Quality: Updated Inventory of Known Aerosol Sources

Science.gov (United States)

Meyer, Marit

2014-01-01

Spacecraft cabin air quality is of fundamental importance to crew health, with concerns encompassing both gaseous contaminants and particulate matter. Little opportunity exists for direct measurement of aerosol concentrations on the International Space Station (ISS), however, an aerosol source model was developed for the purpose of filtration and ventilation systems design. This model has successfully been applied, however, since the initial effort, an increase in the number of crewmembers from 3 to 6 and new processes on board the ISS necessitate an updated aerosol inventory to accurately reflect the current ambient aerosol conditions. Results from recent analyses of dust samples from ISS, combined with a literature review provide new predicted aerosol emission rates in terms of size-segregated mass and number concentration. Some new aerosol sources have been considered and added to the existing array of materials. The goal of this work is to provide updated filtration model inputs which can verify that the current ISS filtration system is adequate and filter lifetime targets are met. This inventory of aerosol sources is applicable to other spacecraft, and becomes more important as NASA considers future long term exploration missions, which will preclude the opportunity for resupply of filtration products.

Present status of severe head injured patients with an admission glasgow coma scale score of 3 based on the Japan neurotrauma data bank

International Nuclear Information System (INIS)

Uzura, Masahiko

2011-01-01

Severe head injured patients presenting with Glasgow Coma Scale (GCS) score of 3 have been hesitated to treat aggressively. We analyzed present status of patients with GCS score of 3 from the Project 2004 in the Japan Neurotrauma Data Bank. Among 1,101 cases registered, 805 cases with GCS score of 8 or less on admission. Of those, 215 cases with GCS score of 3 were classified the survival group (51 cases) and the dead group (164 cases) and compared each group. These results showed that the characteristics associated with favorable outcome including absence of cardiopulmonary arrest, no abnormality of pupil findings, stable condition of respiration and circulation, serum glucose level (less than 184 mg/dl), absence of initial CT findings including skull base fracture, pneumocephalus and subarachnoid hemorrhage, no serious extracranial injures including Injury Severity Scale score of less than 25, critic al care including intracranial pressure monitoring and temperature management. We suggest that it is important to treat brain and systemic problems aggressively in severe head injured patients with GCS score of 3. (author)

Association of Osteoporosis Self-Assessment Tool for Asians (OSTA Score with Clinical Presentation and Expenditure in Hospitalized Trauma Patients with Femoral Fractures

Directory of Open Access Journals (Sweden)

Chien-Chang Chen

2016-10-01

Full Text Available Background: A cross-sectional study to investigate the association of Osteoporosis Self-Assessment Tool for Asians (OSTA score with clinical presentation and expenditure of hospitalized adult trauma patients with femoral fractures. Methods: According to the data retrieved from the Trauma Registry System between 1 January 2009 and 31 December 2015, a total of 2086 patients aged ≥40 years and hospitalized for treatment of traumatic femoral bone fracture were categorized as high-risk patients (OSTA < −4, n = 814, medium-risk patients (−1 ≥ OSTA ≥ −4, n = 634, and low-risk patients (OSTA > −1, n = 638. Two-sided Pearson’s, chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann-Whitney U-test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed using Number Crunching Statistical Software (NCSS software (NCSS 10; NCSS Statistical Software, Kaysville, UT, USA, with adjusted covariates including mechanism and Glasgow Coma Scale (GCS; injuries were assessed based on the Abbreviated Injury Scale (AIS, and Injury Severity Score (ISS was used to evaluate the effect of OSTA-related grouping on a patient’s outcome. Results: High-risk and medium-risk patients were predominantly female, presented with significantly older age and higher incidences of co-morbidity, and were injured in a fall accident more frequently than low-risk patients. High-risk patients and medium-risk patients had a different pattern of femoral fracture and a significantly lower ISS. Although high-risk and medium-risk patients had significantly shorter lengths hospital of stay (LOS and less total expenditure than low-risk patients did, similar results were not found in the selected propensity score-matched patients, implying that the difference may be attributed to the associated injury severity of the patients with femoral

Direct to Operating Room Trauma Resuscitation Decreases Mortality Among Severely Injured Children.

Science.gov (United States)

Wieck, Minna M; Cunningham, Aaron J; Behrens, Brandon; Ohm, Erika T; Maxwell, Bryan G; Hamilton, Nicholas A; Adams, M Christopher; Cole, Frederick J; Jafri, Mubeen A

2018-03-16

Expediting evaluation and intervention for severely injured patients has remained a mainstay of advanced trauma care. One technique, direct to operating room (DOR) resuscitation, for selective adult patients has demonstrated decreased mortality. We sought to investigate the application of this protocol in children. All DOR pediatric patients from 2009-2016 at a pediatric Level I Trauma Center were identified. DOR criteria included penetrating injury, chest injuries, amputations, significant blood loss, cardiopulmonary resuscitation, and surgeon discretion. Demographics, injury patterns, interventions, and outcomes were analyzed. Observed mortality was compared to expected mortality, calculated using Trauma Injury Severity Score (TRISS) methodology, with two-tailed t-tests and a p-value 15, 33% had GCS≤8, and 9% were hypotensive. The most commonly injured body regions were external (66%), head (34%), chest (30%), and abdomen (27%). Sixty-seven patients (82%) required emergent procedural intervention, most commonly wound exploration/repair (35%), central venous access (22%), tube thoracostomy (19%) and laparotomy (18%). Predictors of intervention were ISS>15 (odds ratio=14, p=0.013) and GCS<9 (odds ratio=8.5, p=0.044). The survival rate to discharge for DOR patients was 84% compared with an expected survival of 79% (TRISS) (p=0.4). The greatest improvement relative to expected mortality was seen in the subgroup with penetrating trauma (84.5% vs. 74.4%, p=0.002). A selective policy of resuscitating the most severely injured children in the operating room can decrease mortality. Patients suffering penetrating trauma with the highest ISS and diminished GCS have the greatest benefit. Trauma centers with appropriate resources should evaluate implementing similar policies. Level II. Diagnostic tests or criteria.

Patients with tattoo reactions have reduced quality of life and suffer from itch

DEFF Research Database (Denmark)

Hutton Carlsen, K; Serup, J

2015-01-01

Life Quality Index (DLQI) scoring system and Itch Severity Scale (ISS). METHODS: Patients attending the 'Tattoo Clinic' at Bispebjerg University Hospital, Denmark with tattoo problems spanning more than 3 months were invited. Forty patients participated during September-November 2012. Patients...... attending their routine consultations completed the ISS and DLQI questionnaires. RESULTS: Patients with tattoo reactions experienced reduced quality of life, DLQI score 7.4 and were burdened by itch, ISS score 7.2. Both DLQI and ISS results attained the level of discomfort of known skin diseases...... such as psoriasis, pruritus and eczema albeit the typical tattooed affected areas are smaller. CONCLUSION/DISCUSSION: Sufferers of tattoo reactions have reduced quality of life and are often burdened by itching attaining the level of other cumbersome afflictions recognized as dermatological diseases associated...

Lightning Imaging Sensor (LIS) on the International Space Station (ISS): Launch, Installation, Activation, and First Results

Science.gov (United States)

Blakeslee, R. J.; Christian, H. J., Jr.; Mach, D. M.; Buechler, D. E.; Wharton, N. A.; Stewart, M. F.; Ellett, W. T.; Koshak, W. J.; Walker, T. D.

2017-12-01

Over two decades, the NASA Marshall Space Flight Center, the University of Alabama in Huntsville, and their partners developed and demonstrated the effectiveness and value of space-based lightning observations as a remote sensing tool for Earth science research and applications, and, in the process, established a robust global lightning climatology. The Lightning Imaging Sensor (LIS) on the Tropical Rainfall Measuring Mission (TRMM) provided global observations of tropical lightning for an impressive 17 years before that mission came to a close in April 2015. Now a space-qualified LIS, built as the flight spare for TRMM, has been installed on the International Space Station (ISS) for a minimum two year mission following its SpaceX launch on February 19, 2017. The LIS, flown as a hosted payload on the Department of Defense Space Test Program-Houston 5 (STP-H5) mission, was robotically installed in an Earth-viewing position on the outside of the ISS, providing a great opportunity to not only extend the 17-year TRMM LIS record of tropical lightning measurements but also to expand that coverage to higher latitudes missed by the TRMM mission. Since its activation, LIS has continuously observed the amount, rate, and radiant energy lightning within its field-of-view as it orbits the Earth. A major focus of this mission is to better understand the processes which cause lightning, as well as the connections between lightning and subsequent severe weather events. This understanding is a key to improving weather predictions and saving lives and property here in the United States and around the world. The LIS measurements will also help cross-validate observations from the new Geostationary Lightning Mapper (GLM) operating on NOAA's newest weather satellite GOES-16. An especially unique contribution from the ISS platform will be the availability of real-time lightning data, especially valuable for operational forecasting and warning applications over data sparse regions such

Detection and severity of coronary disease: comparison between Framingham and calcium scores using multi-slice tomography

International Nuclear Information System (INIS)

Rodriguez Gomez, Maria Liliana; Montenegro, Edison; Ruiz, Angela Maria; Ardila, Jaime

2011-01-01

Introduction: multiple studies have shown that the coronary calcium index is an independent, more accurate predictor of future coronary events in relation to traditional risk factors. However, these studies have not been conducted in populations of developing countries like Colombia. Objective: to compare the strength of association between the Framingham index and the coronary calcium score in detecting the presence and severity of coronary disease as defined by 64-channel multi-slice angio-CT in order to provide additional information for decision-making in our asymptomatic coronary population. Methodology: we reviewed the written reports of coronary angiography scans performed in past 3 years. Based on this information, bivariate (calculation of Spearman rho correlation coefficients) and multivariate (logistic regression) analyses were performed. Results: the coronary calcium score showed a higher correlation with the presence and severity of coronary disease, Spearman Rho coefficient, compared with the Framingham index, Spearman's Rho coefficient of 0.30 (p<0.001). The moderate Framingham index (10-19%) shows no strength of association with significant and non-significant coronary artery disease, OR = 2, 51 CI 95% (0.7-8.9) and OR = 2.3 CI 95% (0.86-6.15), respectively. Patients with calcium values = 100 showed significant strength of association, OR = 182, 95% (17.4 -190.2), with significant coronary disease compared with high Framingham index values (=20%), OR = 18.6, CI 95% (1.75-198). Conclusions: the coronary calcium score has a higher correlation with the presence and severity of coronary disease when compared with the Framingham index. There is a low correlation between the index and Framingham coronary calcium.

Application of the ATLAS score for evaluating the severity of Clostridium difficile infection in teaching hospitals in Mexico.

Science.gov (United States)

Hernández-García, Raúl; Garza-González, Elvira; Miller, Mark; Arteaga-Muller, Giovanna; Galván-de los Santos, Alejandra María; Camacho-Ortiz, Adrián

2015-01-01

For clinicians, a practical bedside tool for severity assessment and prognosis of patients with Clostridium difficile infection is a highly desirable unmet medical need. Two general teaching hospitals in northeast Mexico. Adult patients with C. difficile infection. Prospective observational study. Patients included had a median of 48 years of age, 54% of male gender and an average of 24.3 days length of hospital stay. Third generation cephalosporins were the antibiotics most commonly used prior to C. difficile infection diagnosis. Patients diagnosed with C. difficile infection had a median ATLAS score of 4 and 56.7% of the subjects had a score between 4 and 7 points. Patients with a score of 8 through 10 points had 100% mortality. The ATLAS score is a potentially useful tool for the routine evaluation of patients at the time of C. difficile infection diagnosis. At 30 days post-diagnosis, patients with a score of ≤3 points had 100% survival while all of those with scores ≥8 died. Patients with scores between 4 and 7 points had a greater probability of colectomy with an overall cure rate of 70.1%. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

[Predictive values of different critical scoring systems for mortality in patients with severe acute respiratory failure supported by extracorporeal membrane oxygenation].

Science.gov (United States)

Wang, R; Sun, B; Li, X Y; He, H Y; Tang, X; Zhan, Q Y; Tong, Z H

2016-09-01

To investigate the predictive values of different critical scoring systems for mortality in patients with severe acute respiratory failure (ARF) supported by venovenous extracorporeal membrane oxygenation (VV-ECMO). Forty-two patients with severe ARF supported by VV-ECMO were enrolled from November 2009 to July 2015.There were 25 males and 17 females. The mean age was (44±18) years (rang 18-69 years). Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, Ⅲ, Ⅳ, Simplified Acute Physiology Score Ⅱ (SAPS) Ⅱ, Sequential Organ Failure Assessment (SOFA), ECMO net, PRedicting dEath for SEvere ARDS on VVECMO (PRESERVE), and Respiratory ECMO Survival Prediction (RESP) scores were collected within 6 hours before VV-ECMO support. The patients were divided into the survivors group (n=17) and the nonsurvivors group (n=25) by survival at 180 d after receiving VV-ECMO. The patient clinical characteristics and aforementioned scoring systems were compared between groups. Scoring systems for predicting prognosis were assessed using the area under the receiver-operating characteristic (ROC) curve. The Kaplan-Meier method was used to draw the surviving curve, and the survival of the patients was analyzed by the Log-rank test. The risk factors were assessed for prognosis by multiple logistic regression analysis. (1) Positive end expiratory pressure (PEEP) 6 hours prior to VV-ECMO support in the survivors group [(9.7±5.0)cmH2O, (1 cmH2O=0.098 kPa)] was lower than that in the nonsurvivors group [(13.2±5.4)cmH2O, t=-2.134, P=0.039]. VV-ECMO combination with continuous renal replacement therapy(CRRT) in the nonsurvivors group (32%) was used more than in the survivors group (6%, χ(2)=4.100, P=0.043). Duration of VV-ECMO support in the nonsurvivors group [(15±13) d] was longer than that in the survivors group [(12±11)d, t=-2.123, P=0.041]. APACHE Ⅱ, APACHE Ⅲ, APACHE Ⅳ, ECMO net, PRESERVE, and RESP scores in the survivors group were superior to the nonsurvivors

Visual-Constructional Ability in Individuals with Severe Obesity: Rey Complex Figure Test Accuracy and the Q-Score

Directory of Open Access Journals (Sweden)

Hanna L. Sargénius

2017-09-01

Full Text Available The aims of this study were to investigate visual-construction and organizational strategy among individuals with severe obesity, as measured by the Rey Complex Figure Test (RCFT, and to examine the validity of the Q-score as a measure for the quality of performance on the RCFT. Ninety-six non-demented morbidly obese (MO patients and 100 healthy controls (HC completed the RCFT. Their performance was calculated by applying the standard scoring criteria. The quality of the copying process was evaluated per the directions of the Q-score scoring system. Results revealed that the MO did not perform significantly lower than the HC on Copy accuracy (mean difference −0.302, CI −1.374 to 0.769, p = 0.579. In contrast, the groups did statistically differ from each other, with MO performing poorer than the HC on the Q-score (mean −1.784, CI −3.237 to −0.331, p = 0.016 and the Unit points (mean −1.409, CI −2.291 to −0.528, p = 0.002, but not on the Order points score (mean −0.351, CI −0.994 to 0.293, p = 0.284. Differences on the Unit score and the Q-score were slightly reduced when adjusting for gender, age, and education. This study presents evidence supporting the presence of inefficiency in visuospatial constructional ability among MO patients. We believe we have found an indication that the Q-score captures a wider range of cognitive processes that are not described by traditional scoring methods. Rather than considering accuracy and placement of the different elements only, the Q-score focuses more on how the subject has approached the task.

The value of coronary artery calcium score assessed by dual-source computed tomography coronary angiography for predicting presence and severity of coronary artery disease

International Nuclear Information System (INIS)

Almasi, Alireza; Pouraliakbar, Hamidreza; Sedghian, Ahmad; Karimi, Mohammad Ali; Firouzi, Ata; Tehrai, Mahmood

2014-01-01

Measuring coronary artery calcium score (CACS) using a dual-source CT scanner is recognized as a major indicator for assessing coronary artery disease. The present study aimed to validate the clinical significance of CACS in predicting coronary artery stenosis and its severity. This prospective study was conducted on 202 consecutive patients who underwent both conventional coronary angiography and dual-source (256-slice) computed tomography coronary angiography (CTA) for any reason in our cardiac imaging center from March to September 2013. CACS was measured by Agatston algorithm on non-enhanced CT. The severity of coronary artery disease was assessed by Gensini score on conventional angiography. There was a significant relationship between the number of diseased coronary vessels and mean calcium score, i.e. the mean calcium score was 202.25±450.06 in normal coronary status, 427.50±607.24 in single-vessel disease, 590.03±511.34 in two-vessel disease, and 953.35±1023.45 in three-vessel disease (p<0.001). There was a positive association between calcium score and Gensini score (r=0.636, p<0.001). In a linear regression model, calcium score was a strong determinant of the severity of coronary artery disease. Calcium scoring had an acceptable value for discriminating coronary disease from normal condition with optimal cutoff point of 350, yielding a sensitivity and specificity of 83% and 70%, respectively. Our study confirmed the strong relationship between the coronary artery calcium score and the presence and severity of stenosis in coronary arteries assessed by both the number of diseased coronary vessels and also by the Gnesini score

ITER ISS system alternative specification study

International Nuclear Information System (INIS)

Kveton, O.K.

1990-08-01

Recent comments suggested that the fuel systems, in particular the ISS, could be simplified if the ITER specifications were relaxed from the data specified for ITER. This interim report addresses the first part of the analysis, which considers the impact of design specifications on fuel systems design

ISS protocol for EPR tooth dosimetry

International Nuclear Information System (INIS)

Onori, S.; Aragno, D.; Fattibene, P.; Petetti, E.; Pressello, M.C.

2000-01-01

The accuracy in Electron Paramagnetic Resonance (EPR) dose reconstruction with tooth enamel is affected by sample preparation, dosimetric signal amplitude evaluation and unknown dose estimate. Worldwide efforts in the field of EPR dose reconstruction with tooth enamel are focused on the optimization of the three mentioned steps in dose assessment. In the present work, the protocol implemented at ISS in the framework of the European Community Nuclear Fission Safety project 'Dose Reconstruction' is presented. A combined mechanical-chemical procedure for ground enamel sample preparation is used. The signal intensity evaluation is carried out with powder spectra simulation program. Finally, the unknown dose is evaluated individually for each sample with the additive dose method. The unknown dose is obtained by subtracting a mean native dose from the back-extrapolated dose. As an example of the capability of the ISS protocol in unknown dose evaluation, the results obtained in the framework of the 2nd International Intercomparison on EPR tooth enamel dosimetry are reported

Report on ISS Oxygen Production, Resupply, and Partial Pressure Management

Science.gov (United States)

Schaezler, Ryan; Ghariani, Ahmed; Leonard, Daniel; Lehman, Daniel

2011-01-01

The majority of oxygen used on International Space Station (ISS) is for metabolic support and denitrogenation procedures prior to Extra-Vehicular Activities. Oxygen is supplied by various visiting vehicles such as the Progress and Shuttle in addition to oxygen production capability on both the United States On-Orbit Segment (USOS) and Russian Segment (RS). To maintain a habitable atmosphere the oxygen partial pressure is controlled between upper and lower bounds. The full range of the allowable oxygen partial pressure along with the increased ISS cabin volume is utilized as a buffer allowing days to pass between oxygen production or direct addition of oxygen to the atmosphere from reserves. This paper summarizes amount of oxygen supplied and produced from all of the sources and describes past experience of managing oxygen partial pressure along with the range of management options available to the ISS.

ISS qualified thermal carrier equipment

Science.gov (United States)

Deuser, Mark S.; Vellinger, John C.; Jennings, Wm. M.

2000-01-01

Biotechnology is undergoing a period of rapid and sustained growth, a trend which is expected to continue as the general population ages and as new medical treatments and products are conceived. As pharmaceutical and biomedical companies continue to search for improved methods of production and, for answers to basic research questions, they will seek out new avenues of research. Space processing on the International Space Station (ISS) offers such an opportunity! Space is rapidly becoming an industrial laboratory for biotechnology research and processing. Space bioprocessing offers exciting possibilities for developing new pharmaceuticals and medical treatments, which can be used to benefit mankind on Earth. It also represents a new economic frontier for the private sector. For over eight years, the thermal carrier development team at SHOT has been working with government and commercial sector scientists who are conducting microgravity experiments that require thermal control. SHOT realized several years ago that the hardware currently being used for microgravity thermal control was becoming obsolete. It is likely that the government, academic, and industrial bioscience community members could utilize SHOT's hardware as a replacement to their current microgravity thermal carrier equipment. Moreover, SHOT is aware of several international scientists interested in utilizing our space qualified thermal carrier. SHOT's economic financing concept could be extremely beneficial to the international participant, while providing a source of geographic return for their particular region. Beginning in 2000, flight qualified thermal carriers are expected to be available to both the private and government sectors. .

Photography of Coral Reefs from ISS

Science.gov (United States)

Robinson, Julie A.

2009-01-01

This viewgraph presentation reviews the uses of photography from the International Space Station (ISS) in studying Earth's coral reefs. The photographs include reefs in various oceans . The photographs have uses for science in assisting NASA mapping initiatives, distribution worldwide through ReefBase, and by biologist in the field.

Using the International Space Station (ISS) Oxygen Generation Assembly (OGA) Is Not Feasible for Mars Transit

Science.gov (United States)

Jones, Harry W.

2016-01-01

A review of two papers on improving the International Space Station (ISS) Oxygen Generation Assembly (OGA) shows that it would not save substantial mass on a Mars transit. The ISS OGA requires redesign for satisfactory operation, even for the ISS. The planned improvements of the OGA for ISS would not be sufficient to make it suitable for Mars, because Mars transit life support has significantly different requirements than ISS. The OGA for Mars should have lower mass, better reliability and maintainability, greater safety, radiation hardening, and capability for quiescent operation. NASA's methodical, disciplined systems engineering process should be used to develop the appropriate system.

Patterns in deer-related traffic injuries over a decade: the Mayo clinic experience

Directory of Open Access Journals (Sweden)

Smoot Dustin L

2010-08-01

Full Text Available Abstract Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC. We characterized injury patterns between motorcycle/all-terrain vehicles (MCC and automobile (MVC crashes related to dMVC (deer motor vehicle crash with the hypotheses that MCC will present with higher Injury Severity Score (ISS and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS. Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5 and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained.

Growth of 48 built environment bacterial isolates on board the International Space Station (ISS

Directory of Open Access Journals (Sweden)

David A. Coil

2016-03-01

Full Text Available Background. While significant attention has been paid to the potential risk of pathogenic microbes aboard crewed spacecraft, the non-pathogenic microbes in these habitats have received less consideration. Preliminary work has demonstrated that the interior of the International Space Station (ISS has a microbial community resembling those of built environments on Earth. Here we report the results of sending 48 bacterial strains, collected from built environments on Earth, for a growth experiment on the ISS. This project was a component of Project MERCCURI (Microbial Ecology Research Combining Citizen and University Researchers on ISS. Results. Of the 48 strains sent to the ISS, 45 of them showed similar growth in space and on Earth using a relative growth measurement adapted for microgravity. The vast majority of species tested in this experiment have also been found in culture-independent surveys of the ISS. Only one bacterial strain showed significantly different growth in space. Bacillus safensis JPL-MERTA-8-2 grew 60% better in space than on Earth. Conclusions. The majority of bacteria tested were not affected by conditions aboard the ISS in this experiment (e.g., microgravity, cosmic radiation. Further work on Bacillus safensis could lead to interesting insights on why this strain grew so much better in space.

Life science experiments performed in space in the ISS/Kibo facility and future research plans.

Science.gov (United States)

Ohnishi, Takeo

2016-08-01

Over the past several years, current techniques in molecular biology have been used to perform experiments in space, focusing on the nature and effects of space radiation. In the Japanese 'Kibo' facility in the International Space Station (ISS), the Japan Aerospace Exploration Agency (JAXA) has performed five life science experiments since 2009, and two additional experiments are currently in progress. The first life science experiment in space was the 'Rad Gene' project, which utilized two human cultured lymphoblastoid cell lines containing a mutated P53 : gene (m P53 : ) and a parental wild-type P53 : gene (wt P53 : ) respectively. Four parameters were examined: (i) detecting space radiation-induced DSBs by observing γH2AX foci; (ii) observing P53 : -dependent gene expression during space flight; (iii) observing P53 : -dependent gene expression after space flight; and (iv) observing the adaptive response in the two cell lines containing the mutated and wild type P53 : genes after exposure to space radiation. These observations were completed and have been reported, and this paper is a review of these experiments. In addition, recent new information from space-based experiments involving radiation biology is presented here. These experiments involve human cultured cells, silkworm eggs, mouse embryonic stem cells and mouse eggs in various experiments designed by other principal investigators in the ISS/Kibo. The progress of Japanese science groups involved in these space experiments together with JAXA are also discussed here. The Japanese Society for Biological Sciences in Space (JSBSS), the Utilization Committee of Space Environment Science (UCSES) and the Science Council of Japan (ACJ) have supported these new projects and new experimental facilities in ISS/Kibo. Currently, these organizations are proposing new experiments for the ISS through 2024. © The Author 2016. Published by Oxford University Press on behalf of The Japan Radiation Research Society and

Life science experiments performed in space in the ISS/Kibo facility and future research plans

International Nuclear Information System (INIS)

Ohnishi, Takeo

2016-01-01

Over the past several years, current techniques in molecular biology have been used to perform experiments in space, focusing on the nature and effects of space radiation. In the Japanese ‘Kibo’ facility in the International Space Station (ISS), the Japan Aerospace Exploration Agency (JAXA) has performed five life science experiments since 2009, and two additional experiments are currently in progress. The first life science experiment in space was the ‘Rad Gene’ project, which utilized two human cultured lymphoblastoid cell lines containing a mutated p53 gene (mp53) and a parental wild-type p53 gene (wtp53) respectively. Four parameters were examined: (i) detecting space radiation–induced DSBs by observing γH2AX foci; (ii) observing p53-dependent gene expression during space flight; (iii) observing p53-dependent gene expression after space flight; and (iv) observing the adaptive response in the two cell lines containing the mutated and wild type p53 genes after exposure to space radiation. These observations were completed and have been reported, and this paper is a review of these experiments. In addition, recent new information from space-based experiments involving radiation biology is presented here. These experiments involve human cultured cells, silkworm eggs, mouse embryonic stem cells and mouse eggs in various experiments designed by other principal investigators in the ISS/Kibo. The progress of Japanese science groups involved in these space experiments together with JAXA are also discussed here. The Japanese Society for Biological Sciences in Space (JSBSS), the Utilization Committee of Space Environment Science (UCSES) and the Science Council of Japan (ACJ) have supported these new projects and new experimental facilities in ISS/Kibo. Currently, these organizations are proposing new experiments for the ISS through 2024

Space Environment Effects on Materials at Different Positions and Operational Periods of ISS

Science.gov (United States)

Kimoto, Yugo; Ichikawa, Shoichi; Miyazaki, Eiji; Matsumoto, Koji; Ishizawa, Junichiro; Shimamura, Hiroyuki; Yamanaka, Riyo; Suzuki, Mineo

2009-01-01

A space materials exposure experiment was condcuted on the exterior of the Russian Service Module (SM) of the International Space Station (ISS) using the Micro-Particles Capturer and Space Environment Exposure Device (MPAC&SEED) of the Japan Aerospace Exploration Agency (JAXA). Results reveal artificial environment effects such as sample contamination, attitude change effects on AO fluence, and shading effects of UV on ISS. The sample contamination was coming from ISS components. The particles attributed to micrometeoroids and/or debris captured by MPAC might originate from the ISS solar array. Another MPAC&SEED will be aboard the Exposure Facility of the Japanese Experiment Module, KIBO Exposure Facility (EF) on ISS. The JEM/MPAC&SEED is attached to the Space Environment Data Acquisition Equipment-Attached Payload (SEDA-AP) and is exposed to space. Actually, SEDA-AP is a payload on EF to be launched by Space Shuttle flight 2J/A. In fact, SEDA-AP has space environment monitors such as a high-energy particle monitor, atomic oxygen monitor, and plasma monitor to measure in-situ natural space environment data during JEM/MPAC&SEED exposure. Some exposure samples for JEM/MPAC&SEED are identical to SM/MPAC&SEED samples. Consequently, effects on identical materials at different positions and operation periods of ISS will be evaluated. This report summarizes results from space environment monitoring samples for atomic oxygen analysis on SM/MPAC&SEED, along with experimental plans for JEM/MPAC&SEED.

Effect of Age on Glasgow Coma Scale in Patients with Moderate and Severe Traumatic Brain Injury: An Approach with Propensity Score-Matched Population

Directory of Open Access Journals (Sweden)

Cheng-Shyuan Rau

2017-11-01

Full Text Available Background: The most widely used methods of describing traumatic brain injury (TBI are the Glasgow Coma Scale (GCS and the Abbreviated Injury Scale (AIS. Recent evidence suggests that presenting GCS in older patients may be higher than that in younger patients for an equivalent anatomical severity of TBI. This study aimed to assess these observations with a propensity-score matching approach using the data from Trauma Registry System in a Level I trauma center. Methods: We included all adult patients (aged ≥20 years old with moderate to severe TBI from 1 January 2009 to 31 December 2016. Patients were categorized into elderly (aged ≥65 years and young adults (aged 20–64 years. The severity of TBI was defined by an AIS score in the head (AIS 3‒4 and 5 indicate moderate and severe TBI, respectively. We examined the differences in the GCS scores by age at each head AIS score. Unpaired Student’s t- and Mann–Whitney U-tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using either the Pearson chi-square or two-sided Fisher’s exact tests. Matched patient populations were allocated in a 1:1 ratio according to the propensity scores calculated using NCSS software with the following covariates: sex, pre-existing chronic obstructive pulmonary disease, systolic blood pressure, hemoglobin, sodium, glucose, and alcohol level. Logistic regression was used to evaluate the effects of age on the GCS score in each head AIS stratum. Results: The study population included 2081 adult patients with moderate to severe TBI. These patients were categorized into elderly (n = 847 and young adults (n = 1234: each was exclusively further divided into three groups of patients with head AIS of 3, 4, or 5. In the 162 well-balanced pairs of TBI patients with head AIS of 3, the elderly demonstrated a significantly higher GCS score than the young adults (14.1 ± 2.2 vs. 13.1 ± 3

Prestroke CHA2DS2-VASc Score and Severity of Acute Stroke in Patients with Atrial Fibrillation: findings from RAF Study

OpenAIRE

Acciarresi, Monica; Paciaroni, Maurizio; Agnelli, Giancarlo; Falocci, Nicola; Caso, Valeria; Becattini, Cecilia; Marcheselli, Simona; Rueckert, Christina; Pezzini, Alessandro; Morotti, Andrea; Costa, Paolo; Padovani, Alessandro; Csiba, László; Szabó, Lilla; Sohn, Sung-Il

2017-01-01

Background and Purpose:\\ud \\ud The aim of this study was to investigate for a possible association between both prestroke CHA2DS2-VASc score and the severity of stroke at presentation, as well as disability and mortality at 90 days, in patients with acute stroke and atrial fibrillation (AF).\\ud Methods:\\ud \\ud This prospective study enrolled consecutive patients with acute ischemic stroke, AF, and assessment of prestroke CHA2DS2-VASc score. Severity of stroke was assessed on admission using t...

ISS Payload Operations: The Need for and Benefit of Responsive Planning

Science.gov (United States)

Nahay, Ed; Boster, Mandee

2000-01-01

International Space Station (ISS) payload operations are controlled through implementation of a payload operations plan. This plan, which represents the defined approach to payload operations in general, can vary in terms of level of definition. The detailed plan provides the specific sequence and timing of each component of a payload's operations. Such an approach to planning was implemented in the Spacelab program. The responsive plan provides a flexible approach to payload operations through generalization. A responsive approach to planning was implemented in the NASA/Mir Phase 1 program, and was identified as a need during the Skylab program. The current approach to ISS payload operations planning and control tends toward detailed planning, rather than responsive planning. The use of detailed plans provides for the efficient use of limited resources onboard the ISS. It restricts flexibility in payload operations, which is inconsistent with the dynamic nature of the ISS science program, and it restricts crew desires for flexibility and autonomy. Also, detailed planning is manpower intensive. The development and implementation of a responsive plan provides for a more dynamic, more accommodating, and less manpower intensive approach to planning. The science program becomes more dynamic and responsive as the plan provides flexibility to accommodate real-time science accomplishments. Communications limitations and the crew desire for flexibility and autonomy in plan implementation are readily accommodated with responsive planning. Manpower efficiencies are accomplished through a reduction in requirements collection and coordination, plan development, and maintenance. Through examples and assessments, this paper identifies the need to transition from detailed to responsive plans for ISS payload operations. Examples depict specific characteristics of the plans. Assessments identify the following: the means by which responsive plans accommodate the dynamic nature of

Independent associations between a metabolic syndrome severity score and future diabetes by sex and race: the Atherosclerosis Risk In Communities Study and Jackson Heart Study.

Science.gov (United States)

Gurka, Matthew J; Golden, Sherita H; Musani, Solomon K; Sims, Mario; Vishnu, Abhishek; Guo, Yi; Cardel, Michelle; Pearson, Thomas A; DeBoer, Mark D

2017-07-01

The study aimed to assess for an association between the degree of severity of the metabolic syndrome and risk of type 2 diabetes beyond that conferred by the individual components of the metabolic syndrome. We assessed HRs for an Adult Treatment Panel III (ATP-III) metabolic syndrome score (ATP-III MetS) and a sex- and race-specific continuous metabolic syndrome severity z score related to incident diabetes over a median of 7.8 years of follow-up among participants of two observational cohorts, the Atherosclerosis Risk in Communities study (n = 10,957) and the Jackson Heart Study (n = 2137). The ATP-III MetS had an HR for incident diabetes of 4.36 (95% CI 3.83, 4.97), which was attenuated in models that included the individual metabolic syndrome components. By contrast, participants in the fourth quartile of metabolic syndrome severity (compared with the first quartile) had an HR of 17.4 (95% CI 12.6, 24.1) for future diabetes; in models that also included the individual metabolic syndrome components, this remained significant, with an HR of 3.69 (95% CI 2.42, 5.64). There was a race × metabolic syndrome interaction in these models such that HR was greater for black participants (5.30) than white participants (2.24). When the change in metabolic syndrome severity score was included in the hazard models, this conferred a further association, with changes in metabolic syndrome severity score of ≥0.5 having a HR of 2.66 compared with changes in metabolic syndrome severity score of ≤0. Use of a continuous sex- and race-specific metabolic syndrome severity z score provided an additional prediction of risk of diabetes beyond that of the individual metabolic syndrome components, suggesting an added risk conferred by the processes underlying the metabolic syndrome. Increases in this score over time were associated with further risk, supporting the potential clinical utility of following metabolic syndrome severity over time.

International Cooperation in the Field of International Space Station (ISS) Payload Safety

Science.gov (United States)

Grayson, C.; Sgobba, T.; Larsen, A.; Rose, S.; Heimann, T.; Ciancone, M.; Mulhern, V.

2005-12-01

In the frame of the International Space Station (ISS) Program cooperation, in 1998 the European Space Agency (ESA) approached the National Aeronautics and Space Administration (NASA) with the unique concept of a Payload Safety Review Panel (PSRP) "franchise" based at the European Space Technology Center (ESTEC), where the panel would be capable of autonomously reviewing flight hardware for safety. This paper will recount the course of an ambitious idea as it progressed into a fully functional reality. It will show how a panel initially conceived at NASA to serve a national programme has evolved into an international safety cooperation asset. The PSRP established at NASA began reviewing ISS payloads approximately in late 1994 or early 1995 as an expansion of the pre- existing Shuttle Program PSRP. This paper briefly describes the fundamental Shuttle safety process and the establishment of the safety requirements for payloads intending to use the Space Transportation System and ISS. The paper will also offer some historical statistics about the experiments that completed the payload safety process for Shuttle and ISS. The paper then presents the background of ISS agreements and international treaties that had to be considered when establishing the ESA PSRP. The paper will expound upon the detailed franchising model, followed by an outline of the cooperation charter approved by the NASA Associate Administrator, Office of Space Flight, and ESA Director of Manned Spaceflight and Microgravity. The paper will then address the resulting ESA PSRP implementation and its success statistics to date. Additionally, the paper presents ongoing developments with the Japan Aerospace Exploration Agency (JAXA). The discussion will conclude with ideas for future developments, such to achieve a fully integrated international system of payload safety panels for ISS.

International Cooperation in the Field of International Space Station (ISS) Payload Safety

Science.gov (United States)

Heimann, Timothy; Larsen, Axel M.; Rose, Summer; Sgobba, Tommaso

2005-01-01

In the frame of the International Space Station (ISS) Program cooperation, in 1998, the European Space Agency (ESA) approached the National Aeronautics and Space Administration (NASA) with the unique concept of a Payload Safety Review Panel (PSRP) "franchise" based at the European Space Technology Center (ESTEC), where the panel would be capable of autonomously reviewing flight hardware for safety. This paper will recount the course of an ambitious idea as it progressed into a fully functional reality. It will show how a panel initially conceived at NASA to serve a national programme has evolved into an international safety cooperation asset. The PSRP established at NASA began reviewing ISS payloads approximately in late 1994 or early 1995 as an expansion of the pre-existing Shuttle Program PSRP. This paper briefly describes the fundamental Shuttle safety process and the establishment of the safety requirements for payloads intending to use the Space Transportation System and International Space Station (ISS). The paper will also offer some historical statistics about the experiments that completed the payload safety process for Shuttle and ISS. The paper 1 then presents the background of ISS agreements and international treaties that had to be taken into account when establishing the ESA PSRP. The detailed franchising model will be expounded upon, followed by an outline of the cooperation charter approved by the NASA Associate Administrator, Office of Space Flight, and ESA Director of Manned Spaceflight and Microgravity. The resulting ESA PSRP implementation and its success statistics to date will then be addressed. Additionally the paper presents the ongoing developments with the Japan Aerospace Exploration Agency. The discussion will conclude with ideas for future developments, such to achieve a fully integrated international system of payload safety panels for ISS.

NRT Lightning Imaging Sensor (LIS) on International Space Station (ISS) Science Data Vb0

Data.gov (United States)

National Aeronautics and Space Administration — The NRT Lightning Imaging Sensor (LIS) on International Space Station (ISS) Science Data were collected by the LIS instrument on the ISS used to detect the...

Electrocardiographic scores of severity and acuteness of myocardial ischemia predict myocardial salvage in patients with anterior ST-segment elevation myocardial infarction

DEFF Research Database (Denmark)

Fakhri, Yama; Sejersten, Maria; Schoos, Mikkel Malby

2018-01-01

inferior infarct locations. METHODS: In STEMI patients, the severity and acuteness scores were obtained from the admission ECG. Based on the ECG patients were assigned with severe or non-severe ischemia and acute or non-acute ischemia. Cardiac magnetic resonance (CMR) was performed 2-6days after primary...

Utilizing the ISS Mission as a Testbed to Develop Cognitive Communications Systems

Science.gov (United States)

Jackson, Dan

2016-01-01

The ISS provides an excellent opportunity for pioneering artificial intelligence software to meet the challenges of real-time communications (comm) link management. This opportunity empowers the ISS Program to forge a testbed for developing cognitive communications systems for the benefit of the ISS mission, manned Low Earth Orbit (LEO) science programs and future planetary exploration programs. In November, 1998, the Flight Operations Directorate (FOD) started the ISS Antenna Manager (IAM) project to develop a single processor supporting multiple comm satellite tracking for two different antenna systems. Further, the processor was developed to be highly adaptable as it supported the ISS mission through all assembly stages. The ISS mission mandated communications specialists with complete knowledge of when the ISS was about to lose or gain comm link service. The current specialty mandated cognizance of large sun-tracking solar arrays and thermal management panels in addition to the highly-dynamic satellite service schedules and rise/set tables. This mission requirement makes the ISS the ideal communications management analogue for future LEO space station and long-duration planetary exploration missions. Future missions, with their precision-pointed, dynamic, laser-based comm links, require complete autonomy for managing high-data rate communications systems. Development of cognitive communications management systems that permit any crew member or payload science specialist, regardless of experience level, to control communications is one of the greater benefits the ISS can offer new space exploration programs. The IAM project met a new mission requirement never previously levied against US space-born communications systems management: process and display the orientation of large solar arrays and thermal control panels based on real-time joint angle telemetry. However, IAM leaves the actual communications availability assessment to human judgement, which introduces

Evaluation of the correlation between Scoring Feline Allergic Dermatitis and Feline Extent and Severity Index and skin hydration in atopic cats.

Science.gov (United States)

Szczepanik, Marcin P; Wilkołek, Piotr M; Adamek, Łukasz R; Zając, Marcin; Gołyński, Marcin; Sitkowski, Wiesław; Taszkun, Iwona

2018-02-01

Evaluation of the severity of clinical signs of cats with allergic skin diseases has used two scoring systems: Scoring Feline Allergic Dermatitis (SCORFAD) and the Feline Extent and Severity Index (FeDESI). The integrity of the cutaneous barrier can also be evaluated by measuring skin hydration. A correlation between the clinical score and skin hydration has been observed in humans and dogs with atopic dermatitis (AD). To demonstrate a correlation between the clinical score and skin hydration of cats affected with presumed AD. European short hair cats (n = 18): 11 females and seven males with a confirmed diagnosis of AD. SCORFAD and FeDESI scores were calculated and the measurements of skin hydration were assessed from seven body sites using corneometry. The correlation between the SCORFAD and FeDESI systems and skin hydration of each site, and the average skin hydration was calculated. There was a positive correlation between the SCORFAD score and skin hydration for the axilla, thorax and forelimb; for FeDESI and axilla and lumbar sites. There was a negative correlation between the FeDESI and skin hydration for the pinna (r = -0.47). Measurements of skin hydration could be a useful tool for the evaluation of allergic cats. There is limited evidence of any useful correlation between clinical scoring systems and measurements of hydration. The pinna may be a suitable region for the assessment of skin barrier function in normal and allergic cats. © 2017 ESVD and ACVD.

Stratospheric Aerosol and Gas Experiment III on the International Space Station (SAGE III/ISS)

Science.gov (United States)

Gasbarre, Joseph; Walker, Richard; Cisewski, Michael; Zawodny, Joseph; Cheek, Dianne; Thornton, Brooke

2015-01-01

The Stratospheric Aerosol and Gas Experiment III on the International Space Station (SAGE III/ISS) mission will extend the SAGE data record from the ideal vantage point of the International Space Station (ISS). The ISS orbital inclination is ideal for SAGE measurements providing coverage between 70 deg north and 70 deg south latitude. The SAGE data record includes an extensively validated data set including aerosol optical depth data dating to the Stratospheric Aerosol Measurement (SAM) experiments in 1975 and 1978 and stratospheric ozone profile data dating to the Stratospheric Aerosol and Gas Experiment (SAGE) in 1979. These and subsequent data records, notably from the SAGE II experiment launched on the Earth Radiation Budget Satellite in 1984 and the SAGE III experiment launched on the Russian Meteor-3M satellite in 2001, have supported a robust, long-term assessment of key atmospheric constituents. These scientific measurements provide the basis for the analysis of five of the nine critical constituents (aerosols, ozone (O3), nitrogen dioxide (NO2), water vapor (H2O), and air density using O2) identified in the U.S. National Plan for Stratospheric Monitoring. SAGE III on ISS was originally scheduled to fly on the ISS in the same timeframe as the Meteor-3M mission, but was postponed due to delays in ISS construction. The project was re-established in 2009.

Leadership Challenges in ISS Operations: Lessons Learned from Junior and Senior Mission Control Personnel

Science.gov (United States)

Clement, James L.; Ritsher, Jennifer Boyd; Saylor, Stephanie A.; Kanas, Nick

2006-01-01

The International Space Station (ISS) is operated by a multi-national, multi-organizational team that is dispersed across multiple locations, time zones, and work schedules. At NASA, both junior and senior mission control personnel have had to find ways to address the leadership challenges inherent in such work, but neither have had systematic training in how to do so. The goals of this study were to examine the major leadership challenges faced by ISS mission control personnel and to highlight the approaches that they have found most effective to surmount them. We pay particular attention to the approaches successfully employed by the senior personnel and to the training needs identified by the junior personnel. We also evaluate the extent to which responses are consistent across the junior and senior samples. Further, we compare the issues identified by our interview survey to those identified by a standardized questionnaire survey of mission control personnel and a contrasting group of space station crewmembers. We studied a sample of 14 senior ISS flight controllers and a contrasting sample of 12 more junior ISS controllers. Data were collected using a semi-structured qualitative interview and content analyzed using an iterative process with multiple coders and consensus meetings to resolve discrepancies. To further explore the meaning of the interview findings, we also conducted new analyses of data from a previous questionnaire study of 13 American astronauts, 17 Russian cosmonauts, and 150 U.S. and 36 Russian mission control personnel supporting the ISS or Mir space stations. The interview data showed that the survey respondents had substantial consensus on several leadership challenges and on key strategies for dealing with them, and they offered a wide range of specific tactics for implementing these strategies. Interview data from the junior respondents will be presented for the first time at the meeting. The questionnaire data showed that the US mission

High prevalence of methotrexate intolerance in juvenile idiopathic arthritis : development and validation of a methotrexate intolerance severity score

NARCIS (Netherlands)

Bulatović, Maja; Heijstek, Marloes W; Verkaaik, Marleen; van Dijkhuizen, E H Pieter; Armbrust, Wineke; Hoppenreijs, Esther P A; Kamphuis, Sylvia; Kuis, Wietse; Egberts, Toine C G; Sinnema, Gerben; Rademaker, Carin M A; Wulffraat, Nico M

OBJECTIVE: To design and validate a new questionnaire for identifying patients with methotrexate (MTX) intolerance, and to determine the prevalence of MTX intolerance in patients with juvenile idiopathic arthritis (JIA) using this questionnaire. METHODS: The MTX Intolerance Severity Score (MISS)

High prevalence of methotrexate intolerance in juvenile idiopathic arthritis: development and validation of a methotrexate intolerance severity score

NARCIS (Netherlands)

Bulatovic, M.; Heijstek, M.W.; Verkaaik, M.; Dijkhuizen, E.H. van; Armbrust, W.; Hoppenreijs, E.P.A.H.; Kamphuis, S.; Kuis, W.; Egberts, T.C.; Sinnema, G.; Rademaker, C.M.A.; Wulffraat, N.M.

2011-01-01

OBJECTIVE: To design and validate a new questionnaire for identifying patients with methotrexate (MTX) intolerance, and to determine the prevalence of MTX intolerance in patients with juvenile idiopathic arthritis (JIA) using this questionnaire. METHODS: The MTX Intolerance Severity Score (MISS)

The early IL-6 and IL-10 response in trauma is correlated with injury severity and mortality

DEFF Research Database (Denmark)

Stensballe, J; Christiansen, M; Tønnesen, E

2009-01-01

BACKGROUND: Trauma has previously been shown to influence interleukin (IL)-6 and IL-10 levels, but the association of injury severity and mortality with IL-6 and IL-10 responses in the early phase of accidental trauma remains to be investigated. We wished to describe serum levels of IL-6 and IL-10...... in the first 24 h after trauma and to assess the relationship with severity of injury and mortality. METHODS: Prospective, descriptive cohort study in a Level 1 trauma centre, Copenhagen, Denmark. We included 265 consecutive adult trauma patients admitted directly from the accident scene during an 18-month...... period. Serum levels of IL-6 and IL-10 were measured upon arrival and at 6, 12, and 24 h after admittance using an enzyme-linked immunosorbent assay. Correlation analysis was used to assess the relationship between Injury Severity Score (ISS) and levels of IL-6 and IL-10. Analysis of variance was used...

ISS Expeditions 16 through 20: Chemical Analysis Results for Potable Water

Science.gov (United States)

Straub, John E., II; Plumlee, Debrah K.; Schultz, John R.

2010-01-01

During the 2-year span from Expedition 16 through Expedition 20, the chemical quality of the potable water onboard the International Space Station (ISS) was verified safe for crew consumption through the return and chemical analysis of archival water samples by the Water and Food Analytical Laboratory (WAFAL) at Johnson Space Center (JSC). Reclaimed cabin humidity condensate and Russian ground-supplied water were the principal sources of potable water for Expeditions 16 through 18. During Expedition 18 the U.S. water processor assembly was delivered, installed, and tested during a 90-day checkout period. Beginning with Expedition 19, U.S. potable water recovered from a combined waste stream of humidity condensate and pretreated urine was also available for ISS crew use. A total of 74 potable water samples were collected using U.S. sampling hardware during Expeditions 16 through 20 and returned on both Shuttle and Soyuz vehicles. The results of JSC chemical analyses of these ISS potable water samples are presented in this paper. Eight potable water samples collected in flight with Russian hardware were also received for analysis, as well as 5 preflight samples of Rodnik potable water delivered to ISS on Russian Progress vehicles 28 to 34. Analytical results for these additional potable water samples are also reported and discussed.

Performance Evaluation of the ISS Water Processor Multifiltration Beds

Science.gov (United States)

Bowman, Elizabeth M.; Carter, Layne; Wilson, Mark; Cole, Harold; Orozco, Nicole; Snowdon, Doug

2012-01-01

The ISS Water Processor Assembly (WPA) produces potable water from a waste stream containing humidity condensate and urine distillate. The primary treatment process is achieved in the Multifiltration Bed, which includes adsorbent media and ion exchange resin for the removal of dissolved organic and inorganic contaminants. The first Multifiltration Bed was replaced on ISS in July 2010 after initial indication of inorganic breakthrough. This bed was returned to ground in July 2011 for an engineering investigation. The water resident in the bed was analyzed for various parameters to evaluate adsorbent loading, performance of the ion exchange resin, microbial activity, and generation of leachates from the ion exchange resin. Portions of the adsorbent media and ion exchange resin were sampled and subsequently desorbed to identify the primary contaminants removed at various points in the bed. In addition, an unused Multifiltration Bed was evaluated after two years in storage to assess the generation of leachates during storage. This assessment was performed to evaluate the possibility that these leachates are impacting performance of the Catalytic Reactor located downstream of the Multifiltration Bed. The results of these investigations and implications to the operation of the WPA on ISS are documented in this paper.

Viewing ISS Data in Real Time via the Internet

Science.gov (United States)

Myers, Gerry; Chamberlain, Jim

2004-01-01

EZStream is a computer program that enables authorized users at diverse terrestrial locations to view, in real time, data generated by scientific payloads aboard the International Space Station (ISS). The only computation/communication resource needed for use of EZStream is a computer equipped with standard Web-browser software and a connection to the Internet. EZStream runs in conjunction with the TReK software, described in a prior NASA Tech Briefs article, that coordinates multiple streams of data for the ground communication system of the ISS. EZStream includes server components that interact with TReK within the ISS ground communication system and client components that reside in the users' remote computers. Once an authorized client has logged in, a server component of EZStream pulls the requested data from a TReK application-program interface and sends the data to the client. Future EZStream enhancements will include (1) extensions that enable the server to receive and process arbitrary data streams on its own and (2) a Web-based graphical-user-interface-building subprogram that enables a client who lacks programming expertise to create customized display Web pages.

Using ISS Telescopes for Electromagnetic Follow-up of Gravitational Wave Detections of NS-NS and NS-BH Mergers

Science.gov (United States)

Camp, J.; Barthelmy, S.; Blackburn, L.; Carpenter, K. G.; Gehrels, N.; Kanner, J.; Marshall, F. E.; Racusin, J. L.; Sakamoto, T.

2013-01-01

The International Space Station offers a unique platform for rapid and inexpensive deployment of space telescopes. A scientific opportunity of great potential later this decade is the use of telescopes for the electromagnetic follow-up of ground-based gravitational wave detections of neutron star and black hole mergers. We describe this possibility for OpTIIX, an ISS technology demonstration of a 1.5 m diffraction limited optical telescope assembled in space, and ISS-Lobster, a wide-field imaging X-ray telescope now under study as a potential NASA mission. Both telescopes will be mounted on pointing platforms, allowing rapid positioning to the source of a gravitational wave event. Electromagnetic follow-up rates of several per year appear likely, offering a wealth of complementary science on the mergers of black holes and neutron stars.

Positrusion Filament Recycling System for ISS, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — The Positrusion ISS Recycler enables recycling of scrap and waste plastics into high-quality filament for 3D printers to enable sustainable in-situ manufacturing on...

Radiation dosimetry onboard the International Space Station ISS

International Nuclear Information System (INIS)

Berger, Thomas

2008-01-01

Besides the effects of the microgravity environment, and the psychological and psychosocial problems encountered in confined spaces, radiation is the main health detriment for long duration human space missions. The radiation environment encountered in space differs in nature front that on earth, consisting mostly of high energetic ions from protons up to iron, resulting in radiation levels far exceeding the ones encountered on earth for occupational radiation workers. Therefore the determination and the control of the radiation load on astronauts is a moral obligation of the space faring nations. The requirements for radiation detectors in space are very different to that on earth. Limitations in mass, power consumption and the complex nature of the space radiation environment define and limit the overall construction of radiation detectors. Radiation dosimetry onboard the International Space Station (ISS) is accomplished to one part as ''operational'' dosimetry aiming for area monitoring of the radiation environment as well as astronaut surveillance. Another part focuses on ''scientific'' dosimetry aiming for a better understanding of the radiation environment and its constitutes. Various research activities for a more detailed quantification of the radiation environment as well as its distribution in and outside the space station have been accomplished in the last years onboard the ISS. The paper will focus on the current radiation detectors onboard the ISS, their results, as well as on future planned activities. (orig.)

IVA Ultrasonic and Eddy Current NDE for ISS

Data.gov (United States)

National Aeronautics and Space Administration — The project intends to develop a combined Ultrasonic and Eddy Current nondestructive evaluation (NDE) instrument for IVA use on ISS. A suite of IVA and EVA NDE...

Implementation of ALARA radiation protection on the ISS through polyethylene shielding augmentation of the Service Module Crew Quarters

Science.gov (United States)

Shavers, M. R.; Zapp, N.; Barber, R. E.; Wilson, J. W.; Qualls, G.; Toupes, L.; Ramsey, S.; Vinci, V.; Smith, G.; Cucinotta, F. A.

2004-01-01

With 5-7 month long duration missions at 51.6° inclination in Low Earth Orbit, the ionizing radiation levels to which International Space Station (ISS) crewmembers are exposed will be the highest planned occupational exposures in the world. Even with the expectation that regulatory dose limits will not be exceeded during a single tour of duty aboard the ISS, the "as low as reasonably achievable" (ALARA) precept requires that radiological risks be minimized when possible through a dose optimization process. Judicious placement of efficient shielding materials in locations where crewmembers sleep, rest, or work is an important means for implementing ALARA for spaceflight. Polyethylene (C nH n) is a relatively inexpensive, stable, and, with a low atomic number, an effective shielding material that has been certified for use aboard the ISS. Several designs for placement of slabs or walls of polyethylene have been evaluated for radiation exposure reduction in the Crew Quarters (CQ) of the Zvezda (Star) Service Module. Optimization of shield designs relies on accurate characterization of the expected primary and secondary particle environment and modeling of the predicted radiobiological responses of critical organs and tissues. Results of the studies shown herein indicate that 20% or more reduction in equivalent dose to the CQ occupant is achievable. These results suggest that shielding design and risk analysis are necessary measures for reducing long-term radiological risks to ISS inhabitants and for meeting legal ALARA requirements. Verification of shield concepts requires results from specific designs to be compared with onboard dosimetry.

Coppersmith Self-Esteem Inventory Scores of Boys with Severe Behavior Problems

Science.gov (United States)

Wood, Frank H.; Johnson, Ardes

1972-01-01

Scores on the Coopersmith Self-Esteem Inventory of 44 behaviorally disturbed boys ranging in age from 8 to 12 years were compared with the test's norms, with later retest scores, with teacher assigned self esteem ranks, and with peer group status as measured by sociometric procedures. (DB)

Amateur Radio on the International Space Station - the First Operational Payload on the ISS

Science.gov (United States)

Bauer, F. H.; McFadin, L.; Steiner, M.; Conley, C. L.

2002-01-01

As astronauts and cosmonauts have adapted to life on the International Space Station (ISS), they have found Amateur Radio and its connection to life on Earth to be a constant companion and a substantial psychological boost. Since its first use in November 2000, the first five expedition crews have utilized the amateur radio station in the FGB to talk to thousands of students in schools, to their families on Earth, and to amateur radio operators around the world. Early in the development of ISS, an international organization called ARISS (Amateur Radio on the International Space Station) was formed to coordinate the construction and operation of amateur radio (ham radio) equipment on ISS. ARISS represents a melding of the volunteer teams that have pioneered the development and use of amateur radio equipment on human spaceflight vehicles. The Shuttle/Space Amateur Radio Experiment (SAREX) team enabled Owen Garriott to become the first astronaut ham to use amateur radio from space in 1983. Since then, amateur radio teams in the U.S. (SAREX), Germany, (SAFEX), and Russia (Mirex) have led the development and operation of amateur radio equipment on board NASA's Space Shuttle, Russia's Mir space station, and the International Space Station. The primary goals of the ARISS program are fourfold: 1) educational outreach through crew contacts with schools, 2) random contacts with the Amateur Radio public, 3) scheduled contacts with the astronauts' friends and families and 4) ISS-based communications experimentation. To date, over 65 schools have been selected from around the world for scheduled contacts with the orbiting ISS crew. Ten or more students at each school ask the astronauts questions, and the nature of these contacts embodies the primary goal of the ARISS program, -- to excite student's interest in science, technology and amateur radio. The ARISS team has developed various hardware elements for the ISS amateur radio station. These hardware elements have flown to ISS

Re-Engineering the ISS Payload Operations Control Center During Increased Utilization and Critical Onboard Events

Science.gov (United States)

Dudley, Stephanie R. B.; Marsh, Angela L.

2014-01-01

With an increase in utilization and hours of payload operations being executed onboard the International Space Station (ISS), upgrading the NASA Marshall Space Flight Center (MSFC) Huntsville Operations Support Center (HOSC) ISS Payload Control Area (PCA) was essential to gaining efficiencies and assurance of current and future payload health and science return. PCA houses the Payload Operations Integration Center (POIC) responsible for the execution of all NASA payloads onboard the ISS. POIC Flight Controllers are responsible for the operation of voice, stowage, command, telemetry, video, power, thermal, and environmental control in support of ISS science experiments. The methodologies and execution of the PCA refurbishment were planned and performed within a four-month period in order to assure uninterrupted operation of ISS payloads and minimal impacts to payload operations teams. To vacate the PCA, three additional HOSC control rooms were reconfigured to handle ISS real-time operations, Backup Control Center (BCC) to Mission Control in Houston, simulations, and testing functions. This involved coordination and cooperation from teams of ISS operations controllers, multiple engineering and design disciplines, management, and construction companies performing an array of activities simultaneously and in sync delivering a final product with no issues that impacted the schedule. For each console operator discipline, studies of Information Technology (IT) tools and equipment layouts, ergonomics, and lines of sight were performed. Infusing some of the latest IT into the project was an essential goal in ensuring future growth and success of the ISS payload science returns. Engineering evaluations led to a state of the art Video Wall implementation and more efficient ethernet cabling distribution providing the latest products and the best solution for the POIC. These engineering innovations led to cost savings for the project. Constraints involved in the management of

Spacesuit Water Membrane Evaporator Integration with the ISS Extravehicular Mobility Unit

Science.gov (United States)

Margiott, Victoria; Boyle, Robert

2014-01-01

NASA has developed a Solid Water Membrane Evaporation (SWME) to provide cooling for the next generation spacesuit. The current spacesuit team has looked at this technology from the standpoint of using the ISS EMU to demonstrate the SWME technology while EVA, and from the standpoint of augmenting EMU cooling in the case of a fouled EMU cooling system. One approach to increasing the TRL of the system is to incorporate this hardware with the existing EMU. Several integration issues were addressed to support a potential demonstration of the SWME with the existing EMU. Systems analysis was performed to assess the capability of the SWME to maintain crewmember cooling and comfort as a replacement for sublimation. The materials of the SWME were reviewed to address compatibility with the EMU. Conceptual system placement and integration with the EMU via an EVA umbilical system to ensure crew mobility and Airlock egress were performed. A concept of operation for EVA use was identified that is compatible with the existing system. This concept is extensible as a means to provide cooling for the existing EMU. The cooling system of one of the EMUs on orbit has degraded, with the root cause undetermined. Should there be a common cause resident on ISS, this integration could provide a means to recover cooling capability for EMUs on orbit.

Application of the Mandible Injury Severity Score to Pediatric Mandibular Fractures.

Science.gov (United States)

Swanson, Edward W; Susarla, Srinivas M; Ghasemzadeh, Ali; Mundinger, Gerhard S; Redett, Richard J; Tufaro, Anthony P; Manson, Paul N; Dorafshar, Amir H

2015-07-01

The Mandible Injury Severity Score (MISS) has been used to evaluate adult mandibular fractures. The purpose of this study was to evaluate the MISS in a cohort of pediatric patients. This was a retrospective study of pediatric patients treated for mandibular fractures over a 20-year period. Patients were included if they had computed tomographic imaging available for review and had at least 1 post-treatment visit. The primary predictor variable was the MISS. Secondary predictors were demographic and injury-associated factors. The outcome was treatment-associated complications. Descriptive, bivariate, and multiple logistic regression statistics were computed. One hundred sixteen patients with mandibular fractures were identified; 73 (62.9%) met the inclusion criteria. The sample's mean age was 8.5 ± 4.1 years; 44% were girls. Motor vehicle collisions (60%) and falls (15.1%) were the most common mechanisms. More than 50% of patients had an extra-mandibular injury. The mean MISS was 13.5 ± 7.8. Forty-five percent of the sample underwent open reduction and internal fixation. Complications were noted in 20.5% of patients, of which malocclusion was the most common (8.2%). Increasing MISS was associated with complications (P pediatric patients with mandibular fractures, increased severity of injury is associated with complications, even after controlling for the effects of multiple confounders, including open treatment. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Severe street and mountain bicycling injuries in adults: a comparison of the incidence, risk factors and injury patterns over 14 years.

Science.gov (United States)

Roberts, Derek J; Ouellet, Jean-Francois; Sutherland, Francis R; Kirkpatrick, Andrew W; Lall, Rohan N; Ball, Chad G

2013-06-01

Street and mountain bicycling are popular recreational activities and prevalent modes of transportation with the potential for severe injury. The purpose of this investigation was to compare the incidence, risk factors and injury patterns among adults with severe street versus mountain bicycling injuries. We conducted a retrospective cohort study using the Southern Alberta Trauma Database of all adults who were severely injured (injury severity score [ISS] ≥ 12) while street or mountain bicycling between Apr. 1, 1995, and Mar. 31, 2009. Among 11 772 severely injured patients, 258 (2.2%) were injured (mean ISS 17, hospital stay 6 d, mortality 7%) while street (n = 209) or mountain bicycling (n = 49). Street cyclists were often injured after being struck by a motor vehicle, whereas mountain bikers were frequently injured after faulty jump attempts, bike tricks and falls (cliffs, roadsides, embankments). Mountain cyclists were admitted more often on weekends than weekdays (61.2% v. 45.0%, p = 0.040). Injury patterns were similar for both cohorts (all p > 0.05), with trauma to the head (67.4%), extremities (38.4%), chest (34.1%), face (26.0%) and abdomen (10.1%) being common. Spinal injuries, however, were more frequent among mountain cyclists (65.3% v. 41.1%, p = 0.003). Surgical intervention was required in 33.3% of patients (9.7% open reduction internal fixation, 7.8% spinal fixation, 7.0% craniotomy, 5.8% facial repair and 2.7% laparotomy). With the exception of spine injuries, severely injured cyclists display similar patterns of injury and comparable outcomes, regardless of style (street v. mountain). Helmets and thoracic protection should be advocated for injury prevention.

``DMS-R, the Brain of the ISS'', 10 Years of Continuous Successful Operation in Space

Science.gov (United States)

Wolff, Bernd; Scheffers, Peter

2012-08-01

Space industries on both sides of the Atlantic were faced with a new situation of collaboration in the beginning of the 1990s.In 1995, industrial cooperation between ASTRIUM ST, Bremen and RSC-E, Moscow started aiming the outfitting of the Russian Service Module ZVEZDA for the ISS with computers. The requested equipments had to provide not only redundancy but fault tolerance and high availability. The design and development of two fault tolerant computers, (FTCs) responsible for the telemetry (Telemetry Computer: TC) and the central control (CC), as well as the man machine interface CPC were contracted to ASTRIUM ST, Bremen. The computer system is responsible e.g. for the life support system and the ISS re-boost control.In July 2000, the integration of the Russian Service Module ZVEZDA with Russian ZARYA FGB and American Node 1 bears witness for transatlantic and European cooperation.The Russian Service module ZVEZDA provides several basic functions as Avionics Control, the Environmental Control and Life Support (ECLS) in the ISS and control of the docked Automatic Transfer Vehicle (ATV) which includes re-boost of ISS. If these elementary functions fail or do not work reliable the effects for the ISS will be catastrophic with respect to Safety (manned space) and ISS mission.For that reason the responsible computer system Data Management System - Russia (DMS-R) is also called "The brain of the ISS".The Russian Service module ZVEZDA, including DMS-R, was launched on 12th of July, 2000. DMS-R was operational also during launch and docking.The talk provide information about the definition, design and development of DMS-R, the integration of DMS-R in the Russian Service module and the maintenance of the system in space. Besides the technical aspects are also the German - Russian cooperation an important subject of this speech. An outlook finalises the talk providing further development activities and application of fault tolerant systems.The importance of the DMS

NRT Lightning Imaging Sensor (LIS) on International Space Station (ISS) Provisional Science Data Vp0

Data.gov (United States)

National Aeronautics and Space Administration — The International Space Station (ISS) Lightning Imaging Sensor (LIS) datasets were collected by the LIS instrument on the ISS used to detect the distribution and...

Using the ISS as a testbed to prepare for the next generation of space-based telescopes

Science.gov (United States)

Postman, Marc; Sparks, William B.; Liu, Fengchuan; Ess, Kim; Green, Joseph; Carpenter, Kenneth G.; Thronson, Harley; Goullioud, Renaud

2012-09-01

The infrastructure available on the ISS provides a unique opportunity to develop the technologies necessary to assemble large space telescopes. Assembling telescopes in space is a game-changing approach to space astronomy. Using the ISS as a testbed enables a concentration of resources on reducing the technical risks associated with integrating the technologies, such as laser metrology and wavefront sensing and control (WFS&C), with the robotic assembly of major components including very light-weight primary and secondary mirrors and the alignment of the optical elements to a diffraction-limited optical system in space. The capability to assemble the optical system and remove and replace components via the existing ISS robotic systems such as the Special Purpose Dexterous Manipulator (SPDM), or by the ISS Flight Crew, allows for future experimentation as well as repair if necessary. In 2015, first light will be obtained by the Optical Testbed and Integration on ISS eXperiment (OpTIIX), a small 1.5-meter optical telescope assembled on the ISS. The primary objectives of OpTIIX include demonstrating telescope assembly technologies and end-to-end optical system technologies that will advance future large optical telescopes.

Using ISS to develop telescope technology

Science.gov (United States)

Saenz-Otero, Alvar; Miller, David W.

2005-08-01

Future space telescope missions concepts have introduced new technologies such as precision formation flight, optical metrology, and segmented mirrors. These new technologies require demonstration and validation prior to deployment in final missions such as the James Webb Space Telescope, Terrestrial Planet Finder, and Darwin. Ground based demonstrations do not provide the precision necessary to obtain a high level of confidence in the technology; precursor free flyer space missions suffer from the same problems as the final missions. Therefore, this paper proposes the use of the International Space Station as an intermediate research environment where these technologies can be developed, demonstrated, and validated. The ISS provides special resources, such as human presence, communications, power, and a benign atmosphere which directly reduce the major challenges of space technology maturation: risk, complexity, cost, remote operations, and visibility. Successful design of experiments for use aboard the space station, by enabling iterative research and supporting multiple scientists, can further reduce the effects of these challenges of space technology maturation. This paper presents results of five previous MIT Space Systems Laboratory experiments aboard the Space Shuttle, MIR, and the ISS to illustrate successful technology maturation aboard these facilities.

Mortality in severe trauma patients attended by emergency services in Navarre, Spain: validation of a new prediction model and comparison with the Revised Injury Severity Classification Score II.

Science.gov (United States)

Ali Ali, Bismil; Lefering, Rolf; Fortún Moral, Mariano; Belzunegui Otano, Tomás

2018-01-01

To validate the Mortality Prediction Model of Navarre (MPMN) to predict death after severe trauma and compare it to the Revised Injury Severity Classification Score II (RISCII). Retrospective analysis of a cohort of severe trauma patients (New Injury Severity Score >15) who were attended by emergency services in the Spanish autonomous community of Navarre between 2013 and 2015. The outcome variable was 30-day all-cause mortality. Risk was calculated with the MPMN and the RISCII. The performance of each model was assessed with the area under the receiver operating characteristic (ROC) curve and precision with respect to observed mortality. Calibration was assessed with the Hosmer-Lemeshow test. We included 516 patients. The mean (SD) age was 56 (23) years, and 363 (70%) were males. Ninety patients (17.4%) died within 30 days. The 30-day mortality rates predicted by the MPMN and RISCII were 16.4% and 15.4%, respectively. The areas under the ROC curves were 0.925 (95% CI, 0.902-0.952) for the MPMN and 0.941 (95% CI, 0.921-0.962) for the RISCII (P=0.269, DeLong test). Calibration statistics were 13.6 (P=.09) for the MPMN and 8.9 (P=.35) for the RISCII. Both the MPMN and the RISCII show good ability to discriminate risk and predict 30-day all-cause mortality in severe trauma patients.

Radiation dosimetry onboard the International Space Station ISS

Energy Technology Data Exchange (ETDEWEB)

Berger, Thomas [German Aerospace Center - DLR, Inst. of Aerospace Medicine, Radiation Biology, Cologne (Germany)

2008-07-01

Besides the effects of the microgravity environment, and the psychological and psychosocial problems encountered in confined spaces, radiation is the main health detriment for long duration human space missions. The radiation environment encountered in space differs in nature front that on earth, consisting mostly of high energetic ions from protons up to iron, resulting in radiation levels far exceeding the ones encountered on earth for occupational radiation workers. Therefore the determination and the control of the radiation load on astronauts is a moral obligation of the space faring nations. The requirements for radiation detectors in space are very different to that on earth. Limitations in mass, power consumption and the complex nature of the space radiation environment define and limit the overall construction of radiation detectors. Radiation dosimetry onboard the International Space Station (ISS) is accomplished to one part as 'operational' dosimetry aiming for area monitoring of the radiation environment as well as astronaut surveillance. Another part focuses on 'scientific' dosimetry aiming for a better understanding of the radiation environment and its constitutes. Various research activities for a more detailed quantification of the radiation environment as well as its distribution in and outside the space station have been accomplished in the last years onboard the ISS. The paper will focus on the current radiation detectors onboard the ISS, their results, as well as on future planned activities. (orig.)

ISS Crew Transportation and Services Requirements Document

Science.gov (United States)

Bayt, Robert L. (Compiler); Lueders, Kathryn L. (Compiler)

2016-01-01

The ISS Crew Transportation and Services Requirements Document (CCT-REQ-1130) contains all technical, safety, and crew health medical requirements that are mandatory for achieving a Crew Transportation System Certification that will allow for International Space Station delivery and return of NASA crew and limited cargo. Previously approved on TN23183.

The Columbus-CC—Operating the European laboratory at ISS

Science.gov (United States)

Kuch, T.; Sabath, D.

2008-07-01

The European ISS Columbus Control Center (Col-CC) joined the club of ISS mission control centers in Moscow, Houston and Huntsville. It took some time to reach that goal. In 1998 the European Space Agency (ESA) awarded the German Aerospace Center DLR to design, develop and implement the Col-CC at its premises in Oberpfaffenhofen, near Munich, Germany. In 2002 a core mission operations team was built up. An integrated team of ESA, industry and control center started to define processes and implemented first operations products and tools. This was accompanied by regular meetings with the international partners in the US and Russia. With intensive training and numerous simulations the team was able to gain experience and is now eagerly waiting for the launch of Columbus. However, thanks to the involvement in some operational activities the Col-CC staff has already been able to gain operational ISS experience. After the inauguration in October 2004 Col-CC supported the Eneide mission in April 2005 when the Italian ESA-Astronaut Roberto Vittori flew onboard a Soyuz to the ISS where he spent 10 days. Another very important milestone was the operations support for ESA's Astrolab mission. The Astrolab mission was of major importance for Europe and particularly for Germany because it implied the first long duration flight of ESA astronaut Thomas Reiter, an astronaut of German nationality. The tasks of Col-CC are described and also the experiences made with the first operational long-term mission which took place from July to December 2006. Meanwhile the Col-CC was able to reach the operational readiness status for the Columbus mission which is set for a launch date later in 2007. Despite the concentration on the challenging Columbus Assembly and Checkout phase emphasis is already laid on the following increments for the European ISS operations. Early 2006 ESA transferred the operational tasks and responsibilities to the hands of the industrial operator. This approach creates

A practice report of bladder injuries due to gunshot wounds in Syrian refugees.

Science.gov (United States)

Inci, Mehmet; Karakuş, Ali; Rifaioglu, Mehmet Murat; Yengil, Erhan; Atçi, Nesrin; Akin, Ömer; Tuzcu, Kasım; Kiper, Ahmet; Demirbaş, Onur; Şahan, Mustafa

2014-09-01

This study was intended to report our recent experience of bladder injuries due to gunshots in the Syrian conflict and review the literature regarding diagnosis and treatment. Twenty-two cases with abdominal and inguinal firearm wounds and bladder ruptures sustained in the Syrian conflict were reported. Age, mechanism/location of damage, associated injuries, Revised Trauma Score (RTS), Injury Severity Score (ISS), Trauma Injury Severity Score (TRISS), and complications were analyzed. The severity of the bladder injuries was classified according to the American Association for the Surgery of Trauma Organ Injury Scaling (AAST-OIS grade ?II database).The type of the bladder rupture was defined according to the classification System for Bladder Injury Based on Findings at CT Cystography. The mean age was 26 years (range, 18-36). The mean ISS was 22 (10-57), mean TRISS was 0.64 (0.004-0.95), and mean RTS was 6.97 (3.30-7.84). In the mortality group, the mean ISS, TRISS, and RTS were 48 (36-57), 0.016 (0.004-0.090), and 4.10 (3.30-4.92), respectively; whereas, the mean ISS, TRISS, and RTS were found as 21 (10-26), 0.64 (0.49-0.95), and 7.24 (5.65-7.84), respectively in the survival group (P=0.06). CT-cystography showed seventeen type 2, three type 4, and two type 5 bladder injuries. According to AAST-OIS, there were nine grade IV, six grade III, five grade II, and two grade V injuries. In war settings, when injuries are often severe and multiple surgical exploration and closure are mandatory, mortality risk is associated with high ISS and low TRISS and RTS values.

BEOS-A new approach to promote and organize industrial ISS utilization

Science.gov (United States)

Luttmann, Helmut; Buchholz, Henning; Bratke, Burkhard; Hueser, Detlev; Dittus, Hansjörg

2000-01-01

In order to develop and to market innovative services and products for the operation of the ISS and its utilization, three players have teamed up together and established an entity called BEOS (Bremen Engineering Operations Science). The team is made up of DaimlerChrysler Aerospace, OHB-System and ZARM, the Center of Applied Space Technology and Microgravity at the University of Bremen. It is the aim of BEOS to represent a competent industrial interface to potential ISS users from the space and non-space industries. In this effort BEOS is supporting and supplementing the activities of the space agencies, especially in the field of industrial and/or commercial ISS utilization. With this approach BEOS is creating new business opportunities not only for its team members but also for its customers from industry. Besides the fostering of industrial research in space, nontechnical fields of space utilization like entertainment, advertisement, education and space travel represent further key sectors for the marketing efforts of BEOS. .

Assembling and supplying the ISS the space shuttle fulfills its mission

CERN Document Server

Shayler, David J

2017-01-01

The creation and utilization of the International Space Station (ISS) is a milestone in space exploration. But without the Space Shuttle, it would have remained an impossible dream. Assembling and Supplying the ISS is the story of how, between 1998 and 2011, the Shuttle became the platform which enabled the construction and continued operation of the primary scientific research facility in Earth orbit. Fulfilling an objective it had been designed to complete decades before, 37 Shuttle missions carried the majority of the hardware needed to build the ISS and then acted as a ferry and supply train for early resident crews to the station. Building upon the decades of development and experience described in the companion volume Linking the Space Shuttle and Space Stations: Early Docking Technologies from Concept to Implementation, this book explores • a purpose-built hardware processing facility • challenging spacewalking objectives • extensive robotic operations • undocking a unmanned orbiter The experie...

Noorte eesti režissööride uued filmid Sõpruses / Mari Peegel

Index Scriptorium Estoniae

Peegel, Mari, 1978-

2005-01-01

Sõpruse kinos esilinastub homme kaks eesti lühimängufilmi - "Vanameeste paradiis" : stsenaristid Ove Musting, Urmas Lennuk : režissöör Ove Musting : mängivad Tõnu Aav, Aleksander Eelmaa jt ning "Ukse taga" : stsenarist Margit Keerdo : režissöör Andrus Tuisk : osades Hele Kõre, Karin Lätsim, Kirill Käro, Igor Gavrilov

Lessons learned from the STS-120/ISS 10A robotics operations

Science.gov (United States)

Aziz, Sarmad

2010-01-01

The STS-120/ISS 10A assembly mission was an unprecedented period during the life of the International Space Stations (ISS). The successful completion of the mission laid the foundation for the launch of the European and Japanese laboratories and continued assembly of the station. Unlike previous missions that concluded when the Space Shuttle undocked from the ISS, the 10A mission required critical assembly operations to continue after the Shuttle's departure to relocate the Harmony module to its permanent location and activate its systems. The end-to-end mission lasted for almost a month and required the execution of seven space walks, over 20 major robotics operations, and countless hours of ground commanding. The Canadian built mobile servicing system (MSS) and its robotics space station remote manipulator system (SSRMS) played a key a role in the success of the assembly operations. The mission presented the ISS robotics flight control team (ROBO) with unique challenges during the pre-mission planning and real-time execution of complex assembly tasks. The mission included the relocation of the P6 truss segment from the Z1 Node to its permanent location on the P5 truss; a three day marathon of highly choreographed sequence of robotics operations and space walks, and the reconfiguration of ISS structure to attach Harmony (Node 2) to the US destiny laboratory module; a six day sequence of complex robotics operations the majority of which was executed after the departure of the shuttle and included an unprecedented amount of ground commanded robotics operations. Of all the robotics operations executed during the mission, none were more challenging than supporting the repair of a torn P6 solar array that was damaged during its deployment; a dramatic space walk that pushed the MSS and the robotics flight control team to new limits and required the real-time planning and execution of an intricate series of operations that spanned two days. This paper will present an

Development of the Respiratory Index of Severity in Children (RISC score among young children with respiratory infections in South Africa.

Directory of Open Access Journals (Sweden)

Carrie Reed

Full Text Available OBJECTIVE: Pneumonia is a leading cause of death in children worldwide. A simple clinical score predicting the probability of death in a young child with lower respiratory tract infection (LRTI could aid clinicians in case management and provide a standardized severity measure during epidemiologic studies. METHODS: We analyzed 4,148 LRTI hospitalizations in children <24 months enrolled in a pneumococcal conjugate vaccine trial in South Africa from 1998-2001, to develop the Respiratory Index of Severity in Children (RISC. Using clinical data at admission, a multivariable logistic regression model for mortality was developed and statistically evaluated using bootstrap resampling techniques. Points were assigned to risk factors based on their coefficients in the multivariable model. A child's RISC score is the sum of points for each risk factor present. Separate models were developed for HIV-infected and non-infected children. RESULTS: Significant risk factors for HIV-infected and non-infected children included low oxygen saturation, chest indrawing, wheezing, and refusal to feed. The models also included age and HIV clinical classification (for HIV-infected children or weight-for-age (for non-infected children. RISC scores ranged up to 7 points for HIV-infected or 6 points for non-infected children and correlated with probability of death (0-47%, HIV-infected; 0-14%, non-infected. Final models showed good discrimination (area under the ROC curve and calibration (goodness-of-fit. CONCLUSION: The RISC score incorporates a simple set of risk factors that accurately discriminate between young children based on their risk of death from LRTI, and may provide an objective means to quantify severity based on the risk of mortality.

Global Precipitation Measurement (GPM) and International Space Station (ISS) Coordination for CubeSat Deployments to Minimize Collision Risk

Science.gov (United States)

Pawloski, James H.; Aviles, Jorge; Myers, Ralph; Parris, Joshua; Corley, Bryan; Hehn, Garrett; Pascucci, Joseph

2016-01-01

The Global Precipitation Measurement Mission (GPM) is a joint U.S. and Japan mission to observe global precipitation, extending the Tropical Rainfall Measuring Mission (TRMM), which was launched by H-IIA from Tanegashima in Japan on February 28TH, 2014 directly into its 407km operational orbit. The International Space Station (ISS) is an international human research facility operated jointly by Russia and the USA from NASA's Johnson Space Center (JSC) in Houston Texas. Mission priorities lowered the operating altitude of ISS from 415km to 400km in early 2105, effectively placing both vehicles into the same orbital regime. The ISS has begun a program of deployments of cost effective CubeSats from the ISS that allow testing and validation of new technologies. With a major new asset flying at the same effective altitude as the ISS, CubeSat deployments became a serious threat to GPM and therefore a significant indirect threat to the ISS. This paper describes the specific problem of collision threat to GPM and risk to ISS CubeSat deployment and the process that was implemented to keep both missions safe from collision and maximize their project goals.

Assessment of RFID Read Accuracy for ISS Water Kit

Science.gov (United States)

Chu, Andrew

2011-01-01

The Space Life Sciences Directorate/Medical Informatics and Health Care Systems Branch (SD4) is assessing the benefits Radio Frequency Identification (RFID) technology for tracking items flown onboard the International Space Station (ISS). As an initial study, the Avionic Systems Division Electromagnetic Systems Branch (EV4) is collaborating with SD4 to affix RFID tags to a water kit supplied by SD4 and studying the read success rate of the tagged items. The tagged water kit inside a Cargo Transfer Bag (CTB) was inventoried using three different RFID technologies, including the Johnson Space Center Building 14 Wireless Habitat Test Bed RFID portal, an RFID hand-held reader being targeted for use on board the ISS, and an RFID enclosure designed and prototyped by EV4.

Experiences with Extra-Vehicular Activities in Response to Critical ISS Contingencies

Science.gov (United States)

Van Cise, E. A.; Kelly, B. J.; Radigan, J. P.; Cranmer, C. W.

2016-01-01

The maturation of the International Space Station (ISS) design from the proposed Space Station Freedom to today's current implementation resulted in external hardware redundancy vulnerabilities in the final design. Failure to compensate for or respond to these vulnerabilities could put the ISS in a posture where it could no longer function as a habitable space station. In the first years of ISS assembly, these responses were to largely be addressed by the continued resupply and Extra-Vehicular Activity (EVA) capabilities of the Space Shuttle. Even prior to the decision to retire the Space Shuttle, it was realized that ISS needed to have its own capability to be able to rapidly repair or replace external hardware without needing to wait for the next cargo resupply mission. As documented in a previous publication, in 2006 development was started to baseline Extra-Vehicular Activity (EVA, or spacewalk) procedures to replace hardware components whose failure would expose some of the ISS vulnerabilities should a second failure occur. This development work laid the groundwork for the onboard crews and the ground operations and engineering teams to be ready to replace any of this failed hardware. In 2010, this development work was put to the test when one of these pieces of hardware failed. This paper will provide a brief summary of the planning and processes established in the original Contingency EVA development phase. It will then review how those plans and processes were implemented in 2010, highlighting what went well as well as where there were deficiencies between theory and reality. This paper will show that the original approach and analyses, though sound, were not as thorough as they should have been in the realm of planning for next worse failures, for documenting Programmatic approval of key assumptions, and not pursuing sufficient engineering analysis prior to the failure of the hardware. The paper will further highlight the changes made to the Contingency

Bacteremic pneumococcal pneumonia: serotype distribution, antimicrobial susceptibility, severity scores, risk factors, and mortality in a single center in Chile

Directory of Open Access Journals (Sweden)

Alberto Fica

2014-03-01

Conclusions: BPP had a high case-fatality rate in this group of adult patients with no association to resistant isolates, and a low immunization record. Three independent factors were related to death and the prognostic yield of different severity scores was low.

Vitamin D: Findings from Antarctic, Bed Rest, Houston, and ISS

Science.gov (United States)

Zwart, Sara R.; Locke, J.; Pierson, D.; Mehta, S.; Bourbeau, Y.; Parsons, H.; Smith, S. M.

2009-01-01

Obtaining vitamin D is critical for space travelers because they lack ultraviolet light exposure and have an insufficient dietary supply of vitamin D. Despite the provision of 400 IU vitamin D supplements to International Space Station (ISS) early crewmembers, vitamin D status was consistently lower after flight than before flight, and in several crewmembers has decreased to levels considered clinically significant. Vitamin D has long been known to play a role in calcium metabolism, and more recently its non-calcitropic functions have been recognized. According to the results of several recent studies, functionally relevant measures indicate that the lower limit of serum 25-hydroxyvitamin D (a marker of vitamin D status) should be raised from the current 23 nmol/L to 80 nmol/L. The mean preflight serum 25-hydroxyvitamin D (25-OH vit D) for U.S. ISS crewmembers to date is 63 +/- 16 nmol/L, and after a 4- to 6-mo space flight it typically decreases 25-30% despite supplementation (400 IU/d). The sub-optimal pre- and postflight vitamin D status is an issue that needs to be addressed, to allow NASA to better define the appropriate amount of supplemental vitamin D to serve as a countermeasure against vitamin D deficiency in astronaut crews. A series of ground-based and flight studies in multiple models have been conducted, including Antarctica in winter months when UV-B radiation levels are essentially zero, bed rest where subjects are not exposed to UV-B radiation for 60-90 days, in free-living individuals in Houston, and in International Space Station crewmembers. In these studies, we looked at dose regimen and efficacy, compliance issues, as well as toxicity. Preliminary results from these studies will be presented. Together, the data from these studies will enable us to provide space crews with evidence-based recommendations for vitamin D supplementation. The findings also have implications for other persons with limited UV light exposure, including polar workers and

Some benefit from physiotherapy intervention in the subgroup of patients with severe ankle sprain as determined by the ankle function score: a randomised trial.

Science.gov (United States)

van Rijn, Rogier M; van Heest, Jos A C; van der Wees, Philip; Koes, Bart W; Bierma-Zeinstra, Sita M A

2009-01-01

Do patients with a severe ankle injury (baseline ankle function score 40)? Does physiotherapy intervention have more effect on patients with a severe injury compared with a mild injury in the short- or long-term? Is self-reported recovery related to ankle function score over time? Subgroup analysis of a randomised trial. 102 adults with an acute lateral ankle sprain. The experimental group received physiotherapist-supervised exercises in addition to conventional intervention. Outcomes were self-reported recovery, pain, and instability all measured on a 10-point visual analogue scale, and incidence of re-sprain. Measurements were collected at baseline, 4 and 8 weeks, 3 and 12 months. Participants with a severe injury did worse in 3 out of 7 outcomes than those with a mild injury at 4 weeks but not at 8 weeks. There was no difference in effect of physiotherapy intervention in those with a severe injury compared with a mild injury, at 8 weeks or 12 months. However, there was an effect of physiotherapy intervention in those with a severe injury in 3 out of 7 outcomes at 8 weeks. Self-reported recovery was related to ankle function score at all points in time (r = 0.48 to 0.79). The results of this study only partially support the recommendations regarding the use of the ankle function score in the 'Acute Ankle Injury' guideline of the Royal Dutch Society of Physiotherapists.

Establishing a Distance Learning Plan for International Space Station (ISS) Interactive Video Education Events (IVEE)

Science.gov (United States)

Wallington, Clint

1999-01-01

Educational outreach is an integral part of the International Space Station (ISS) mandate. In a few scant years, the International Space Station has already established a tradition of successful, general outreach activities. However, as the number of outreach events increased and began to reach school classrooms, those events came under greater scrutiny by the education community. Some of the ISS electronic field trips, while informative and helpful, did not meet the generally accepted criteria for education events, especially within the context of the classroom. To make classroom outreach events more acceptable to educators, the ISS outreach program must differentiate between communication events (meant to disseminate information to the general public) and education events (designed to facilitate student learning). In contrast to communication events, education events: are directed toward a relatively homogeneous audience who are gathered together for the purpose of learning, have specific performance objectives which the students are expected to master, include a method of assessing student performance, and include a series of structured activities that will help the students to master the desired skill(s). The core of the ISS education events is an interactive videoconference between students and ISS representatives. This interactive videoconference is to be preceded by and followed by classroom activities which help the students aftain the specified learning objectives. Using the interactive videoconference as the centerpiece of the education event lends a special excitement and allows students to ask questions about what they are learning and about the International Space Station and NASA. Whenever possible, the ISS outreach education events should be congruent with national guidelines for student achievement. ISS outreach staff should recognize that there are a number of different groups that will review the events, and that each group has different criteria

Non-Quality Controlled Lightning Imaging Sensor (LIS) on International Space Station (ISS) Science Data Vb0

Data.gov (United States)

National Aeronautics and Space Administration — The Non-Quality Controlled Lightning Imaging Sensor (LIS) on International Space Station (ISS) Science Data were collected by the LIS instrument on the ISS used to...

Electrostatic Levitation Furnace for the ISS

Science.gov (United States)

Murakami, Keiji; Koshikawa, Naokiyo; Shibasaki, Kohichi; Ishikawa, Takehiko; Okada, Junpei; Takada, Tetsuya; Arai, Tatsuya; Fujino, Naoki; Yamaura, Yukiko

2012-01-01

JAXA (Japan Aerospace Exploration Agency) has just started the development of Electrostatic Levitation Furnace to be launched in 2014 for the ISS. This furnace can control the sample position with electrostatic force and heat it above 2000 degree Celsius using semiconductor laser from four different directions. The announcement of Opportunity will be issued soon for this furnace. In this paper, we will show the specifications of this furnace and also the development schedule

Development and Certification of Ultrasonic Background Noise Test (UBNT) System for use on the International Space Station (ISS)

Science.gov (United States)

Prosser, William H.; Madaras, Eric I.

2011-01-01

As a next step in the development and implementation of an on-board leak detection and localization system on the International Space Station (ISS), there is a documented need to obtain measurements of the ultrasonic background noise levels that exist within the ISS. This need is documented in the ISS Integrated Risk Management System (IRMA), Watch Item #4669. To address this, scientists and engineers from the Langley Research Center (LaRC) and the Johnson Space Center (JSC), proposed to the NASA Engineering and Safety Center (NESC) and the ISS Vehicle Office a joint assessment to develop a flight package as a Station Development Test Objective (SDTO) that would perform ultrasonic background noise measurements within the United States (US) controlled ISS structure. This document contains the results of the assessment

International Space Station (ISS) Bacterial Filter Elements (BFEs): Filter Efficiency and Pressure Testing of Returned Units

Science.gov (United States)

Green, Robert D.; Agui, Juan H.; Vijayakumar, R.

2017-01-01

The air revitalization system aboard the International Space Station (ISS) provides the vital function of maintaining a clean cabin environment for the crew and the hardware. This becomes a serious challenge in pressurized space compartments since no outside air ventilation is possible, and a larger particulate load is imposed on the filtration system due to lack of sedimentation due to the microgravity environment in Low Earth Orbit (LEO). The ISS Environmental Control and Life Support (ECLS) system architecture in the U.S. Segment uses a distributed particulate filtration approach consisting of traditional High-Efficiency Particulate Adsorption (HEPA) media filters deployed at multiple locations in each U.S. Segment module; these filters are referred to as Bacterial Filter Elements, or BFEs. These filters see a replacement interval, as part of maintenance, of 2-5 years dependent on location in the ISS. In this work, we present particulate removal efficiency, pressure drop, and leak test results for a sample set of 8 BFEs returned from the ISS after filter replacement. The results can potentially be utilized by the ISS Program to ascertain whether the present replacement interval can be maintained or extended to balance the on-ground filter inventory with extension of the lifetime of ISS beyond 2024. These results can also provide meaningful guidance for particulate filter designs under consideration for future deep space exploration missions.

Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience.

Science.gov (United States)

Veysi, Veysi T; Nikolaou, Vassilios S; Paliobeis, Christos; Efstathopoulos, Nicolas; Giannoudis, Peter V

2009-10-01

A review of prospectively collected data in our trauma unit for the years 1998-2003 was undertaken. Adult patients who suffered multiple trauma with an Injury Severity Score (ISS) of >/=16, admitted to hospital for more than 72 hours and with sustained blunt chest injuries were included in the study. Demographic details including pre-hospital care, trauma history, admission vital signs, blood transfusions, details of injuries and their abbreviated injury scores (AIS), operations, length of intensive care unit and hospital stays, Injury Severity Score (ISS) and mortality were analysed. Fulfilling the inclusion criteria with at least one chest injury were 1,164 patients. The overall mortality reached 18.7%. As expected, patients in the higher AIS groups had both a higher overall ISS and mortality rate with one significant exception; patients with minor chest injuries (AIS(chest) = 1) were associated with mortality comparable to injuries involving an AIS(chest) = 3. Additionally, the vast majority of polytraumatised patients with an AIS(chest) = 1 died in ICU sooner than patients of groups 2-5.

Opals: Mission System Operations Architecture for an Optical Communications Demonstration on the ISS

Science.gov (United States)

Abrahamson, Matthew J.; Sindiy, Oleg V.; Oaida, Bogdan V.; Fregoso, Santos; Bowles-Martinez, Jessica N.; Kokorowski, Michael; Wilkerson, Marcus W.; Konyha, Alexander L.

2014-01-01

In April of 2014, the Optical PAyload for Lasercomm Science (OPALS) Flight System (FS) launched to the International Space Station (ISS) to demonstrate space-to-ground optical communications. During a planned 90-day baseline mission, the OPALS FS will downlink high quality, short duration videos to the Optical Communications Telescope Laboratory (OCTL) ground station in Wrightwood, California. Interfaces to the ISS payload operations infrastructure have been established to facilitate activity planning, hazardous laser operations, commanding, and telemetry transmission. In addition, internal processes, such as pointing prediction and data processing, satisfy the technical requirements of the mission. The OPALS operations team participates in Operational Readiness Tests (ORTs) with external partners to exercise coordination processes and train for the overall mission. The ORTs have provided valuable insight into operational considerations for the instrument on the ISS.

Converting the ISS to an Earth-Moon Transport System Using Nuclear Thermal Propulsion

International Nuclear Information System (INIS)

Paniagua, John; Maise, George; Powell, James

2008-01-01

Using Nuclear Thermal Propulsion (NTP), the International Space Station (ISS) can be placed into a cyclic orbit between the Earth and the Moon for 2-way transport of personnel and supplies to a permanent Moon Base. The ISS cycler orbit apogees 470,000 km from Earth, with a period of 13.66 days. Once a month, the ISS would pass close to the Moon, enabling 2-way transport between it and the surface using a lunar shuttle craft. The lunar shuttle craft would land at a desired location on the surface during a flyby and return to the ISS during a later flyby. At Earth perigee 7 days later at 500 km altitude, there would be 2-way transport between it and Earth's surface using an Earth shuttle craft. The docking Earth shuttle would remain attached to the ISS as it traveled towards the Moon, while personnel and supplies transferred to a lunar shuttle spacecraft that would detach and land at the lunar base when the ISS swung around the Moon. The reverse process would be carried out to return personnel and materials from the Moon to the Earth. The orbital mechanics for the ISS cycle are described in detail. Based on the full-up mass of 400 metric tons for the ISS, an ISP of 900 seconds, and a delta V burn of 3.3 km/sec to establish the orbit, 200 metric tons of liquid H-2 propellant would be required. The 200 metric tons could be stored in 3 tanks, each 8 meters in diameter and 20 meters in length. An assembly of 3 MITEE NTP engines would be used, providing redundancy if an engine were to fail. Two different MITEE design options are described. Option 1 is an 18,000 Newton, 100 MW engine with a thrust to weight ratio of 6.6/1; Option 2 is a 180,000 Newton, 1000 MW engine with a thrust to weight ratio of 23/1. Burn times to establish the orbit are ∼1 hour for the large 3 engine assembly, and 10 hours for the small 3 engine assembly. Both engines would use W-UO2 cermet fuel at ∼2750 K which has demonstrated the capability to operate for at least 50 hours in 2750 K hydrogen

Ionizing radiation effects on ISS ePTFE jacketed cable assembly

Science.gov (United States)

Koontz, S. L.; Golden, J. L.; Lorenz, M. J.; Pedley, M. D.

2003-09-01

Polytetrafluoroethylene (PTFE), which is susceptible to embrittlement by ionizing radiation, is used as a primary material in the Mobile Transporter's (MT) Trailing Umbilical System (TUS) cable on the International Space Station (ISS). The TUS cable provides power and data service between the ISS truss and the MT. The TUS cable is normally stowed in an uptake reel and is fed out to follow the MT as it moves along rails on the ISS truss structure. For reliable electrical and mechanical performance, TUS cable polymeric materials must be capable of >3.5% elongation without cracking or breaking. The MT TUS cable operating temperature on ISS is expected to range between -100°C and +130°C. The on-orbit functional life requirement for the MT TUS cable is 10 years. Analysis and testing were performed to verify that the MT TUS cable would be able to meet full-life mechanical and electrical performance requirements, despite progressive embrittlement by the natural ionizing radiation environment. Energetic radiation belt electrons (trapped electrons) are the principal contributor to TUS cable radiation dose. TUS cable specimens were irradiated, in vacuum, with both energetic electrons and gamma rays. Electron beam energy was chosen to minimize charging effects on the non-conductive ePTFE (expanded PTFE) targets. Tensile testing was then performed, over the expected range of operating temperatures, as a function of radiation dose. When compared to the expected in-flight radiation dose/depth profile, atomic oxygen (AO) erosion of the radiation damaged TUS cable jacket surfaces is more rapid than the development of radiation induced embrittlement of the same surfaces. Additionally, the layered construction of the jacket prevents crack growth propagation, leaving the inner layer material compliant with the design elongation requirements. As a result, the TUS cable insulation design was verified to meet performance life requirements.

The definition of polytrauma: variable interrater versus intrarater agreement--a prospective international study among trauma surgeons.

Science.gov (United States)

Butcher, Nerida E; Enninghorst, Natalie; Sisak, Krisztian; Balogh, Zsolt J

2013-03-01

The international trauma community has recognized the lack of a validated consensus definition of "polytrauma." We hypothesized that using a subjective definition, trauma surgeons will not have substantial agreement; thus, an objective definition is needed. A prospective observational study was conducted between December 2010 and June 2011 (John Hunter Hospital, Level I trauma center). Inclusion criteria were all trauma call patients with subsequent intensive care unit admission. The study was composed of four stages as follows: (1) four trauma surgeons assessed patients until 24 hours, then coded as either "yes" or "no" for polytrauma, and results compared for agreement; (2) eight trauma surgeons representing the United States, Germany, and the Netherlands graded the same prospectively assessed patients and coded as either "yes" or "no" for polytrauma; (3) 12 months later, the original four trauma surgeons repeated assessment via data sheets to test intrarater variability; and (4) individual subjective definitions were compared with three anatomic scores, namely, (a) Injury Severity Score (ISS) of greater than 15, (b) ISS of greater 17, and (c) Abbreviated Injury Scale (AIS) score of greater than 2 in at least two ISS body regions. A total of 52 trauma patients were included. Results for each stage were as follows: (1) κ score of 0.50, moderate agreement; (2) κ score of 0.41, moderate agreement; (3) Rater 1 had moderate intrarater agreement (κ score, 0.59), while Raters 2, 3, 4 had substantial intrarater agreement (κ scores, 0.75, 0.66, and 0.71, respectively); and (4) none had most agreement with ISS of greater than 15 (κ score, 0.16), while both definitions ISS greater than 17 and Abbreviated Injury Scale (AIS) score of greater than 2 in at least two ISS body regions had on average fair agreement (κ scores, 0.27 and 0.39, respectively). Based on subjective assessments, trauma surgeons do not agree on the definition of polytrauma, with the subjective

Mortality in patients with pelvic fractures

DEFF Research Database (Denmark)

Hauschild, Oliver; Strohm, Peter C; Culemann, Ulf

2008-01-01

hospitals were evaluated for age, gender, Injury Severity Score (ISS), Hannover Polytrauma Score (PTS), fracture type (using Tile's classification), peripelvic soft tissue injury, need for emergency measures, mortality, cause of death, and need for operative stabilization. We compared the patients...

Onboard cross-calibration of the Pille-ISS Detector System and measurement of radiation shielding effect of the water filled protective curtain in the ISS crew cabin

International Nuclear Information System (INIS)

Szántó, P.; Apáthy, I.; Deme, S.; Hirn, A.; Nikolaev, I.V.; Pázmándi, T.; Shurshakov, V.A.; Tolochek, R.V.; Yarmanova, E.N.

2015-01-01

As a preparation for long duration space missions it is important to determine and minimize the impact of space radiation on human health. One of the methods to diminish the radiation burden is using an additional local shielding in the places where the crewmembers can stay for longer time. To increase the crew cabin shielding a special protective curtain was designed and delivered to ISS in 2010 containing four layers of hygienic wipes and towels providing an additional shielding thickness of about 8 g/cm"2 water-equivalent matter. The radiation shielding effect of the protective curtain, in terms of absorbed dose, was measured with the thermoluminescent Pille-ISS Detector System. In order to verify the reliability of the Pille system an onboard cross-calibration was also performed. The measurement proved that potentially 25% reduction of the absorbed dose rate in the crew cabin can be achieved, that results in 8% (∼16 μGy/day) decrease of the total absorbed dose to the crew, assuming that they spend 8 h in the crew cabin a day. - Highlights: • The dose level in the ISS Zvezda crew quarters is higher than the average dose level in the module. • A shielding made of hygienic wipes and towels was set up onboard as additional protection. • Onboard cross calibration of the Pille-ISS space dosimeter (TL) system was performed. • The shielding effect of the protective curtain in terms of absorbed dose was measured with the onboard Pille system. • The shielding effect of the protective water curtain is approximately 24 ± 9% in absorbed dose.

ISS Assessment of the Influence of Nonpore Surface in the XPS Analysis of Oil-Producing Reservoir Rocks

Science.gov (United States)

Leon; Toledo; Araujo

1997-08-15

The application of X-ray photoelectron spectroscopy (XPS) to oil-producing reservoir rocks is new and has shown that pore surface concentrations can be related to rock wettability. In the preparation of fresh fractures of rocks, however, some nonpore surface corresponding to the connection regions in the rocks is created and exposed to XPS. To assess the potential influence of this nonpore surface in the XPS analysis of rocks here we use ion scattering spectroscopy (ISS), which has a resolution comparable to the size of the pores, higher than that of XPS, with an ion gun of He+ at maximum focus. Sample charging effects are partially eliminated with a flood gun of low energy electrons. All the ISS signals are identified by means of a formula which corrects any residual charging on the samples. Three rock samples are analyzed by XPS and ISS. The almost unchanged ISS spectra obtained at different points of a given sample suggest that the nonpore surface created in the fracture process is negligibly small, indicating that XPS data, from a larger surface spot, represents the composition of true pore surfaces. The significant changes observed in ISS spectra from different samples indicate that ISS is sample specific. Copyright 1997Academic Press

Hemorrhage recurrence risk factors in cerebral amyloid angiopathy: Comparative analysis of the overall small vessel disease severity score versus individual neuroimaging markers.

Science.gov (United States)

Boulouis, Gregoire; Charidimou, Andreas; Pasi, Marco; Roongpiboonsopit, Duangnapa; Xiong, Li; Auriel, Eitan; van Etten, Ellis S; Martinez-Ramirez, Sergi; Ayres, Alison; Vashkevich, Anastasia; Schwab, Kristin M; Rosand, Jonathan; Goldstein, Joshua N; Gurol, M Edip; Greenberg, Steven M; Viswanathan, Anand

2017-09-15

An MRI-based score of total small vessel disease burden (CAA-SVD-Score) in cerebral amyloid angiopathy (CAA) has been demonstrated to correlate with severity of pathologic changes. Evidence suggests that CAA-related intracerebral hemorrhage (ICH) recurrence risk is associated with specific disease imaging manifestations rather than overall severity. We compared the correlation between the CAA-SVD-Score with the risk of recurrent CAA-related lobar ICH versus the predictive role of each of its components. Consecutive patients with CAA-related ICH from a single-center prospective cohort were analyzed. Radiological markers of CAA related SVD damage were quantified and categorized according to the CAA-SVD-Score (0-6 points). Subjects were followed prospectively for recurrent symptomatic ICH. Adjusted Cox proportional hazards models were used to investigate associations between the CAA-SVD-Score as well as each of the individual MRI signatures of CAA and the risk of recurrent ICH. In 229 CAA patients with ICH, a total of 56 recurrent ICH events occurred during a median follow-up of 2.8years [IQR 0.9-5.4years, 781 person-years). Higher CAA-SVD-Score (HR=1.26 per additional point, 95%CI [1.04-1.52], p=0.015) and older age were independently associated with higher ICH recurrence risk. Analysis of individual markers of CAA showed that CAA-SVD-Score findings were due to the independent effect of disseminated superficial siderosis (HR for disseminated cSS vs none: 2.89, 95%CI [1.47-5.5], p=0.002) and high degree of perivascular spaces enlargement (RR=3.50-95%CI [1.04-21], p=0.042). In lobar CAA-ICH patients, higher CAA-SVD-Score does predict recurrent ICH. Amongst individual elements of the score, superficial siderosis and dilated perivascular spaces are the only markers independently associated with ICH recurrence, contributing to the evidence for distinct CAA phenotypes singled out by neuro-imaging manifestations. Copyright © 2017 Elsevier B.V. All rights reserved.

The Effect of Sharrows, Painted Bicycle Lanes and Physically Protected Paths on the Severity of Bicycle Injuries Caused by Motor Vehicles.

Science.gov (United States)

Wall, Stephen P; Lee, David C; Frangos, Spiros G; Sethi, Monica; Heyer, Jessica H; Ayoung-Chee, Patricia; DiMaggio, Charles J

2016-01-01

We conducted individual and ecologic analyses of prospectively collected data from 839 injured bicyclists who collided with motorized vehicles and presented to Bellevue Hospital, an urban Level-1 trauma center in New York City, from December 2008 to August 2014. Variables included demographics, scene information, rider behaviors, bicycle route availability, and whether the collision occurred before the road segment was converted to a bicycle route. We used negative binomial modeling to assess the risk of injury occurrence following bicycle path or lane implementation. We dichotomized U.S. National Trauma Data Bank Injury Severity Scores (ISS) into none/mild (0-8) versus moderate, severe, or critical (>8) and used adjusted multivariable logistic regression to model the association of ISS with collision proximity to sharrows (i.e., bicycle lanes designated for sharing with cars), painted bicycle lanes, or physically protected paths. Negative binomial modeling of monthly counts, while adjusting for pedestrian activity, revealed that physically protected paths were associated with 23% fewer injuries. Painted bicycle lanes reduced injury risk by nearly 90% (IDR 0.09, 95% CI 0.02-0.33). Holding all else equal, compared to no bicycle route, a bicycle injury nearby sharrows was nearly twice as likely to be moderate, severe, or critical (adjusted odds ratio 1.94; 95% confidence interval (CI) 0.91-4.15). Painted bicycle lanes and physically protected paths were 1.52 (95% CI 0.85-2.71) and 1.66 (95% CI 0.85-3.22) times as likely to be associated with more than mild injury respectively.

The Effect of Sharrows, Painted Bicycle Lanes and Physically Protected Paths on the Severity of Bicycle Injuries Caused by Motor Vehicles

Directory of Open Access Journals (Sweden)

Stephen P. Wall

2016-12-01

Full Text Available We conducted individual and ecologic analyses of prospectively collected data from 839 injured bicyclists who collided with motorized vehicles and presented to Bellevue Hospital, an urban Level-1 trauma center in New York City, from December 2008 to August 2014. Variables included demographics, scene information, rider behaviors, bicycle route availability, and whether the collision occurred before the road segment was converted to a bicycle route. We used negative binomial modeling to assess the risk of injury occurrence following bicycle path or lane implementation. We dichotomized U.S. National Trauma Data Bank Injury Severity Scores (ISS into none/mild (0–8 versus moderate, severe, or critical (>8 and used adjusted multivariable logistic regression to model the association of ISS with collision proximity to sharrows (i.e., bicycle lanes designated for sharing with cars, painted bicycle lanes, or physically protected paths. Negative binomial modeling of monthly counts, while adjusting for pedestrian activity, revealed that physically protected paths were associated with 23% fewer injuries. Painted bicycle lanes reduced injury risk by nearly 90% (IDR 0.09, 95% CI 0.02–0.33. Holding all else equal, compared to no bicycle route, a bicycle injury nearby sharrows was nearly twice as likely to be moderate, severe, or critical (adjusted odds ratio 1.94; 95% confidence interval (CI 0.91–4.15. Painted bicycle lanes and physically protected paths were 1.52 (95% CI 0.85–2.71 and 1.66 (95% CI 0.85–3.22 times as likely to be associated with more than mild injury respectively.

Influence of Deep Breathing on Heart Rate Variability in Parkinson's Disease: Co-relation with Severity of Disease and Non-Motor Symptom Scale Score.

Science.gov (United States)

Bidikar, Mukta Pritam; Jagtap, Gayatri J; Chakor, Rahul T

2014-07-01

Dysautonomia and non-motor symptoms (NMS) in Parkinson's disease (PD) are frequent, disabling and reduce quality of life of patient. There is a paucity of studies on autonomic dysfunction in PD in Indian population. The study aimed to evaluate autonomic dysfunction in PD patients and co-relate the findings with severity of PD and Non-Motor Symptoms Scale (NMSS) score. We evaluated autonomic function in 30 diagnosed patients of PD (age 55-70 years) and 30 healthy age-matched controls by 3 min deep breathing test (DBT). NMSS was used to identify non-motor symptoms and Hoehn and Yahr (HY) Scale to grade severity of PD. The DBT findings were co-related with severity of PD (HY staging) and NMSS score. DBT was found to be abnormal in 40% while it was on borderline in 33.3% of PD patients. There was a statistically significant difference (psymptom. A negative co-relation was found between results of deep breathing test and clinical severity of disease and NMSS score. Abnormalities of autonomic function and NMS were integral and present across all the stages of PD patients. Early recognition and treatment of these may decrease morbidity and improve quality of life of PD patients.

Validation of a self-reported HIV symptoms list: the ISS-HIV symptoms scale.

Science.gov (United States)

Bucciardini, Raffaella; Pugliese, Katherina; Francisci, Daniela; Costantini, Andrea; Schiaroli, Elisabetta; Cognigni, Miriam; Tontini, Chiara; Lucattini, Stefano; Fucili, Luca; Di Gregorio, Massimiliano; Mirra, Marco; Fragola, Vincenzo; Pompili, Sara; Murri, Rita; Vella, Stefano

2016-01-01

To describe the development and the psychometric properties of the Istituto Superiore di Sanità-HIV symptoms scale (lSS-HIV symptoms scale). The ISS-HIV symptom scale was developed by an Italian working team including researchers, physicians and people living with HIV. The development process went through the following steps: (1) review of HIV/AIDS literature; (2) focus group; (3) pre-test analysis; (4) scale validation. The 22 symptoms of HIV-ISS symptoms scale were clustered in five factors: pain/general discomfort (7 items); depression/anxiety (4 items); emotional reaction/psychological distress (5 items); gastrointestinal discomfort (4 items); sexual discomfort (2 items). The internal consistence reliability was for all factors within the minimum accepted standard of 0.70. The results of this study provide a preliminary evidence of the reliability and validity of the ISS-HIV symptoms scale. In the new era where HIV infection has been transformed into a chronic diseases and patients are experiencing a complex range of symptoms, the ISS-HIV symptoms scale may represent an useful tool for a comprehensive symptom assessment with the advantage of being easy to fill out by patients and potentially attractive to physicians mainly because it is easy to understand and requires short time to interpret the results.

Gas monitoring onboard ISS using FTIR spectroscopy

Science.gov (United States)

Gisi, Michael; Stettner, Armin; Seurig, Roland; Honne, Atle; Witt, Johannes; Rebeyre, Pierre

2017-06-01

In the confined, enclosed environment of a spacecraft, the air quality must be monitored continuously in order to safeguard the crew's health. For this reason, OHB builds the ANITA2 (Analysing Interferometer for Ambient Air) technology demonstrator for trace gas monitoring onboard the International Space Station (ISS). The measurement principle of ANITA2 is based on the Fourier Transform Infrared (FTIR) technology with dedicated gas analysis software from the Norwegian partner SINTEF. This combination proved to provide high sensitivity, accuracy and precision for parallel measurements of 33 trace gases simultaneously onboard ISS by the precursor instrument ANITA1. The paper gives a technical overview about the opto-mechanical components of ANITA2, such as the interferometer, the reference Laser, the infrared source and the gas cell design and a quick overview about the gas analysis. ANITA2 is very well suited for measuring gas concentrations specifically but not limited to usage onboard spacecraft, as no consumables are required and measurements are performed autonomously. ANITA2 is a programme under the contract of the European Space Agency, and the air quality monitoring system is a stepping stone into the future, as a precursor system for manned exploration missions.

Who Is Worst Off? Developing a Severity-scoring Model of Complex Emergency Affected Countries in Order to Ensure Needs Based Funding.

Science.gov (United States)

Eriksson, Anneli; Ohlsén, Ylva Kristina; Garfield, Richard; von Schreeb, Johan

2015-11-03

Disasters affect close to 400 million people each year. Complex Emergencies (CE) are a category of disaster that affects nearly half of the 400 million and often last for several years. To support the people affected by CE, humanitarian assistance is provided with the aim of saving lives and alleviating suffering. It is widely agreed that funding for this assistance should be needs-based. However, to date, there is no model or set of indicators that quantify and compare needs from one CE to another. In an effort to support needs-based and transparent funding of humanitarian assistance, the aim of this study is to develop a model that distinguishes between levels of severity among countries affected by CE. In this study, severity serves as a predictor for level of need. The study focuses on two components of severity: vulnerability and exposure. In a literature and Internet search we identified indicators that characterize vulnerability and exposure to CE. Among the more than 100 indicators identified, a core set of six was selected in an expert ratings exercise. Selection was made based on indicator availability and their ability to characterize preexisting or underlying vulnerabilities (four indicators) or to quantify exposure to a CE (two indicators). CE from 50 countries were then scored using a 3-tiered score (Low-Moderate, High, Critical).  The developed model builds on the logic of the Utstein template. It scores severity based on the readily available value of four vulnerability and four exposure indicators. These are 1) GNI per capita, PPP, 2) Under-five mortality rate, per 1 000 live births, 3) Adult literacy rate, % of people ages 15 and above, 4) Underweight, % of population under 5 years, and 5) number of persons and proportion of population affected, and 6) number of uprooted persons and proportion of population uprooted. The model can be used to derive support for transparent, needs-based funding of humanitarian assistance. Further research is

Non-Quality Controlled Lightning Imaging Sensor (LIS) on International Space Station (ISS) Provisional Science Data Vp0

Data.gov (United States)

National Aeronautics and Space Administration — The International Space Station (ISS) Lightning Imaging Sensor (LIS) datasets were collected by the LIS instrument on the ISS used to detect the distribution and...

Evaluation of Severity Score in Patients with Lower Limb and Pelvic Fractures Injured in Motor Vehicle Front-Impact Collisions.

Science.gov (United States)

Gokalp, Mehmet Ata; Hekimoglu, Yavuz; Gozen, Abdurrahim; Guner, Savas; Asirdizer, Mahmut

2016-12-01

BACKGROUND Lower limb and pelvic injuries and fractures occur at a very high incidence in motor vehicle accidents. In this study, the characteristics (e.g., body side, bone location, and fracture severity) of lower limb and pelvic fractures that occurred during front-impact collisions were correlated with the injured patients' sex, age, and position in the vehicle. MATERIAL AND METHODS We retrospectively evaluated 191 patients (136 males, 55 females) who were injured in motor vehicle accidents, specifically in frontal collisions. RESULTS This study revealed that most of lower limb and pelvic fractures occurred in males (71.2%; p=.000), 19-36 years old (55.5%; p=.000), small vehicles (86.4%; p=.000), and rear seat passengers (49.2%; p=.000). Fractures most commonly occurred in the left side of the body (46.6%; p=.000) and upper legs (37.7%; p=.000). Severity scores were higher (2.76) in males than females (2.07). No statistically significant was found in severity scores of patients and other personal characteristics and fracture features of patients with lower limb and pelvic fractures who were injured in a vehicle during front-impact collisions (p>0.05). CONCLUSIONS The results of this study will be useful for the automobile industry, forensics and criminal scientists, and for trauma research studies.

Health-related quality of life after mild, moderate and severe traumatic brain injury: patterns and predictors of suboptimal functioning during the first year after injury.

Science.gov (United States)

Scholten, A C; Haagsma, J A; Andriessen, T M J C; Vos, P E; Steyerberg, E W; van Beeck, E F; Polinder, S

2015-04-01

The Glasgow Outcome Scale Extended (GOSE) is the established functional outcome scale to assess disability following traumatic brain injury (TBI), however does not capture the patient's subjective perspective. Health-related quality of life (HRQL) does capture the individual's perception of disability after TBI, and has therefore been recognized as an important outcome in TBI. In contrast to GOSE, HRQL enables comparison of health outcome across various disease states and with healthy individuals. We aimed to assess functional outcome, HRQL, recovery, and predictors of 6 and 12-month outcome in a comprehensive sample of patients with mild, moderate or severe TBI, and to examine the relationship between functional impairment (GOSE) and HRQL. A prospective cohort study was conducted among a sample of 2066 adult TBI patients who attended the emergency department (ED). GOSE was determined through questionnaires or structured interviews. Questionnaires 6 and 12 months after ED treatment included socio-demographic information and HRQL measured with Short-Form Health Survey (SF-36; reflecting physical, mental and social functioning) and Perceived Quality of Life Scale (PQoL; measuring degree of satisfaction with functioning). 996 TBI survivors with mild, moderate or severe TBI completed the 6-month questionnaire. Functional outcome and HRQL after moderate or severe TBI was significantly lower than after mild TBI. Patients with moderate TBI showed greatest improvement. After one year, the mild TBI group reached outcomes comparable to population norms. TBI of all severities highly affected SF-36 domains physical and social functioning, and physical and emotional role functioning. GOSE scores were highly related to all SF-36 domains and PQoL scores. Female gender, older age, co-morbidity and high ISS were strongest independent predictors of decreased HRQL at 6 and 12 months after TBI. HRQL and recovery patterns differ for mild, moderate and severe TBI. This study indicates

"Detsembrikuumuse" helirežissöör sai Emmy

Index Scriptorium Estoniae

2008-01-01

Hollywoodis töötav helirežissöör Solange S. Schwalbe sai septembris Los Angeleses toimunud 2007-2008 Creative Arts Primetime Emmys tseremoonial Emmy minisarja "John Adams" heliefektide eest. Tema meeskond helindas ka meie uue mängufilmi

ISS External Payload Platform - a new opportunity for research in the space environment

Science.gov (United States)

Steimle, Christian; Pape, Uwe

The International Space Station (ISS) is a widely accepted platform for research activities in low Earth orbit. To a wide extent these activities are conducted in the pressurised laboratories of the station and less in the outside environment. Suitable locations outside the ISS are rare, existing facilities fully booked for the coming years. To overcome this limitation, an external payload platform accessible for small size payloads on a commercial basis will be launched to the ISS and installed on the Japanese Experiment Module External Facility (JEM-EF) in the third quarter of 2014 and will be ready to be used by the scientific community on a fully commercial basis. The new External Payload Platform (EPP) and its opportunities and constraints assessed regarding future research activities on-board the ISS. The small size platform is realised in a cooperation between the companies NanoRacks, Astrium North America in the United States, and Airbus Defence and Space in Germany. The hardware allows the fully robotic installation and operation of payloads. In the nominal mission scenario payload items are installed not later than one year after the signature of the contract, stay in operation for 15 weeks, and can be returned to the scientist thereafter. Payload items are transported among the pressurised cargo usually delivered to the station with various supply vehicles. Due to the high frequency of flights and the flexibility of the vehicle manifests the risk of a delay in the payload readiness can be mitigated by delaying to the next flight opportunity which on average is available not more than two months later. The mission is extra-ordinarily fast and of low cost in comparison to traditional research conducted on-board the ISS and can fit into short-term funding cycles available on national and multi-national levels. The size of the payload items is limited by handling constraints on-board the ISS. Therefore, the standard experiment payload size is a multiple of a

Further Evidence that Severe Scores in the Aggression/Anxiety-Depression/Attention Subscales of Child Behavior Checklist (Severe Dysregulation Profile) Can Screen for Bipolar Disorder Symptomatology: A Conditional Probability Analysis

Science.gov (United States)

Uchida, Mai; Faraone, Stephen V; Martelon, MaryKate; Kenworthy, Tara; Woodworth, K Yvonne; Spencer, Thomas; Wozniak, Janet; Biederman, Joseph

2014-01-01

Background Previous work shows that children with high scores (2 SD, combined score ≥ 210) on the Attention Problems, Aggressive Behavior, and Anxious-Depressed (A-A-A) subscales of the Child Behavior Checklist (CBCL) are more likely than other children to meet criteria for bipolar (BP)-I disorder. However, the utility of this profile as a screening tool has remained unclear. Methods We compared 140 patients with pediatric BP-I disorder, 83 with attention deficit hyperactivity disorder (ADHD), and 114 control subjects. We defined the CBCL-Severe Dysregulation profile as an aggregate cutoff score of ≥ 210 on the A-A-A scales. Patients were assessed with structured diagnostic interviews and functional measures. Results Patients with BP-I disorder were significantly more likely than both control subjects (Odds Ratio [OR]: 173.2; 95% Confidence Interval [CI], 21.2 to 1413.8; P < 0.001) and those with ADHD (OR: 14.6; 95% CI, 6.2 to 34.3; P < 0.001) to have a positive CBCL-Severe Dysregulation profile. Receiver Operating Characteristics analyses showed that the area under the curve for this profile comparing children with BP-I disorder against control subjects and those with ADHD was 99% and 85%, respectively. The corresponding positive predictive values for this profile were 99% and 92% with false positive rates of < 0.2% and 8% for the comparisons with control subjects and patients with ADHD, respectively. Limitations Non-clinician raters administered structured diagnostic interviews, and the sample was referred and largely Caucasian. Conclusions The CBCL-Severe Dysregulation profile can be useful as a screen for BP-I disorder in children in clinical practice. PMID:24882182

Lightning Imaging Sensor (LIS) on the International Space Station (ISS): Launch, Installation, Activation, and First Results

Science.gov (United States)

Blakeslee, R. J.; Christian, H. J., Jr.; Mach, D. M.; Buechler, D. E.; Koshak, W. J.; Walker, T. D.; Bateman, M. G.; Stewart, M. F.; O'Brien, S.; Wilson, T. O.; Pavelitz, S. D.; Coker, C.

2016-12-01

Over the past 20 years, the NASA Marshall Space Flight Center, the University of Alabama in Huntsville, and their partners developed and demonstrated the effectiveness and value of space-based lightning observations as a remote sensing tool for Earth science research and applications, and, in the process, established a robust global lightning climatology. The observations included measurements from the Lightning Imaging Sensor (LIS) on the Tropical Rainfall Measuring Mission (TRMM) and its Optical Transient Detector (OTD) predecessor that acquired global observations of total lightning (i.e., intracloud and cloud-to-ground discharges) spanning a period from May 1995 through April 2015. As an exciting follow-on to these prior missions, a space-qualified LIS built as a flight-spare for TRMM will be delivered to the International Space Station (ISS) for a 2 year or longer mission, flown as a hosted payload on the Department of Defense (DoD) Space Test Program-Houston 5 (STP-H5) mission. The STP-H5 payload containing LIS is scheduled launch from NASA's Kennedy Space Center to the ISS in November 2016, aboard the SpaceX Cargo Resupply Services-10 (SpaceX-10) mission, installed in the unpressurized "trunk" of the Dragon spacecraft. After the Dragon is berth to ISS Node 2, the payload will be removed from the trunk and robotically installed in a nadir-viewing location on the external truss of the ISS. Following installation on the ISS, the LIS Operations Team will work with the STP-H5 and ISS Operations Teams to power-on LIS and begin instrument checkout and commissioning. Following successful activation, LIS orbital operations will commence, managed from the newly established LIS Payload Operations Control Center (POCC) located at the National Space Science Technology Center (NSSTC) in Huntsville, AL. The well-established and robust processing, archival, and distribution infrastructure used for TRMM was easily adapted to the ISS mission, assuring that lightning

Liquid Structures and Physical Properties -- Ground Based Studies for ISS Experiments

Science.gov (United States)

Kelton, K. F.; Bendert, J. C.; Mauro, N. A.

2012-01-01

Studies of electrostatically-levitated supercooled liquids have demonstrated strong short- and medium-range ordering in transition metal and alloy liquids, which can influence phase transitions like crystal nucleation and the glass transition. The structure is also related to the liquid properties. Planned ISS experiments will allow a deeper investigation of these results as well as the first investigations of a new type of coupling in crystal nucleation in primary crystallizing liquids, resulting from a linking of the stochastic processes of diffusion with interfacial-attachment. A brief description of the techniques used for ground-based studies and some results relevant to planned ISS investigations are discussed.

Fundamental Space Biology-1: HHR and Incubator for ISS Space Life Sciences

Science.gov (United States)

Kirven-Brooks, M.; Fahlen, T.; Sato, K.; Reiss-Bubenheim, D.

The Space Station Biological Research Project (SSBRP) is developing an Incubator and a Habitat Holding Rack (HHR) to support life science experiments aboard the International Space Station (ISS). The HHR provides for cooling and power needs, and supports data transfer (including telemetry, commanding, video processing, Ethernet), video compression, and data and command storage). The Incubator is a habitat that provides for controlled temperature between +4 C and +45 C and air circulation. It has a set of connector ports for power, analog and digital sensors, and video pass-through to support experiment-unique hardware within the Incubator specimen chamber. The Incubator exchanges air with the ISS cabin. The Fundamental Space Biology-1 (FSB-1) Project will be delivering, the HHR and two Incubators to ISS. The two inaugural experiments to be conducted on ISS using this hardware will investigate the biological effects of the space environment on two model organisms, Saccharomyces cerevisiae (S. cerevisiae; yeast) and Caenorhabditis elegans (C. elegans; nematode). The {M}odel {Y}east {C}ultures {o}n {S}tation (MYCOS) experiment will support examination of the effect of microgravity and cosmic radiation on yeast biology. In the second series of experiments during the same increment, the effects of microgravity and space environment radiation on C. elegans will be examined. The {F}undamental Space Biology {I}ncubator {E}xperiment {R}esearch using {C}. {e}legans (FIERCE) study is designed to support a long duration, multi-generational study of nematodes. FIERCE on-orbit science operations will include video monitoring, sub-culturing and periodic fixation and freezing of samples. For both experiments, investigators will be solicited via an International Space Life Sciences Research Announcement. In the near future, the Centrifuge Accommodation Module will be delivered to ISS, which will house the SSBRP 2.5 m Centrifuge Rotor. The Incubator can be placed onto the Centrifuge

Very high coronary artery calcium score with normal myocardial perfusion SPECT imaging is associated with a moderate incidence of severe coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Yuoness, Salem A.; Goha, Ahmed M.; Romsa, Jonathan G.; Akincioglu, Cigdem; Warrington, James C.; Datta, Sudip; Gambhir, Sanjay; Urbain, Jean-Luc C.; Vezina, William C. [London Health Sciences Centre, Department of Nuclear Medicine, London, ON (Canada); Massel, David R. [London Health Sciences Centre, Division of Cardiology, London, ON (Canada); Martell, Rafael [Private Practice, London, ON (Canada)

2015-09-15

Myocardial perfusion imaging (MPI) has limitations in the presence of balanced multivessel disease (MVD) and left main (LM) coronary artery disease, occasionally resulting in false-normal results despite the high cardiovascular risk associated with this condition. The purpose of this study was to assess the incidence of severe coronary artery disease (CAD) in the presence of a very high Agatston coronary artery calcium (CAC) score (>1,000) in stable symptomatic patients without known CAD but with normal MPI results. A total of 2,659 prospectively acquired consecutive patients were referred for MPI and evaluation of CAC score by CT. Of this patient population, 8 % (222/2,659) had ischemia without myocardial infarction (MI) on MPI and 11 % (298/2,659) had abnormal MPI (MI and/or ischemia). On presentation 1 % of the patients (26/2,659) were symptomatic, had a CAC score >1,000 and normal MPI results. The definition of normal MPI was strict and included a normal hemodynamic response without ischemic ECG changes and normal imaging, particularly absence of transient ischemic dilation. All of these 26 patients with a CAC score >1,000 and normal MPI findings underwent cardiac catheterization. Of these 26 patients, 58 % (15/26) had severe disease (≥70 % stenosis) leading to revascularization. Of this group, 47 % (7/15) underwent percutaneous intervention, and 53 % (8/15) underwent coronary artery bypass grafting. All of these 15 patients had either MVD (14/15) or LM coronary artery disease (1/15), and represented 0.6 % (15/2,659) of all referred patients (95 % CI 0.3 - 0.9 %). The majority, 90 % (8/9), had severe CAD with typical chest pain. A very high CAC score (>1,000) with normal MPI in a small subset of symptomatically stable patients was associated with a moderate incidence of severe CAD (95 % CI 37 - 77 %). Larger studies and/or a meta-analysis of small studies are needed to more precisely estimate the incidence of CAD in this population. This study also supports

Development and Implementation of Efficiency-Improving Analysis Methods for the SAGE III on ISS Thermal Model Originating

Science.gov (United States)

Liles, Kaitlin; Amundsen, Ruth; Davis, Warren; Scola, Salvatore; Tobin, Steven; McLeod, Shawn; Mannu, Sergio; Guglielmo, Corrado; Moeller, Timothy

2013-01-01

The Stratospheric Aerosol and Gas Experiment III (SAGE III) instrument is the fifth in a series of instruments developed for monitoring aerosols and gaseous constituents in the stratosphere and troposphere. SAGE III will be delivered to the International Space Station (ISS) via the SpaceX Dragon vehicle in 2015. A detailed thermal model of the SAGE III payload has been developed in Thermal Desktop (TD). Several novel methods have been implemented to facilitate efficient payload-level thermal analysis, including the use of a design of experiments (DOE) methodology to determine the worst-case orbits for SAGE III while on ISS, use of TD assemblies to move payloads from the Dragon trunk to the Enhanced Operational Transfer Platform (EOTP) to its final home on the Expedite the Processing of Experiments to Space Station (ExPRESS) Logistics Carrier (ELC)-4, incorporation of older models in varying unit sets, ability to change units easily (including hardcoded logic blocks), case-based logic to facilitate activating heaters and active elements for varying scenarios within a single model, incorporation of several coordinate frames to easily map to structural models with differing geometries and locations, and streamlined results processing using an Excel-based text file plotter developed in-house at LaRC. This document presents an overview of the SAGE III thermal model and describes the development and implementation of these efficiency-improving analysis methods.

Corporate sponsored education initiatives on board the ISS

Science.gov (United States)

Durham, Ian T.; Durham, Alyson S.; Pawelczyk, James A.; Brod, Lawrence B.; Durham, Thomas F.

1999-01-01

This paper proposes the creation of a corporate sponsored ``Lecture from Space'' program on board the International Space Station (ISS) with funding coming from a host of new technology and marketing spin-offs. This program would meld existing education initiatives in NASA with new corporate marketing techniques. Astronauts in residence on board the ISS would conduct short ten to fifteen minute live presentations and/or conduct interactive discussions carried out by a teacher in the classroom. This concept is similar to a program already carried out during the Neurolab mission on Shuttle flight STS-90. Building on that concept, the interactive simulcasts would be broadcast over the Internet and linked directly to computers and televisions in classrooms worldwide. In addition to the live broadcasts, educational programs and demonstrations can be recorded in space, and marketed and sold for inclusion in television programs, computer software, and other forms of media. Programs can be distributed directly into classrooms as an additional presentation supplement, as well as over the Internet or through cable and broadcast television, similar to the Canadian Discovery Channel's broadcasts of the Neurolab mission. Successful marketing and advertisement can eventually lead to the creation of an entirely new, privately run cottage industry involving the distribution and sale of educationally related material associated with the ISS that would have the potential to become truly global in scope. By targeting areas of expertise and research interest in microgravity, a large curriculum could be developed using space exploration as a unifying theme. Expansion of this concept could enhance objectives already initiated through the International Space University to include elementary and secondary school students. The ultimate goal would be to stimulate interest in space and space related sciences in today's youth through creative educational marketing initiatives while at the

Analyzing Power Supply and Demand on the ISS

Science.gov (United States)

Thomas, Justin; Pham, Tho; Halyard, Raymond; Conwell, Steve

2006-01-01

Station Power and Energy Evaluation Determiner (SPEED) is a Java application program for analyzing the supply and demand aspects of the electrical power system of the International Space Station (ISS). SPEED can be executed on any computer that supports version 1.4 or a subsequent version of the Java Runtime Environment. SPEED includes an analysis module, denoted the Simplified Battery Solar Array Model, which is a simplified engineering model of the ISS primary power system. This simplified model makes it possible to perform analyses quickly. SPEED also includes a user-friendly graphical-interface module, an input file system, a parameter-configuration module, an analysis-configuration-management subsystem, and an output subsystem. SPEED responds to input information on trajectory, shadowing, attitude, and pointing in either a state-of-charge mode or a power-availability mode. In the state-of-charge mode, SPEED calculates battery state-of-charge profiles, given a time-varying power-load profile. In the power-availability mode, SPEED determines the time-varying total available solar array and/or battery power output, given a minimum allowable battery state of charge.

CIB: An Improved Communication Architecture for Real-Time Monitoring of Aerospace Materials, Instruments, and Sensors on the ISS

Directory of Open Access Journals (Sweden)

Michael J. Krasowski

2013-01-01

Full Text Available The Communications Interface Board (CIB is an improved communications architecture that was demonstrated on the International Space Station (ISS. ISS communication interfaces allowing for real-time telemetry and health monitoring require a significant amount of development. The CIB simplifies the communications interface to the ISS for real-time health monitoring, telemetry, and control of resident sensors or experiments. With a simpler interface available to the telemetry bus, more sensors or experiments may be flown. The CIB accomplishes this by acting as a bridge between the ISS MIL-STD-1553 low-rate telemetry (LRT bus and the sensors allowing for two-way command and telemetry data transfer. The CIB was designed to be highly reliable and radiation hard for an extended flight in low Earth orbit (LEO and has been proven with over 40 months of flight operation on the outside of ISS supporting two sets of flight experiments. Since the CIB is currently operating in flight on the ISS, recent results of operations will be provided. Additionally, as a vehicle health monitoring enabling technology, an overview and results from two experiments enabled by the CIB will be provided. Future applications for vehicle health monitoring utilizing the CIB architecture will also be discussed.

Effect of 0.5g/L cyclosporine A for symptom and sign scores in patients with moderate to severe dry eye

Directory of Open Access Journals (Sweden)

Su-Ying Yu

2016-05-01

Full Text Available AIM:To investigate the effect of 0.5g/L cyclosporine A for symptom and sign scores in patients with moderate to severe dry eye.METHODS:Eighty patients(160 eyeswith moderate to severe dry eye were divided into two groups by double-blind and random principles:40 patients(80 eyesin observation group were treated with 10g/L sodium carboxymethyl cellulose and 0.5g/L cyclosporine A eye drops, 40 patients(80 eyesin the control group were treated with 10g/L sodium carboxymethyl cellulose eye drops. The changes of ocular sign and symptom scores were compared between the two groups.RESULTS:The total effective rate of observation group was 95.0%, which was significantly higher than that of control group(85.0%, PPPP>0.05. After treatment, the four parameters of observation group were improved significantly(PPPCONCLUSION:The 0.5g/L cyclosporine A eye drops can effectively relieve the symptoms and signs of moderate to severe dry eye, promote tear secretion, and improve ocular surface environment. The treatment effect is good.

The OPALS Plan for Operations: Use of ISS Trajectory and Attitude Models in the OPALS Pointing Strategy

Science.gov (United States)

Abrahamson, Matthew J.; Oaida, Bogdan; Erkmen, Baris

2013-01-01

This paper will discuss the OPALS pointing strategy, focusing on incorporation of ISS trajectory and attitude models to build pointing predictions. Methods to extrapolate an ISS prediction based on past data will be discussed and will be compared to periodically published ISS predictions and Two-Line Element (TLE) predictions. The prediction performance will also be measured against GPS states available in telemetry. The performance of the pointing products will be compared to the allocated values in the OPALS pointing budget to assess compliance with requirements.

Impact of baseline Diabetic Retinopathy Severity Scale scores on visual outcomes in the VIVID-DME and VISTA-DME studies.

Science.gov (United States)

Staurenghi, Giovanni; Feltgen, Nicolas; Arnold, Jennifer J; Katz, Todd A; Metzig, Carola; Lu, Chengxing; Holz, Frank G

2017-10-19

To evaluate intravitreal aflibercept versus laser in subgroups of patients with baseline Diabetic Retinopathy Severity Scale (DRSS) scores ≤43, 47, and ≥53 in VIVID-DME and VISTA-DME. Patients with diabetic macular oedema were randomised to receive intravitreal aflibercept 2 mg every 4 weeks (2q4), intravitreal aflibercept 2 mg every 8 weeks after five initial monthly doses (2q8), or macular laser photocoagulation at baseline with sham injections at every visit. These post hoc analyses evaluate outcomes based on baseline DRSS scores in patients in the integrated dataset. The 2q4 and 2q8 treatment groups were also pooled. 748 patients had a baseline DRSS score based on fundus photographs (≤43, n=301; 47, n=153; ≥53, n=294). At week 100, the least squares mean difference between treatment groups (effect of intravitreal aflibercept above that of laser, adjusting for baseline best-corrected visual acuity) was 8.9 (95% CI 5.99 to 11.81), 9.7 (95% CI 5.54 to 13.91), and 11.0 (95% CI 7.96 to 14.1) letters in those with baseline DRSS scores ≤43, 47, and ≥53, respectively. The proportions of patients with ≥2 step DRSS score improvement were greater in the intravitreal aflibercept group versus laser, respectively, for those with baseline DRSS scores of ≤43 (13% vs 5.9%), 47 (25.8% vs 4.5%), and ≥53 (64.5% vs 28.4%). Regardless of baseline DRSS score, functional outcomes were superior in intravitreal aflibercept-treated patients, demonstrating consistent treatment benefit across various baseline levels of retinopathy. NCT01331681 and NCT01363440, Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system and the EORTC quality of life questionnaires

International Nuclear Information System (INIS)

Jensen, Kenneth; Bonde Jensen, Anders; Grau, Cai

2006-01-01

Background and purpose: Morbidity is an important issue in cancer research. The observer-based toxicity scoring system used by DAHANCA (the Danish head and neck cancer study group) has proved itself sensitive to differences in toxicity in a large randomised study, but like other toxicity scoring systems it has not been formally validated. Conversely, the EORTC quality of life questionnaire (QLQ) has been validated as a tool for collecting information about the consequences of disease and treatment on the well being of cancer patients. The purpose of this study was to examine the relationship between the two methods of side effect recording. Patients and methods: One hundred and sixteen recurrence free patients with laryngeal (n=44), pharyngeal (n=34) and oral cavity (n=38) cancer attending follow-up after radiotherapy (n=83) or surgery (n=33) completed EORTC C30, the core questionnaire concerning general symptoms and function and EORTC H and N35 the head and neck specific questionnaire. The attending physicians in the follow-up clinic evaluated and recorded DAHANCA toxicity scores on the same patients. Results: The DAHANCA toxicity scoring system and the EORTC QLQ correlated with several clinical endpoints. The conceptually similar endpoints of the two methods correlated significantly. The objective endpoints of the DAHANCA scoring system were only correlated with quality of life endpoints to a very low degree. The DAHANCA toxicity scores had a low sensitivity (0.48-0.74) in detecting equivalent subjective complaints from the questionnaires and the observer-based scoring system severely underestimated patient complaints. A specific patient group where the DAHANCA score had a higher tendency to fail could not be detected. Conclusion: The DAHANCA toxicity score is an effective instrument in assessing objective treatment induced toxicity in head and neck cancer patients but insensitive and non-specific with regard to patient assessed subjective endpoints. This

Development of Onboard Computer Complex for Russian Segment of ISS

Science.gov (United States)

Branets, V.; Brand, G.; Vlasov, R.; Graf, I.; Clubb, J.; Mikrin, E.; Samitov, R.

1998-01-01

Report present a description of the Onboard Computer Complex (CC) that was developed during the period of 1994-1998 for the Russian Segment of ISS. The system was developed in co-operation with NASA and ESA. ESA developed a new computation system under the RSC Energia Technical Assignment, called DMS-R. The CC also includes elements developed by Russian experts and organizations. A general architecture of the computer system and the characteristics of primary elements of this system are described. The system was integrated at RSC Energia with the participation of American and European specialists. The report contains information on software simulators, verification and de-bugging facilities witch were been developed for both stand-alone and integrated tests and verification. This CC serves as the basis for the Russian Segment Onboard Control Complex on ISS.

The BRICS (Bronchiectasis Radiologically Indexed CT Score): A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis.

Science.gov (United States)

Bedi, Pallavi; Chalmers, James D; Goeminne, Pieter C; Mai, Cindy; Saravanamuthu, Pira; Velu, Prasad Palani; Cartlidge, Manjit K; Loebinger, Michael R; Jacob, Joe; Kamal, Faisal; Schembri, Nicola; Aliberti, Stefano; Hill, Uta; Harrison, Mike; Johnson, Christopher; Screaton, Nicholas; Haworth, Charles; Polverino, Eva; Rosales, Edmundo; Torres, Antoni; Benegas, Michael N; Rossi, Adriano G; Patel, Dilip; Hill, Adam T

2018-05-01

The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent predicted FEV 1 , sputum purulence, and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV 1 , 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase activity was significantly elevated in the group with emphysema on CT imaging. A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Frequency of methotrexate intolerance in rheumatoid arthritis patients using methotrexate intolerance severity score (MISS questionnaire).

Science.gov (United States)

Fatimah, Nibah; Salim, Babur; Nasim, Amjad; Hussain, Kamran; Gul, Harris; Niazi, Sarah

2016-05-01

The objective of the study was to determine the frequency of methotrexate intolerance in rheumatoid arthritis (RA) patients by applying the methotrexate intolerance severity score (MISS) questionnaire and to see the effect of dose and concomitant use of other disease-modifying antirheumatic drugs (DMARDS) on methotrexate (MTX) intolerance. For the descriptive study, non-probability sampling was carried out in the Female Rheumatology Department of Fauji Foundation Hospital (FFH), Rawalpindi, Pakistan. One hundred and fifty diagnosed cases of RA using oral MTX were selected. The MISS questionnaire embodies five elements: abdominal pain, nausea, vomiting, fatigue and behavioural symptoms. The amplitude of each element was ranked from 0 to 3 being no complaint (0 points), mild (1 point), moderate (2 points) and severe (3 points). A cut-off score of 6 and above ascertained intolerance by the physicians. A total of 33.3 % of the subjects exhibited MTX intolerance according to the MISS questionnaire. Out of which, the most recurring symptom of all was behavioural with a value of 44 % whereas vomiting was least noticeable with a figure of 11 %. About 6.6 % of the women with intolerance were consuming DMARDs in conjunction with MTX. Those using the highest weekly dose of MTX (20 mg) had supreme intolerance with prevalence in 46.2 % of the patients. The frequency of intolerance decreased with a decrease in weekly dose to a minimum of 20 % with 7.5 mg of MTX. MTX intolerance has moderate prevalence in RA patients and if left undetected, the compliance to use of MTX as a first-line therapy will decrease. Methotrexate intolerance is directly proportional to the dose of MTX taken. Also, there is no upstroke seen in intolerance with the use of other disease-modifying agents.

NASA's Plans for Materials Science on ISS: Cooperative Utilization of the MSRR-MSL

Science.gov (United States)

Chiaramonte, Francis; Szofran, Frank

2008-01-01

The ISS Research Project draws Life (non-human) and Physical Sciences investigations on the ISS, free flyer and ground-based into one coordinated project. The project has two categories: I. Exploration Research Program: a) Utilizes the ISS as a low Technology Readiness Level (TRL) test bed for technology development, demonstration and problem resolution in the areas of life support, fire safety, power, propulsion, thermal management, materials technology, habitat design, etc.; b) Will include endorsement letters from other ETDP projects to show relevancy. II. Non-Exploration Research Program; a) Not directly related to supporting the human exploration program. Research conducted in the life (non-human) and physical sciences; b) The program will sustain, to the maximum extent practicable, the United States scientific expertise and research capability in fundamental microgravity research. Physical Sciences has about 44 grants, and Life Sciences has approximately 32 grants, mostly with universities, to conduct low TRL research; this includes grants to be awarded from the 2008 Fluid Physics and Life Science NRA's.

PSS32 Impact of dry eye on everyday life (Ideel) - Symptom bother: Estimating cut-off scores for dry eye severity groups

OpenAIRE

Acaster, S.; Verboven, Y.; Begley, C.; Chalmers, R.; Abetz, L.; Thompson, T.

2011-01-01

The aims of the study were to estimate score ranges associated with dry eye severity based on the Impact of Dry Eye on Everyday Life (IDEEL) Symptom Bother (SB) domain, and to evaluate the overall performance of the SB domain.

ISS Biotechnology Facility - Overview of Analytical Tools for Cellular Biotechnology Investigations

Science.gov (United States)

Jeevarajan, A. S.; Towe, B. C.; Anderson, M. M.; Gonda, S. R.; Pellis, N. R.

2001-01-01

The ISS Biotechnology Facility (BTF) platform provides scientists with a unique opportunity to carry out diverse experiments in a microgravity environment for an extended period of time. Although considerable progress has been made in preserving cells on the ISS for long periods of time for later return to Earth, future biotechnology experiments would desirably monitor, process, and analyze cells in a timely way on-orbit. One aspect of our work has been directed towards developing biochemical sensors for pH, glucose, oxygen, and carbon dioxide for perfused bioreactor system developed at Johnson Space Center. Another aspect is the examination and identification of new and advanced commercial biotechnologies that may have applications to on-orbit experiments.

Challenges in Evaluating the Severity of Fibropapillomatosis: A Proposal for Objective Index and Score System for Green Sea Turtles (Chelonia mydas) in Brazil.

Science.gov (United States)

Rossi, Silmara; Sánchez-Sarmiento, Angélica María; Vanstreels, Ralph Eric Thijl; Dos Santos, Robson Guimarães; Prioste, Fabiola Eloisa Setim; Gattamorta, Marco Aurélio; Grisi-Filho, José Henrique Hildebrand; Matushima, Eliana Reiko

2016-01-01

Fibropapillomatosis (FP) is a neoplastic disease that affects marine turtles worldwide, especially green sea turtles (Chelonia mydas). FP tumors can develop on the body surface of marine turtles and also internally in the oral cavity and viscera. Depending on their quantity, size and anatomical distribution, these tumors can interfere with hydrodynamics and the ability to feed, hence scoring systems have been proposed in an attempt to quantify the clinical manifestation of FP. In order to establish a new scoring system adapted to geographic regions, we examined 214 juvenile green sea turtles with FP caught or rescued at Brazilian feeding areas, counted their 7466 tumors and classified them in relation to their size and anatomical distribution. The patterns in quantity, size and distribution of tumors revealed interesting aspects in the clinical manifestation of FP in specimens studied in Brazil, and that FP scoring systems developed for other areas might not perform adequately when applied to sea turtles on the Southwest Atlantic Ocean. We therefore propose a novel method to evaluate the clinical manifestation of FP: fibropapillomatosis index (FPI) that provides the Southwest Atlantic fibropapillomatosis score (FPSSWA). In combination, these indexing and scoring systems allow for a more objective, rapid and detailed evaluation of the severity of FP in green sea turtles. While primarily designed for the clinical manifestation of FP currently witnessed in our dataset, this index and the score system can be adapted for other areas and compare the characteristics of the disease across regions. In conclusion, scoring systems to classify the severity of FP can assist our understanding on the environmental factors that modulate its development and its impacts on the individual and population health of green sea turtles.

Siivouksen laadunhallinta asuinkiinteistöissä

OpenAIRE

Huhmarkangas, Riikka

2013-01-01

Työssäni kehitettiin siivouksen laadunhallintaa VTS-kotien asuinkiinteistöissä. Pääpaino oli VTS Kiinteistöpalvelu Oy:n käytössä olevan laadunarviointiohjelman kehittämisessä. Työssäni kartoitettiin, mitä ja miten pitää kehittää asuinkiinteistösiivouksen laadunhallintaa myös tulevaisuudessa. Lähtökohtana oli se, että siivouksen taso tulee saada samalle linjalle kaikkien palveluntuottajien kanssa riippumatta siitä, kuka palvelua tuottaa. Jokaisessa VTS-kodissa tulisi siivouksen lopputulos ...

ISS Habitability Data Collection and Preliminary Findings

Science.gov (United States)

Thaxton, Sherry (Principal Investigator); Greene, Maya; Schuh, Susan; Williams, Thomas; Archer, Ronald; Vasser, Katie

2017-01-01

Habitability is the relationship between an individual and their surroundings (i.e. the interplay of the person, machines, environment, and mission). The purpose of this study is to assess habitability and human factors on the ISS to better prepare for future long-duration space flights. Scheduled data collection sessions primarily require the use of iSHORT (iPad app) to capture near real-time habitability feedback and analyze vehicle layout and space utilization.

Characterization and scoring of skin changes in severe acute malnutrition in children between 6 months and 5 years of age

DEFF Research Database (Denmark)

Heilskov, S; Vestergaard, Christian; Babirekere, E

2015-01-01

BACKGROUND: Severe acute malnutrition is a life-threatening condition. It can be associated with severe skin changes, first properly described by Williams in 1933. The aetiology of these skin changes is still unknown and their character has never been systematically described in dermatological...... objective was to identify the skin changes characteristic of children with severe acute malnutrition and to develop a clinical score that describes the morphology and severity in dermatological terms. We also investigated if any of the different skin changes were connected to prognosis. MATERIALS...... AND METHODS: At Mulago Hospital, Mwanamugimu (Department of Paediatrics and Child Health), Uganda, 120 children were included over a period of six months and observed when treated for severe acute malnutrition. Skin changes were registered through clinical examination and photo documentation and associated...

Use of BMI as marker of adiposity in a metabolic syndrome severity score: derivation and validation in predicting long-term disease outcomes.

Science.gov (United States)

Gurka, Matthew J; Filipp, Stephanie L; Musani, Solomon K; Sims, Mario; DeBoer, Mark D

2018-02-01

Estimates of adiposity in evaluating the metabolic syndrome (MetS) have traditionally utilized measures of waist circumference (WC), whereas body mass index (BMI) is more commonly used clinically. Our objective was to determine if a MetS severity Z-score employing BMI as its measure of adiposity (MetS-Z-BMI) would perform similarly to a WC-based score (MetS-Z-WC) in predicting future disease. To formulate the MetS-Z-BMI, we performed confirmatory factor analysis on a sex- and race/ethnicity-specific basis on MetS-related data for 6870 adult participants of the National Health and Nutrition Survey 1999-2010. We then validated this score and compared it to MetS-Z-WC in assessing correlations with future coronary heart disease (CHD) and Type 2 diabetes mellitus (T2DM) using Cox proportional hazard analysis of 13,094 participants of the Atherosclerosis Risk in Communities study and Jackson Heart Study. Loading factors, which represent the relative contribution of each component to the latent MetS factor, were lower for BMI than for WC in formulating the two respective scores (MetS-Z-BMI and MetS-Z-WC). Nevertheless, MetS-Z-BMI and MetS-Z-WC exhibited similar hazard ratios (HR) toward future disease. For each one standard-deviation-unit increase in MetS-Z-BMI, HR for CHD was 1.76 (95% confidence interval [CI]: 1.65, 1.88) and HR for T2DM was 3.39 (CI 3.16, 3.63) (both p BMI scores in their associations with future CHD and T2DM. A MetS severity Z-score utilizing BMI as its measure of adiposity operated similarly to a WC-based score in predicting future CHD and T2DM, suggesting overall similarity in MetS-based risk as estimated by both measures of adiposity. This indicates potential clinical usefulness of MetS-Z-BMI in assessing and following MetS-related risk over time. Copyright © 2018. Published by Elsevier Inc.

ISS-NIH Collaborative Programme: final report of the projects; Programma di collaborazione ISS-NIH: relazioni conclusive dei progetti

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-07-01

In July 2003, the National Institutes of Health (NIH) of the United States of America and the Istituto Superiore di Sanita (ISS) of Italy signed an agreement aimed at strengthening the ongoing research cooperation between USA and Italy. Over the years, the programme was able to create new partnerships and to foster the establishment of innovative synergies, the exchange of young researcher, and the merging of the best available skills, talents and know-how in different fields of biomedical sciences. This book contains the final report of the projects of the scientific cooperation between the two Countries. The report consists of two parts (in Italian and English) divided into four sections: Cancer, Neuroscience, Cardiovascular diseases, Infectious diseases. [Italian] Nel luglio 2003, i National Institutes of Health (NIH) americani e l'Istituto Superiore di Sanita (ISS) hanno firmato un accordo mirato a rafforzare la cooperazione scientifica tra Italia e USA. Nel corso degli anni il programma ha permesso di ampliare le collaborazioni e di promuovere nuove sinergie attraverso lo scambio di giovani ricercatori e la condivisione delle migliori competenze, conoscenze e capacita in diversi campi delle scienze biomediche. Questo volume contiene le relazioni finali dei progetti del programma di cooperazione scientifica tra i due Paesi. Il rapporto e articolato in due parti (in italiano e inglese) divise in quattro sezioni: Tumori, Neuroscienze, Malattie cardiovascolari, Malattie infettive.

Ionospheric Remote Sensing using GPS Radio Occultation and Ultraviolet Photometry aboard the ISS

Science.gov (United States)

Budzien, S. A.; Powell, S. P.; O'Hanlon, B.; Humphreys, T.; Bishop, R. L.; Stephan, A. W.; Gross, J.; Chakrabarti, S.

2017-12-01

The GPS Radio Occultation and Ultraviolet Photometer Co-located (GROUP-C) experiment launched to the International Space Station (ISS) on February 19, 2017 as part of the Space Test Program Houston #5 payload (STP-H5). After early orbit testing, GROUP-C began routine science operations in late April. GROUP-C includes a high-sensitivity far-ultraviolet photometer measuring horizontal nighttime ionospheric gradients and an advanced software-defined GPS receiver providing ionospheric electron density profiles, scintillation measurements, and lower atmosphere profiles. GROUP-C and a companion experiment, the Limb-Imaging Ionospheric and Thermospheric Extreme-Ultraviolet Spectrograph (LITES), offer a unique capability to study spatial and temporal variability of the thermosphere and ionosphere using multi-sensor approaches, including ionospheric tomography. Data are collected continuously across low- and mid-latitudes as the ISS orbit precesses through all local times every 60 days. The GROUP-C GPS sensor routinely collects dual-frequency GPS occultations, makes targeted raw signal captures of GPS and Galileo occultations, and includes multiple antennas to characterize multipath in the ISS environment. The UV photometer measures the 135.6 nm ionospheric recombination airglow emision along the nightside orbital track. We present the first analysis of ionospheric observations, discuss the challenges and opportunities of remote sensing from the ISS platform, and explore how these new data help address questions regarding the complex and dynamic features of the low and middle latitude ionosphere-thermosphere relevant to the upcoming GOLD and ICON missions.

Hyperspectral Remote Sensing of Terrestrial Ecosystem Productivity from ISS

Science.gov (United States)

Huemmrich, K. F.; Campbell, P. K. E.; Gao, B. C.; Flanagan, L. B.; Goulden, M.

2017-12-01

Data from the Hyperspectral Imager for Coastal Ocean (HICO), mounted on the International Space Station (ISS), were used to develop and test algorithms for remotely retrieving ecosystem productivity. The ISS orbit introduces both limitations and opportunities for observing ecosystem dynamics. Twenty six HICO images were used from four study sites representing different vegetation types: grasslands, shrubland, and forest. Gross ecosystem production (GEP) data from eddy covariance were matched with HICO-derived spectra. Multiple algorithms were successful relating spectral reflectance with GEP, including: Spectral Vegetation Indices (SVI), SVI in a light use efficiency model framework, spectral shape characteristics through spectral derivatives and absorption feature analysis, and statistical models leading to Multiband Hyperspectral Indices (MHI) from stepwise regressions and Partial Least Squares Regression (PLSR). Algorithms were able to achieve r2 better than 0.7 for both GEP at the overpass time and daily GEP. These algorithms were successful using a diverse set of observations combining data from multiple years, multiple times during growing season, different times of day, with different view angles, and different vegetation types. The demonstrated robustness of the algorithms presented in this study over these conditions provides some confidence in mapping spatial patterns of GEP, describing variability within fields as well as the regional patterns based only on spectral reflectance information. The ISS orbit provides periods with multiple observations collected at different times of the day within a period of a few days. Diurnal GEP patterns were estimated comparing the half-hourly average GEP from the flux tower against HICO estimates of GEP (r2=0.87) if morning, midday, and afternoon observations were available for average fluxes in the time period.

International Space Station (ISS) External Thermal Control System (ETCS) Loop A Pump Module (PM) Jettison Options Assessment

Science.gov (United States)

Murri, Daniel G.; Dwyer Cianciolo, Alicia; Shidner, Jeremy D.; Powell, Richard W.

2014-01-01

On December 11, 2013, the International Space Station (ISS) experienced a failure of the External Thermal Control System (ETCS) Loop A Pump Module (PM). To minimize the number of extravehicular activities (EVA) required to replace the PM, jettisoning the faulty pump was evaluated. The objective of this study was to independently evaluate the jettison options considered by the ISS Trajectory Operations Officer (TOPO) and to provide recommendations for safe jettison of the ETCS Loop A PM. The simulation selected to evaluate the TOPO options was the NASA Engineering and Safety Center's (NESC) version of Program to Optimize Simulated Trajectories II (POST2) developed to support another NESC assessment. The objective of the jettison analysis was twofold: (1) to independently verify TOPO posigrade and retrograde jettison results, and (2) to determine jettison guidelines based on additional sensitivity, trade study, and Monte Carlo (MC) analysis that would prevent PM recontact. Recontact in this study designates a propagated PM trajectory that comes within 500 m of the ISS propagated trajectory. An additional simulation using Systems Tool Kit (STK) was run for independent verification of the POST2 simulation results. Ultimately, the ISS Program removed the PM jettison option from consideration. However, prior to the Program decision, the retrograde jettison option remained part of the EVA contingency plan. The jettison analysis presented showed that, in addition to separation velocity/direction and the atmosphere conditions, the key variables in determining the time to recontact the ISS is highly dependent on the ballistic number (BN) difference between the object being jettisoned and the ISS.

ISS Contingency Attitude Control Recovery Method for Loss of Automatic Thruster Control

Science.gov (United States)

Bedrossian, Nazareth; Bhatt, Sagar; Alaniz, Abran; McCants, Edward; Nguyen, Louis; Chamitoff, Greg

2008-01-01

In this paper, the attitude control issues associated with International Space Station (ISS) loss of automatic thruster control capability are discussed and methods for attitude control recovery are presented. This scenario was experienced recently during Shuttle mission STS-117 and ISS Stage 13A in June 2007 when the Russian GN&C computers, which command the ISS thrusters, failed. Without automatic propulsive attitude control, the ISS would not be able to regain attitude control after the Orbiter undocked. The core issues associated with recovering long-term attitude control using CMGs are described as well as the systems engineering analysis to identify recovery options. It is shown that the recovery method can be separated into a procedure for rate damping to a safe harbor gravity gradient stable orientation and a capability to maneuver the vehicle to the necessary initial conditions for long term attitude hold. A manual control option using Soyuz and Progress vehicle thrusters is investigated for rate damping and maneuvers. The issues with implementing such an option are presented and the key issue of closed-loop stability is addressed. A new non-propulsive alternative to thruster control, Zero Propellant Maneuver (ZPM) attitude control method is introduced and its rate damping and maneuver performance evaluated. It is shown that ZPM can meet the tight attitude and rate error tolerances needed for long term attitude control. A combination of manual thruster rate damping to a safe harbor attitude followed by a ZPM to Stage long term attitude control orientation was selected by the Anomaly Resolution Team as the alternate attitude control method for such a contingency.

Analysis of dust samples from the Russian part of the ISS

Data.gov (United States)

National Aeronautics and Space Administration — Our study focuses on the hardiest microorganisms inhabiting the ISS in order to assess their diversity and capabilities to resist certain stresses. We specifically...

Clinical and molecular evaluation of SHOX/PAR1 duplications in Leri-Weill dyschondrosteosis (LWD) and idiopathic short stature (ISS).

Science.gov (United States)

Benito-Sanz, S; Barroso, E; Heine-Suñer, D; Hisado-Oliva, A; Romanelli, V; Rosell, J; Aragones, A; Caimari, M; Argente, J; Ross, J L; Zinn, A R; Gracia, R; Lapunzina, P; Campos-Barros, A; Heath, K E

2011-02-01

Léri-Weill dyschondrosteosis (LWD) is a skeletal dysplasia characterized by disproportionate short stature and the Madelung deformity of the forearm. SHOX mutations and pseudoautosomal region 1 deletions encompassing SHOX or its enhancers have been identified in approximately 60% of LWD and approximately 15% of idiopathic short stature (ISS) individuals. Recently SHOX duplications have been described in LWD/ISS but also in individuals with other clinical manifestations, thus questioning their pathogenicity. The objective of the study was to investigate the pathogenicity of SHOX duplications in LWD and ISS. Multiplex ligation-dependent probe amplification is routinely used in our unit to analyze for SHOX/pseudoautosomal region 1 copy number changes in LWD/ISS referrals. Quantitative PCR, microsatellite marker, and fluorescence in situ hybridization analysis were undertaken to confirm all identified duplications. During the routine analysis of 122 LWD and 613 ISS referrals, a total of four complete and 10 partial SHOX duplications or multiple copy number (n > 3) as well as one duplication of the SHOX 5' flanking region were identified in nine LWD and six ISS cases. Partial SHOX duplications appeared to have a more deleterious effect on skeletal dysplasia and height gain than complete SHOX duplications. Importantly, no increase in SHOX copy number was identified in 340 individuals with normal stature or 104 overgrowth referrals. MLPA analysis of SHOX/PAR1 led to the identification of partial and complete SHOX duplications or multiple copies associated with LWD or ISS, suggesting that they may represent an additional class of mutations implicated in the molecular etiology of these clinical entities.

Lightning Imaging Sensor (LIS) for the International Space Station (ISS): Mission Description and Science Goals

Science.gov (United States)

Blakeslee, R. J.; Christian, H. J.; Mach, D. M.; Buechler, D. E.; Koshak, W. J.; Walker, T. D.; Bateman, M.; Stewart, M. F.; O'Brien, S.; Wilson, T.;

DRAGONS-A Micrometeoroid and Orbital Debris Impact Sensor on the ISS

Science.gov (United States)

Liou, J.-C.; Hamilton, J.; Liolios, S.; Anderson, C.; Sadilek, A.; Corsaro, R.; Giovane, F.; Burchell, M.

2015-01-01

The Debris Resistive/Acoustic Grid Orbital Navy-NASA Sensor (DRAGONS) is intended to be a large area impact sensor for in situ measurements of micrometeoroids and orbital debris (MMOD) in the sub-millimeter to millimeter size regime in the near Earth space environment. These MMOD particles are too small to be detected by ground-based radars and optical telescopes, but still large enough to be a serious threat to human space activities and robotic missions in the low Earth orbit (LEO) region. The nominal detection area of DRAGONS is 1 sq m, consisting of four 0.5 m × 0.5 m independent panels, but the dimensions of the panels can easily be modified to accommodate different payload constraints. The approach of the DRAGONS design is to combine three particle impact detection concepts to maximize information that can be extracted from each detected impact. The first is a resistive grid consisting of 75-micrometer-wide resistive lines, coated in parallel and separated by 75 micrometer gaps on a 25-micrometer thin film. When a particle a few hundred micrometers or larger strikes the grid, it would penetrate the film and sever some resistive lines. The size of the damage area can be estimated from the increased resistance. The second concept is based on polyvinylidene fluoride (PVDF) acoustic impact sensors. Multiple PVDF sensors are attached to the thin film to provide the impact timing information. From the different signal arrival times at different acoustic sensors, the impact location can be calculated via triangulation algorithms. The third concept employs a dual-layer film system where a second 25-micrometer film is placed 15 cm behind the resistive-grid film. Multiple PVDF acoustic sensors are also attached to the second film. The combination of impact timing and location information from the two films allows for direct measurements of the impact direction and speed. The DRAGONS technology development has been funded by several NASA organizations since 2002, first

Standardized error severity score (ESS) ratings to quantify risk associated with child restraint system (CRS) and booster seat misuse.

Science.gov (United States)

Rudin-Brown, Christina M; Kramer, Chelsea; Langerak, Robin; Scipione, Andrea; Kelsey, Shelley

2017-11-17

Although numerous research studies have reported high levels of error and misuse of child restraint systems (CRS) and booster seats in experimental and real-world scenarios, conclusions are limited because they provide little information regarding which installation issues pose the highest risk and thus should be targeted for change. Beneficial to legislating bodies and researchers alike would be a standardized, globally relevant assessment of the potential injury risk associated with more common forms of CRS and booster seat misuse, which could be applied with observed error frequency-for example, in car seat clinics or during prototype user testing-to better identify and characterize the installation issues of greatest risk to safety. A group of 8 leading world experts in CRS and injury biomechanics, who were members of an international child safety project, estimated the potential injury severity associated with common forms of CRS and booster seat misuse. These injury risk error severity score (ESS) ratings were compiled and compared to scores from previous research that had used a similar procedure but with fewer respondents. To illustrate their application, and as part of a larger study examining CRS and booster seat labeling requirements, the new standardized ESS ratings were applied to objective installation performance data from 26 adult participants who installed a convertible (rear- vs. forward-facing) CRS and booster seat in a vehicle, and a child test dummy in the CRS and booster seat, using labels that only just met minimal regulatory requirements. The outcome measure, the risk priority number (RPN), represented the composite scores of injury risk and observed installation error frequency. Variability within the sample of ESS ratings in the present study was smaller than that generated in previous studies, indicating better agreement among experts on what constituted injury risk. Application of the new standardized ESS ratings to installation

What it takes to Fly in Space...Training to be an Astronaut and Daily Operations on ISS

Science.gov (United States)

Ham, Michelle

2009-01-01

This presentation highlights NASA requirements to become an astronaut, training astronauts must do to fly on the International Space Station (ISS), systems and other training, and day-to-day activities onboard ISS. Additionally, stowage, organization and methods of communication (email, video conferenceing, IP phone) are discussed.

Applying lessons learned to enhance human performance and reduce human error for ISS operations

Energy Technology Data Exchange (ETDEWEB)

Nelson, W.R.

1998-09-01

A major component of reliability, safety, and mission success for space missions is ensuring that the humans involved (flight crew, ground crew, mission control, etc.) perform their tasks and functions as required. This includes compliance with training and procedures during normal conditions, and successful compensation when malfunctions or unexpected conditions occur. A very significant issue that affects human performance in space flight is human error. Human errors can invalidate carefully designed equipment and procedures. If certain errors combine with equipment failures or design flaws, mission failure or loss of life can occur. The control of human error during operation of the International Space Station (ISS) will be critical to the overall success of the program. As experience from Mir operations has shown, human performance plays a vital role in the success or failure of long duration space missions. The Department of Energy`s Idaho National Engineering and Environmental Laboratory (INEEL) is developed a systematic approach to enhance human performance and reduce human errors for ISS operations. This approach is based on the systematic identification and evaluation of lessons learned from past space missions such as Mir to enhance the design and operation of ISS. This paper describes previous INEEL research on human error sponsored by NASA and how it can be applied to enhance human reliability for ISS.

Development of the siriraj clinical asthma score.

Science.gov (United States)

Vichyanond, Pakit; Veskitkul, Jittima; Rienmanee, Nuanphong; Pacharn, Punchama; Jirapongsananuruk, Orathai; Visitsunthorn, Nualanong

2013-09-01

Acute asthmatic attack in children commonly occurs despite the introduction of effective controllers such as inhaled corticosteroids and leukotriene modifiers. Treatment of acute asthmatic attack requires proper evaluation of attack severity and appropriate selection of medical therapy. In children, measurement of lung function is difficult during acute attack and thus clinical asthma scoring may aid physician in making further decision regarding treatment and admission. We enrolled 70 children with acute asthmatic attack with age range from 1 to 12 years (mean ± SD = 51.5 ± 31.8 months) into the study. Twelve selected asthma severity items were assessed by 2 independent observers prior to administration of salbutamol nebulization (up to 3 doses at 20 minutes interval). Decision for further therapy and admission was made by emergency department physician. Three different scoring systems were constructed from items with best validity. Sensitivity, specificity and accuracy of these scores were assessed. Inter-rater reliability was assessed for each score. Review of previous scoring systems was also conducted and reported. Three severity items had poor validity, i.e., cyanosis, depressed cerebral function, and I:E ratio (p > 0.05). Three items had poor inter-rater reliability, i.e., breath sound quality, air entry, and I:E ratio. These items were omitted and three new clinical scores were constructed from the remaining items. Clinical scoring system comprised retractions, dyspnea, O2 saturation, respiratory rate and wheezing (rangeof score 0-10) gave the best accuracy and inter-rater variability and were chosen for clinical use-Siriraj Clinical Asthma Score (SCAS). A Clinical Asthma Score that is simple, relatively easy to administer and with good validity and variability is essential for treatment of acute asthma in children. Several good candidate scores have been introduced in the past. We described the development of the Siriraj Clinical Asthma Score (SCAS) in

Development of a severity score for CRPS

NARCIS (Netherlands)

Harden, R.N.; Bruehl, S.; Perez, R.S.G.M.; Birklein, F.; Marinus, J.; Maihofner, C.; Lubenow, T.; Buvanendran, A.; Mackey, S.; Graciosa, J.; Mogilevski, M.; Ramsden, C.; Schlereth, T.; Chont, M.; Vatine, J.J.

2010-01-01

The clinical diagnosis of Complex Regional Pain Syndrome (CRPS) is a dichotomous (yes/no) categorization necessary for clinical decision-making. However, such dichotomous diagnostic categories do not convey an individual's subtle and temporal gradations in severity of the condition, and have poor

Improving the Geolocation Algorithm for Sensors Onboard the ISS: Effect of Drift Angle

Directory of Open Access Journals (Sweden)

Changyong Dou

2014-05-01

Full Text Available The drift angle caused by the Earth’s self-rotation may introduce rotational displacement artifact on the geolocation results of imagery acquired by an Earth observing sensor onboard the International Space Station (ISS. If uncorrected, it would cause a gradual degradation of positional accuracy from the center towards the edges of an image. One correction method to account for the drift angle effect was developed. The drift angle was calculated from the ISS state vectors and positional information of the ground nadir point of the imagery. Tests with images acquired by the International Space Station Agriculture Camera (ISSAC using Google EarthTM as a reference indicated that applying the drift angle correction can reduce the residual geolocation error for the corner points of the ISSAC images from over 1000 to less than 500 m. The improved geolocation accuracy is well within the inherent geolocation uncertainty of up to 800 m, mainly due to imprecise knowledge of the ISS attitude and state parameters required to perform the geolocation algorithm.

Veggie ISS Validation Test Results and Produce Consumption

Science.gov (United States)

Massa, Gioia; Hummerick, Mary; Spencer, LaShelle; Smith, Trent

2015-01-01

The Veggie vegetable production system flew to the International Space Station (ISS) in the spring of 2014. The first set of plants, Outredgeous red romaine lettuce, was grown, harvested, frozen, and returned to Earth in October. Ground control and flight plant tissue was sub-sectioned for microbial analysis, anthocyanin antioxidant phenolic analysis, and elemental analysis. Microbial analysis was also performed on samples swabbed on orbit from plants, Veggie bellows, and plant pillow surfaces, on water samples, and on samples of roots, media, and wick material from two returned plant pillows. Microbial levels of plants were comparable to ground controls, with some differences in community composition. The range in aerobic bacterial plate counts between individual plants was much greater in the ground controls than in flight plants. No pathogens were found. Anthocyanin concentrations were the same between ground and flight plants, while antioxidant and phenolic levels were slightly higher in flight plants. Elements varied, but key target elements for astronaut nutrition were similar between ground and flight plants. Aerobic plate counts of the flight plant pillow components were significantly higher than ground controls. Surface swab samples showed low microbial counts, with most below detection limits. Flight plant microbial levels were less than bacterial guidelines set for non-thermostabalized food and near or below those for fungi. These guidelines are not for fresh produce but are the closest approximate standards. Forward work includes the development of standards for space-grown produce. A produce consumption strategy for Veggie on ISS includes pre-flight assessments of all crops to down select candidates, wiping flight-grown plants with sanitizing food wipes, and regular Veggie hardware cleaning and microbial monitoring. Produce then could be consumed by astronauts, however some plant material would be reserved and returned for analysis. Implementation of

STS-110/Atlantic/ISS 8A Pre-Launch On Orbit-Landing-Crew Egress

Science.gov (United States)

2002-01-01

The crew of STS-110, which consists of Commander Michael Bloomfield, Pilot Stephen Frick, and Mission Specialists Rex Walheim, Ellen Ochoa, Lee Morin, Jerry Ross, and Steven Smith is introduced at the customary pre-flight meal. The narrator provides background information on the astronauts during suit-up. Each crew member is shown in the White Room before boarding Space Shuttle Atlantis, and some display signs to loved ones. Launch footage includes the following replays: Beach Tracker, VAB, Pad B, Tower 1, DLTR-3, Grandstand, Cocoa Beach DOAMS, Playalinda DOAMS, UCS-23, SLF Convoy, OTV-154, OTV-163, OTV-170 (mislabeled), and OTV-171 (mislabeled). After the launch, NASA administrator Sean O'Keefe gives a speech to the Launch Control Center, with political dignitaries present. While on-orbit, Atlantis docks with the International Space Station (ISS), and Canadarm 2 on the ISS lifts the S0 Truss out of the orbiter's payload bay. The video includes highlights of three extravehicular activities (EVAs). In the first, the S0 Truss is fastened to the Destiny Laboratory Module on the ISS. During the third EVA, Walheim and Smith assist in the checkout of the handcart on the S0 Truss. The Atlantis crew is shown gathered together with the Expedition 4 crew of the ISS, and again by itself after undocking. Replays of the landing include: VAB, Tower 1, Mid-field, Runway South End, Runway North End, Tower 2, Playalinda DOAMS, Cocoa Beach DOAMS, and Pilot Point of View (PPOV). After landing, Commander Bloomfield lets each of his crew members give a short speech.

Performance Characterization of Loctite (Registered Trademark) 242 and 271 Liquid Locking Compounds (LLCs) as a Secondary Locking Feature for International Space Station (ISS) Fasteners

Science.gov (United States)

Dube, Michael J.; Gamwell, Wayne R.

2011-01-01

Several International Space Station (ISS) hardware components use Loctite (and other polymer based liquid locking compounds (LLCs)) as a means of meeting the secondary (redundant) locking feature requirement for fasteners. The primary locking method is the fastener preload, with the application of the Loctite compound which when cured is intended to resist preload reduction. The reliability of these compounds has been questioned due to a number of failures during ground testing. The ISS Program Manager requested the NASA Engineering and Safety Center (NESC) to characterize and quantify sensitivities of Loctite being used as a secondary locking feature. The findings and recommendations provided in this investigation apply to the anaerobic LLCs Loctite 242 and 271. No other anaerobic LLCs were evaluated for this investigation. This document contains the findings and recommendations of the NESC investigation

The VASIMR[registered trademark] VF-200-1 ISS Experiment as a Laboratory for Astrophysics

Science.gov (United States)

Glover Tim W.; Squire, Jared P.; Longmier, Benjamin; Cassady, Leonard; Ilin, Andrew; Carter, Mark; Olsen, Chris S.; McCaskill, Greg; Diaz, Franklin Chang; Girimaji, Sharath;

Updated Performance Evaluation of the ISS Water Processor Multifiltration Beds

Science.gov (United States)

Bowman, Elizabeth M.; Carter, Layne; Carpenter, Joyce; Orozco, Nicole; Weir, Natalee; Wilson, Mark

2014-01-01

The ISS Water Processor Assembly (WPA) produces potable water from a waste stream containing humidity condensate and urine distillate. The primary treatment process is achieved in the Multifiltration Beds, which include adsorbent media and ion exchange resin for the removal of dissolved organic and inorganic contaminants. Two Multifiltration Beds (MF Beds) were replaced on ISS in July 2010 after initial indication of inorganic breakthrough of the first bed and an increasing Total Organic Carbon (TOC) trend in the product water. The first bed was sampled and analyzed Sept 2011 through March 2012. The second MF Bed was sampled and analyzed June 2012 through August 2012. The water resident in the both beds was analyzed for various parameters to evaluate adsorbent loading, performance of the ion exchange resin, microbial activity, and generation of leachates from the ion exchange resin. Portions of the adsorbent media and ion exchange resin were sampled and subsequently desorbed to identify the primary contaminants removed at various points in the bed in addition to microbial analysis. Analysis of the second bed will be compared to results from the first bed to provide a comprehensive overview of how the Multifiltration Beds function on orbit. New data from the second bed supplements the analysis of the first bed (previously reported) and gives a more complete picture of breakthrough compounds, resin breakdown products, microbial activity, and difficult to remove compounds. The results of these investigations and implications to the operation of the WPA on ISS are documented in this paper.

SOLAR-ISS: A new reference spectrum based on SOLAR/SOLSPEC observations

Science.gov (United States)

Meftah, M.; Damé, L.; Bolsée, D.; Hauchecorne, A.; Pereira, N.; Sluse, D.; Cessateur, G.; Irbah, A.; Bureau, J.; Weber, M.; Bramstedt, K.; Hilbig, T.; Thiéblemont, R.; Marchand, M.; Lefèvre, F.; Sarkissian, A.; Bekki, S.

2018-03-01

Context. Since April 5, 2008 and up to February 15, 2017, the SOLar SPECtrometer (SOLSPEC) instrument of the SOLAR payload on board the International Space Station (ISS) has performed accurate measurements of solar spectral irradiance (SSI) from the middle ultraviolet to the infrared (165 to 3088 nm). These measurements are of primary importance for a better understanding of solar physics and the impact of solar variability on climate. In particular, a new reference solar spectrum (SOLAR-ISS) is established in April 2008 during the solar minima of cycles 23-24 thanks to revised engineering corrections, improved calibrations, and advanced procedures to account for thermal and aging corrections of the SOLAR/SOLSPEC instrument. Aims: The main objective of this article is to present a new high-resolution solar spectrum with a mean absolute uncertainty of 1.26% at 1σ from 165 to 3000 nm. This solar spectrum is based on solar observations of the SOLAR/SOLSPEC space-based instrument. Methods: The SOLAR/SOLSPEC instrument consists of three separate double monochromators that use concave holographic gratings to cover the middle ultraviolet (UV), visible (VIS), and infrared (IR) domains. Our best ultraviolet, visible, and infrared spectra are merged into a single absolute solar spectrum covering the 165-3000 nm domain. The resulting solar spectrum has a spectral resolution varying between 0.6 and 9.5 nm in the 165-3000 nm wavelength range. We build a new solar reference spectrum (SOLAR-ISS) by constraining existing high-resolution spectra to SOLAR/SOLSPEC observed spectrum. For that purpose, we account for the difference of resolution between the two spectra using the SOLAR/SOLSPEC instrumental slit functions. Results: Using SOLAR/SOLSPEC data, a new solar spectrum covering the 165-3000 nm wavelength range is built and is representative of the 2008 solar minimum. It has a resolution better than 0.1 nm below 1000 nm and 1 nm in the 1000-3000 nm wavelength range. The new

Space Radiation Peculiarities in the Extra Vehicular Environment of the International Space Station (ISS)

Science.gov (United States)

Dachev, Tsvetan; Bankov, Nikolay; Tomov, Borislav; Matviichuk, Yury; Dimitrov, Plamen

2013-12-01

The space weather and the connected with it ionizing radiation were recognized as a one of the main health concern to the International Space Station (ISS) crew. Estimation the effects of radiation on humans in ISS requires at first order accurate knowledge of the accumulated by them absorbed dose rates, which depend of the global space radiation distribution and the local variations generated by the 3D surrounding shielding distribution. The R3DE (Radiation Risks Radiometer-Dosimeter (R3D) for the EXPOSE-E platform on the European Technological Exposure Facility (EuTEF) worked successfully outside of the European Columbus module between February 2008 and September 2009. Very similar instrument named R3DR for the EXPOSE-R platform worked outside Russian Zvezda module of ISS between March 2009 and August 2010. Both are Liulin type, Bulgarian build miniature spectrometers-dosimeters. They accumulated about 5 million measurements of the flux and absorbed dose rate with 10 seconds resolution behind less than 0.41 g cm-2 shielding, which is very similar to the Russian and American space suits [1-3] average shielding. That is why all obtained data can be interpreted as possible doses during Extra Vehicular Activities (EVA) of the cosmonauts and astronauts. The paper first analyses the obtained long-term results in the different radiation environments of: Galactic Cosmic Rays (GCR), inner radiation belt trapped protons in the region of the South Atlantic Anomaly (SAA) and outer radiation belt (ORB) relativistic electrons. The large data base was used for development of an empirical model for calculation of the absorbed dose rates in the extra vehicular environment of ISS at 359 km altitude. The model approximate the averaged in a grid empirical dose rate values to predict the values at required from the user geographical point, station orbit or area in geographic coordinate system. Further in the paper it is presented an intercomparison between predicted by the model dose

Structural Verification of the First Orbital Wonder of the World - The Structural Testing and Analysis of the International Space Station (ISS)

Science.gov (United States)

Zipay, John J.; Bernstein, Karen S.; Bruno, Erica E.; Deloo, Phillipe; Patin, Raymond

2012-01-01

The International Space Station (ISS) can be considered one of the structural engineering wonders of the world. On par with the World Trade Center, the Colossus of Rhodes, the Statue of Liberty, the Great Pyramids, the Petronas towers and the Burj Khalifa skyscraper of Dubai, the ambition and scope of the ISS structural design, verification and assembly effort is a truly global success story. With its on-orbit life projected to be from its beginning in 1998 to the year 2020 (and perhaps beyond), all of those who participated in its development can consider themselves part of an historic engineering achievement representing all of humanity. The structural design and verification of the ISS could be the subject of many scholarly papers. Several papers have been written on the structural dynamic characterization of the ISS once it was assembled on-orbit [1], but the ground-based activities required to assure structural integrity and structural life of the individual elements from delivery to orbit through assembly and planned on-orbit operations have never been totally summarized. This paper is intended to give the reader an overview of some of the key decisions made during the structural verification planning for the elements of the U.S. On-Orbit Segment (USOS) as well as to summarize the many structural tests and structural analyses that were performed on its major elements. An effort is made for this paper to be summarily comprehensive, but as with all knowledge capture efforts of this kind, there are bound to be errors of omission. Should the reader discover any of these, please feel free to contact the principal author. The ISS (Figure 1) is composed of pre-integrated truss segments and pressurized elements supplied by NASA, the Russian Federal Space Agency (RSA), the European Space Agency (ESA) and the Japanese Aerospace Exploration Agency (JAXA). Each of these elements was delivered to orbit by a launch vehicle and connected to one another either robotically or

Risk Factors for the Failure of Spinal Burst Fractures Treated Conservatively According to the Thoracolumbar Injury Classification and Severity Score (TLICS: A Retrospective Cohort Trial.

Directory of Open Access Journals (Sweden)

Jieliang Shen

Full Text Available The management of thoracolumbar (TL burst fractures is still controversial. The thoracolumbar injury classification and severity score (TLICS algorithm is now widely used to guide clinical decision making, however, in clinical practice, we come to realize that TLICS also has its limitations for treating patients with total scores less than 4, for which conservative treatment may not be optimal in all cases.The aim of this study is to identify several risk factors for the failure of conservative treatment of TL burst fractures according to TLICS algorithm.From June 2008 to December 2013, a cohort of 129 patients with T10-l2 TL burst fractures with a TLISC score ≤3 treated non-operatively were identified and included into this retrospective study. Age, sex, pain intensity, interpedicular distance (IPD, canal compromise, loss of vertebral body height and kyphotic angle (KA were selected as potential risk factors and compared between the non-operative success group and the non-operative failure group.One hundred and four patients successfully completed non-operative treatment, the other 25 patients were converted to surgical treatment because of persistent local back pain or progressive neurological deficits during follow-up. Our results showed that age, visual analogue scale (VAS score and IPD, KA were significantly different between the two groups. Furthermore, regression analysis indicated that VAS score and IPD could be considered as significant predictors for the failure of conservative treatment.The recommendation of non-operative treatment for TLICS score ≤3 has limitations in some patients, and VAS score and IPD could be considered as risk factors for the failure of conservative treatment. Thus, conservative treatment should be decided with caution in patients with greater VAS scores or IPD. If non-operative management is decided, a close follow-up is necessary.

The ISS National Inventory of Chemical Substances (INSC).

Science.gov (United States)

Binetti, Roberto; Costamagna, Francesca Marina; Ceccarelli, Federica; D'angiolini, Antonella; Fabri, Alessandra; Riva, Giovanni; Satalia, Susanna; Marcello, Ida

2008-01-01

The INSC (Inventario Nazionale delle Sostanze Chimiche), a factual data bank, produced by Istituto Superiore di Sanità (ISS), consists of an electronic tool on chemical information developed for routine and emergency purposes. Historical background, current status and future perspectives of INSC are discussed. The structure and the feature of INSC are briefly examined. Aspects of information retrieval and the criteria for inclusion of data and priority selection are also considered.

Incremental predictive validity of the Addiction Severity Index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders.

Science.gov (United States)

Thylstrup, Birgitte; Bloomfield, Kim; Hesse, Morten

2018-01-01

The Addiction Severity Index (ASI) is a widely used assessment instrument for substance abuse treatment that includes scales reflecting current status in seven potential problem areas, including psychiatric severity. The aim of this study was to assess the ability of the psychiatric composite score to predict suicide and psychiatric care after residential treatment for drug use disorders after adjusting for history of psychiatric care. All patients treated for drug use disorders in residential treatment centers in Denmark during the years 2000-2010 with complete ASI data were followed through national registers of psychiatric care and causes of death (N=5825). Competing risks regression analyses were used to assess the incremental predictive validity of the psychiatric composite score, controlling for previous psychiatric care, length of intake, and other ASI composite scores, up to 12years after discharge. A total of 1769 patients received psychiatric care after being discharged from residential treatment (30.3%), and 27 (0.5%) committed suicide. After adjusting for all covariates, psychiatric composite score was associated with a higher risk of receiving psychiatric care after residential treatment (subhazard ratio [SHR]=3.44, psuicide (SHR=11.45, pdrug use disorders who could benefit from additional mental health treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

penetrating abdominal trauma

African Journals Online (AJOL)

gender, mechanism of injury, injury severity scores (ISS), penetrating ... ileus, reduced pulmonary function and loss of muscle mass and function, all of .... pathophysiology and rehabilitation. ... quality of life after surgery for colorectal cancer.

Materials International Space Station Experiment (MISSE) 5 Developed to Test Advanced Solar Cell Technology Aboard the ISS

Science.gov (United States)

Wilt, David M.

2004-01-01

The testing of new technologies aboard the International Space Station (ISS) is facilitated through the use of a passive experiment container, or PEC, developed at the NASA Langley Research Center. The PEC is an aluminum suitcase approximately 2 ft square and 5 in. thick. Inside the PEC are mounted Materials International Space Station Experiment (MISSE) plates that contain the test articles. The PEC is carried to the ISS aboard the space shuttle or a Russian resupply vehicle, where astronauts attach it to a handrail on the outer surface of the ISS and deploy the PEC, which is to say the suitcase is opened 180 deg. Typically, the PEC is left in this position for approximately 1 year, at which point astronauts close the PEC and it is returned to Earth. In the past, the PECs have contained passive experiments, principally designed to characterize the durability of materials subjected to the ultraviolet radiation and atomic oxygen present at the ISS orbit. The MISSE5 experiment is intended to characterize state-of-art (SOA) and beyond photovoltaic technologies.

A NeISS collaboration to develop and use e-infrastructure for large-scale social simulation

OpenAIRE

Doherty, Thomas; Skipsey, Samuel; Turner, Andy; Watt, John

2011-01-01

The National e-Infrastructure for Social Simulation (NeISS) project is focused on\\ud developing e-Infrastructure to support social simulation research. Part of NeISS aims to\\ud provide an interface for running contemporary dynamic demographic social simulation\\ud models as developed in the GENESIS project. These GENESIS models operate at the\\ud individual person level and are stochastic. This paper focuses on support for a simplistic\\ud demographic change model that has a daily time steps, an...

ISS and Shuttle Payload Research Development and Processing

Science.gov (United States)

Calhoun, Kyle A.

2010-01-01

NASA's ISS and Spacecraft Processing Directorate (UB) is charged with the performance of payload development for research originating through NASA, ISS international partners, and the National Laboratory. The Payload Development sector of the Directorate takes biological research approved for on orbit experimentation from its infancy stage and finds a way to integrate and implement that research into a payload on either a Shuttle sortie or Space Station increment. From solicitation and selection, to definition, to verification, to integration and finally to operations and analysis, Payload Development is there every step of the way. My specific work as an intern this summer has consisted of investigating data received by separate flight and ground control Advanced Biological Research Systems (ABRS) units for Advanced Plant Experiments (APEX) and Cambium research. By correlation and analysis of this data and specific logbook information I have been working to explain changes in environmental conditions on both the flight and ground control unit. I have then, compiled all of that information into a form that can be presentable to the Principal Investigator (PI). This compilation allows that PI scientist to support their findings and add merit to their research. It also allows us, as the Payload Developers, to further inspect the ABRS unit and its performance

How Do Lessons Learned on the International Space Station (ISS) Help Plan Life Support for Mars?

Science.gov (United States)

Jones, Harry W.; Hodgson, Edward W.; Gentry, Gregory J.; Kliss, Mark H.

2016-01-01

How can our experience in developing and operating the International Space Station (ISS) guide the design, development, and operation of life support for the journey to Mars? The Mars deep space Environmental Control and Life Support System (ECLSS) must incorporate the knowledge and experience gained in developing ECLSS for low Earth orbit, but it must also meet the challenging new requirements of operation in deep space where there is no possibility of emergency resupply or quick crew return. The understanding gained by developing ISS flight hardware and successfully supporting a crew in orbit for many years is uniquely instructive. Different requirements for Mars life support suggest that different decisions may be made in design, testing, and operations planning, but the lessons learned developing the ECLSS for ISS provide valuable guidance.

Electrostatic Discharge Issues in International Space Station Program EVAs

Science.gov (United States)

Bacon, John B.

2009-01-01

EVA activity in the ISS program encounters several dangerous ESD conditions. The ISS program has been aggressive for many years to find ways to mitigate or to eliminate the associated risks. Investments have included: (1) Major mods to EVA tools, suit connectors & analytical tools (2) Floating Potential Measurement Unit (3) Plasma Contactor Units (4) Certification of new ISS flight attitudes (5) Teraflops of computation (6) Thousands of hours of work by scores of specialists (7) Monthly management attention at the highest program levels. The risks are now mitigated to a level that is orders of magnitude safer than prior operations

Suspending in School Suspension?: Is ISS a Valid Means of Disciplinary Action to Reduce Negative Student Behaviors?

Science.gov (United States)

Rahynes, Leron M.

2015-01-01

This paper explored whether or not In School Suspensions (ISS) is effective in reducing student behavioral problems. Research was conducted with 6-8th grade students in a rural middle school in the upstate of South Carolina for the purposes of determining if ISS, in its current design a viable and effective method to reduce negative student…

Predicting severe injury using vehicle telemetry data.

Science.gov (United States)

Ayoung-Chee, Patricia; Mack, Christopher D; Kaufman, Robert; Bulger, Eileen

2013-01-01

In 2010, the National Highway Traffic Safety Administration standardized collision data collected by event data recorders, which may help determine appropriate emergency medical service (EMS) response. Previous models (e.g., General Motors ) predict severe injury (Injury Severity Score [ISS] > 15) using occupant demographics and collision data. Occupant information is not automatically available, and 12% of calls from advanced automatic collision notification providers are unanswered. To better inform EMS triage, our goal was to create a predictive model only using vehicle collision data. Using the National Automotive Sampling System Crashworthiness Data System data set, we included front-seat occupants in late-model vehicles (2000 and later) in nonrollover and rollover crashes in years 2000 to 2010. Telematic (change in velocity, direction of force, seat belt use, vehicle type and curb weight, as well as multiple impact) and nontelematic variables (maximum intrusion, narrow impact, and passenger ejection) were included. Missing data were multiply imputed. The University of Washington model was tested to predict severe injury before application of guidelines (Step 0) and for occupants who did not meet Steps 1 and 2 criteria (Step 3) of the Centers for Disease Control and Prevention Field Triage Guidelines. A probability threshold of 20% was chosen in accordance with Centers for Disease Control and Prevention recommendations. There were 28,633 crashes, involving 33,956 vehicles and 52,033 occupants, of whom 9.9% had severe injury. At Step 0, the University of Washington model sensitivity was 40.0% and positive predictive value (PPV) was 20.7%. At Step 3, the sensitivity was 32.3 % and PPV was 10.1%. Model analysis excluding nontelematic variables decreased sensitivity and PPV. The sensitivity of the re-created General Motors model was 38.5% at Step 0 and 28.1% at Step 3. We designed a model using only vehicle collision data that was predictive of severe injury at

The Mini-EUSO telescope on the ISS

Energy Technology Data Exchange (ETDEWEB)

Scotti, Valentina, E-mail: scottiv@na.infn.it; Osteria, Giuseppe

2017-02-11

The Mini-EUSO project aims to perform observations of the UV-light night emission from Earth. The UV background produced in atmosphere is a key measurement for any experiment aiming at the observation of Extreme Energy Cosmic Rays (EECR) from space, the most energetic component of the cosmic radiation. The Mini-EUSO instrument will be placed within the International Space Station (ISS) in the Russian Module and measures through a UV transparent window. The instrument comprises a compact telescope with a large field of view, based on an optical system employing two Fresnel lenses for increased light collection. The light is focused onto an array of photo-multipliers and the resulting signal is converted into digital, processed and stored via the electronics subsystems on-board. The instrument is designed and built by the members of the JEM-EUSO collaboration. JEM-EUSO is a wide-angle refractive UV telescope being proposed for attachment to the ISS, which has been designed to address basic problems of fundamental physics and high-energy astrophysics investigating the nature of cosmic rays with energies above 10{sup 20} eV. Mini-EUSO will be able to study beside EECRs a wide range of scientific phenomena including atmospheric physics, strange quark matter and bioluminescence. The mission is approved by the Italian Space Agency and the Russian Space Agency. Scientific, technical and programmatic aspects of this project will be described.

Intelligent, Semi-Automated Procedure Aid (ISAPA) for ISS Flight Control, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — We propose to develop the Intelligent, Semi-Automated Procedure Aid (ISAPA) intended for use by International Space Station (ISS) ground controllers to increase the...

SOS score: an optimized score to screen acute stroke patients for obstructive sleep apnea.

Science.gov (United States)

Camilo, Millene R; Sander, Heidi H; Eckeli, Alan L; Fernandes, Regina M F; Dos Santos-Pontelli, Taiza E G; Leite, Joao P; Pontes-Neto, Octavio M

2014-09-01

Obstructive sleep apnea (OSA) is frequent in acute stroke patients, and has been associated with higher mortality and worse prognosis. Polysomnography (PSG) is the gold standard diagnostic method for OSA, but it is impracticable as a routine for all acute stroke patients. We evaluated the accuracy of two OSA screening tools, the Berlin Questionnaire (BQ), and the Epworth Sleepiness Scale (ESS) when administered to relatives of acute stroke patients; we also compared these tools against a combined screening score (SOS score). Ischemic stroke patients were submitted to a full PSG at the first night after onset of symptoms. OSA severity was measured by apnea-hypopnea index (AHI). BQ and ESS were administered to relatives of stroke patients before the PSG and compared to SOS score for accuracy and C-statistics. We prospectively studied 39 patients. OSA (AHI ≥10/h) was present in 76.9%. The SOS score [area under the curve (AUC): 0.812; P = 0.005] and ESS (AUC: 0.789; P = 0.009) had good predictive value for OSA. The SOS score was the only tool with significant predictive value (AUC: 0.686; P = 0.048) for severe OSA (AHI ≥30/h), when compared to ESS (P = 0.119) and BQ (P = 0.191). The threshold of SOS ≤10 showed high sensitivity (90%) and negative predictive value (96.2%) for OSA; SOS ≥20 showed high specificity (100%) and positive predictive value (92.5%) for severe OSA. The SOS score administered to relatives of stroke patients is a useful tool to screen for OSA and may decrease the need for PSG in acute stroke setting. Copyright © 2014 Elsevier B.V. All rights reserved.

Filter Efficiency and Leak Testing of Returned ISS Bacterial Filter Elements After 2.5 Years of Continuous Operation

Science.gov (United States)

Green, Robert D.; Agui, Juan H.; Berger, Gordon M.; Vijayakumar, R.; Perry, Jay L.

2016-01-01

The atmosphere revitalization equipment aboard the International Space Station (ISS) and future deep space exploration vehicles provides the vital functions of maintaining a habitable environment for the crew as well as protecting the hardware from fouling by suspended particulate matter. Providing these functions are challenging in pressurized spacecraft cabins because no outside air ventilation is possible and a larger particulate load is imposed on the filtration system due to lack of sedimentation in reduced gravity conditions. The ISS Environmental Control and Life Support (ECLS) system architecture in the U.S. Segment uses a distributed particulate filtration approach consisting of traditional High-Efficiency Particulate Adsorption (HEPA) filters deployed at multiple locations in each module. These filters are referred to as Bacteria Filter Elements (BFEs). As more experience has been gained with ISS operations, the BFE service life, which was initially one year, has been extended to two to five years, dependent on the location in the U.S. Segment. In previous work we developed a test facility and test protocol for leak testing the ISS BFEs. For this work, we present results of leak testing a sample set of returned BFEs with a service life of 2.5 years, along with particulate removal efficiency and pressure drop measurements. The results can potentially be utilized by the ISS Program to ascertain whether the present replacement interval can be maintained or extended to balance the on-ground filter inventory with extension of the lifetime of ISS to 2024. These results can also provide meaningful guidance for particulate filter designs under consideration for future deep space exploration missions.

Comparison of the predictive performance of the BIG, TRISS, and PS09 score in an adult trauma population derived from multiple international trauma registries.

Science.gov (United States)

Brockamp, Thomas; Maegele, Marc; Gaarder, Christine; Goslings, J Carel; Cohen, Mitchell J; Lefering, Rolf; Joosse, Pieter; Naess, Paal A; Skaga, Nils O; Groat, Tahnee; Eaglestone, Simon; Borgman, Matthew A; Spinella, Philip C; Schreiber, Martin A; Brohi, Karim

2013-07-11

The BIG score (Admission base deficit (B), International normalized ratio (I), and Glasgow Coma Scale (G)) has been shown to predict mortality on admission in pediatric trauma patients. The objective of this study was to assess its performance in predicting mortality in an adult trauma population, and to compare it with the existing Trauma and Injury Severity Score (TRISS) and probability of survival (PS09) score. A retrospective analysis using data collected between 2005 and 2010 from seven trauma centers and registries in Europe and the United States of America was performed. We compared the BIG score with TRISS and PS09 scores in a population of blunt and penetrating trauma patients. We then assessed the discrimination ability of all scores via receiver operating characteristic (ROC) curves and compared the expected mortality rate (precision) of all scores with the observed mortality rate. In total, 12,206 datasets were retrieved to validate the BIG score. The mean ISS was 15 ± 11, and the mean 30-day mortality rate was 4.8%. With an AUROC of 0.892 (95% confidence interval (CI): 0.879 to 0.906), the BIG score performed well in an adult population. TRISS had an area under ROC (AUROC) of 0.922 (0.913 to 0.932) and the PS09 score of 0.825 (0.915 to 0.934). On a penetrating-trauma population, the BIG score had an AUROC result of 0.920 (0.898 to 0.942) compared with the PS09 score (AUROC of 0.921; 0.902 to 0.939) and TRISS (0.929; 0.912 to 0.947). The BIG score is a good predictor of mortality in the adult trauma population. It performed well compared with TRISS and the PS09 score, although it has significantly less discriminative ability. In a penetrating-trauma population, the BIG score performed better than in a population with blunt trauma. The BIG score has the advantage of being available shortly after admission and may be used to predict clinical prognosis or as a research tool to risk stratify trauma patients into clinical trials.

The Bandim tuberculosis score

DEFF Research Database (Denmark)

Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina

2013-01-01

Background: This study was carried out in Guinea-Bissau ’ s capital Bissau among inpatients and outpatients attending for tuberculosis (TB) treatment within the study area of the Bandim Health Project, a Health and Demographic Surveillance Site. Our aim was to assess the variability between 2...... physicians in performing the Bandim tuberculosis score (TBscore), a clinical severity score for pulmonary TB (PTB), and to compare it to the Karnofsky performance score (KPS). Method : From December 2008 to July 2009 we assessed the TBscore and the KPS of 100 PTB patients at inclusion in the TB cohort and...

Microgravity Science Glovebox (MSG) Space Science's Past, Present, and Future on the International Space Station (ISS)

Science.gov (United States)

Spivey, Reggie A.; Spearing, Scott F.; Jordan, Lee P.; McDaniel S. Greg

2012-01-01

The Microgravity Science Glovebox (MSG) is a double rack facility designed for microgravity investigation handling aboard the International Space Station (ISS). The unique design of the facility allows it to accommodate science and technology investigations in a "workbench" type environment. MSG facility provides an enclosed working area for investigation manipulation and observation in the ISS. Provides two levels of containment via physical barrier, negative pressure, and air filtration. The MSG team and facilities provide quick access to space for exploratory and National Lab type investigations to gain an understanding of the role of gravity in the physics associated research areas. The MSG is a very versatile and capable research facility on the ISS. The Microgravity Science Glovebox (MSG) on the International Space Station (ISS) has been used for a large body or research in material science, heat transfer, crystal growth, life sciences, smoke detection, combustion, plant growth, human health, and technology demonstration. MSG is an ideal platform for gravity-dependent phenomena related research. Moreover, the MSG provides engineers and scientists a platform for research in an environment similar to the one that spacecraft and crew members will actually experience during space travel and exploration. The MSG facility is ideally suited to provide quick, relatively inexpensive access to space for National Lab type investigations.

Usefulness of modified Pulmonary Index Score (mPIS) as a quantitative tool for the evaluation of severe acute exacerbation in asthmatic children.

Science.gov (United States)

Koga, Takeshi; Tokuyama, Kenichi; Itano, Atsushi; Morita, Eiji; Ueda, Yutaka; Katsunuma, Toshio

2015-04-01

Acute exacerbation of asthma is divided qualitatively into mild, moderate, and severe attacks and respiratory failure. This system is, however, not suitable for estimating small changes in respiratory condition with time and for determining the efficacy of treatments, because it has a qualitative, but not quantitative nature. To evaluate the usefulness of quantitative estimation of asthma exacerbation, modified Pulmonary Index Score (mPIS) values were measured in 87 asthmatic children (mean age, 5.0 ± 0.4 years) during hospitalization. mPIS was calculated by adding the sum of scores for 6 items (scores of 0-3 were given for each item). These consisted of heart rate, respiratory rate, accessory muscle use, inspiratory-to-expiratory flow ratio, degree of wheezing, and oxygen saturation in room air. Measurements were made at visits and at hospitalization and were then made twice a day until discharge. mPIS values were highly correlated among raters. mPIS values at visits were 9.1 ± 0.1 and 12.6 ± 0.4 in subjects with moderate and severe attacks, respectively (p asthma attacks, including the determination of a treatment plan, and prediction of the period of hospitalization in admitted patients, although prospective studies would be required to establish our hypothesis. Copyright © 2014 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

Cardiovascular risk scores for coronary atherosclerosis.

Science.gov (United States)

Yalcin, Murat; Kardesoglu, Ejder; Aparci, Mustafa; Isilak, Zafer; Uz, Omer; Yiginer, Omer; Ozmen, Namik; Cingozbay, Bekir Yilmaz; Uzun, Mehmet; Cebeci, Bekir Sitki

2012-10-01

The objective of this study was to compare frequently used cardiovascular risk scores in predicting the presence of coronary artery disease (CAD) and 3-vessel disease. In 350 consecutive patients (218 men and 132 women) who underwent coronary angiography, the cardiovascular risk level was determined using the Framingham Risk Score (FRS), the Modified Framingham Risk Score (MFRS), the Prospective Cardiovascular Münster (PROCAM) score, and the Systematic Coronary Risk Evaluation (SCORE). The area under the curve for receiver operating characteristic curves showed that FRS had more predictive value than the other scores for CAD (area under curve, 0.76, P MFRS, PROCAM, and SCORE) may predict the presence and severity of coronary atherosclerosis.The FRS had better predictive value than the other scores.

Relation of ABO blood groups to the severity of coronary atherosclerosis: an Gensini score assessment.

Science.gov (United States)

Gong, Ping; Luo, Song-Hui; Li, Xiao-Lin; Guo, Yuan-Lin; Zhu, Cheng-Gang; Xu, Rui-Xia; Li, Sha; Dong, Qian; Liu, Geng; Chen, Juan; Zeng, Rui-Xiang; Li, Jian-Jun

2014-12-01

Although the study on the relationship between ABO blood groups and coronary atherosclerosis has a long history, few data is available regarding ABO to severity of coronary atherosclerosis in a large cohort study. Therefore, the present study aimed to investigate the relation of the ABO blood groups to the severity of coronary atherosclerosis assessed by Gensini score (GS) in a large Chinese cohort undergoing coronary angiography. A total of 2919 consecutive patients undergoing coronary angiography were enrolled, and their baseline characteristics and ABO blood groups were collected. The GS was calculated as 1st tertile (0-10), 2nd tertile (11-36), 3rd tertile (>36) according to angiographic results. The relation of the ABO blood groups to GS was investigated. The frequency of blood group A was significantly higher in the upper GS tertiles (24.4% vs. 28.2% vs. 29.5%, p = 0.032). Multivariable linear regression analysis revealed that blood group A was independently associated with GS (β = 0.043, p = 0.017). Likewise, multivariable logistic regression analysis showed that group A remained significantly associated with mid-high GS (OR = 1.44, 95% CI 1.16-1.80, p = 0.001), and the group O was showed as a protective factor (OR = 0.77, 95% CI = 0.65-0.92, p = 0.004). In this large Chinese cohort study, the data indicated that there was an association between ABO blood groups and the severity of coronary atherosclerosis. Moreover, the blood group A was an independent risk factor for serious coronary atherosclerosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Qualitative Validation of the IMM Model for ISS and STS Programs

Science.gov (United States)

Kerstman, E.; Walton, M.; Reyes, D.; Boley, L.; Saile, L.; Young, M.; Arellano, J.; Garcia, Y.; Myers, J. G.

2016-01-01

To validate and further improve the Integrated Medical Model (IMM), medical event data were obtained from 32 ISS and 122 STS person-missions. Using the crew characteristics from these observed missions, IMM v4.0 was used to forecast medical events and medical resource utilization. The IMM medical condition incidence values were compared to the actual observed medical event incidence values, and the IMM forecasted medical resource utilization was compared to actual observed medical resource utilization. Qualitative comparisons of these parameters were conducted for both the ISS and STS programs. The results of these analyses will provide validation of IMM v4.0 and reveal areas of the model requiring adjustments to improve the overall accuracy of IMM outputs. This validation effort should result in enhanced credibility of the IMM and improved confidence in the use of IMM as a decision support tool for human space flight.

International Space Station (ISS) Advanced Recycle Filter Tank Assembly (ARFTA)

Science.gov (United States)

Nasrullah, Mohammed K.

2013-01-01

The International Space Station (ISS) Recycle Filter Tank Assembly (RFTA) provides the following three primary functions for the Urine Processor Assembly (UPA): volume for concentrating/filtering pretreated urine, filtration of product distillate, and filtration of the Pressure Control and Pump Assembly (PCPA) effluent. The RFTAs, under nominal operations, are to be replaced every 30 days. This poses a significant logistical resupply problem, as well as cost in upmass and new tanks purchase. In addition, it requires significant amount of crew time. To address and resolve these challenges, NASA required Boeing to develop a design which eliminated the logistics and upmass issues and minimize recurring costs. Boeing developed the Advanced Recycle Filter Tank Assembly (ARFTA) that allowed the tanks to be emptied on-orbit into disposable tanks that eliminated the need for bringing the fully loaded tanks to earth for refurbishment and relaunch, thereby eliminating several hundred pounds of upmass and its associated costs. The ARFTA will replace the RFTA by providing the same functionality, but with reduced resupply requirements

Spacesuit Water Membrane Evaporator Integration with the ISS Extravehicular Mobility

Science.gov (United States)

Margiott, Victoria; Boyle, Robert

2014-01-01

NASA has developed a Solid Water Membrane Evaporation (SWME) to provide cooling for the next generation spacesuit. One approach to increasing the TRL of the system is to incorporate this hardware with the existing EMU. Several integration issues were addressed to support a potential demonstration of the SWME with the existing EMU. Systems analysis was performed to assess the capability of the SWME to maintain crewmember cooling and comfort as a replacement for sublimation. The materials of the SWME were reviewed to address compatibility with the EMU. Conceptual system placement and integration with the EMU via an EVA umbilical system to ensure crew mobility and Airlock egress were performed. A concept of operation for EVA use was identified that is compatible with the existing system. This concept is extensible as a means to provide cooling for the existing EMU. The cooling system of one of the EMUs on orbit has degraded, with the root cause undetermined. Should there be a common cause resident on ISS, this integration could provide a means to recover cooling capability for EMUs on orbit.

Fatores prognósticos relacionados à falha do tratamento não-operatório de lesões esplênicas no trauma abdominal fechado

Directory of Open Access Journals (Sweden)

Fábio Henrique de Carvalho

Full Text Available OBJETIVO: Identificar fatores prognósticos relacionados com a falha do tratamento não-operatório (TNO de lesões esplênicas no trauma abdominal fechado. MÉTODOS: Análise prospectiva de 56 pacientes adultos submetidos à TNO e divididos em um grupo de sucesso e outro de falha, que foi definida como necessidade de laparotomia por qualquer indicação. As lesões foram diagnosticadas por tomografia computadorizada e classificadas de acordo com os critérios da AAST (American Association for Surgery of Trauma. Os parâmetros estudados foram: na admissão - pressão arterial sistólica, frequências cardíaca e respiratória, nível de consciência (Escala de Glasgow e RTS (Revised Trauma Score; durante a hospitalização - presença de lesões associadas, transfusão sanguínea e parâmetros hematológicos, tempo de internação e ISS (Injury Severity Score. RESULTADOS: As falhas do TNO (19,6% foram devidas à dor abdominal (45,4%, instabilidade hemodinâmica (36,4%, queda do volume globular associada a hematoma esplênico (9,1% e abscesso esplênico (9,1%. Não foram observadas diferenças entre os grupos de sucesso e de falha nos dados na admissão. A taxa de falha de acordo com o grau da lesão esplênica foi 0% nos graus I e II agrupados; 17,5% nos graus III e IV agrupados e 80% no grau V (p = 0,0008. O uso de hemoderivados foi maior e mais frequente no grupo de falha (p=0,05. As relação do ISS (Injury Severity Score com as taxas de falha foram 0% nos pacientes com ISS = 8; 15,9% nos com ISS entre 9 e 25, e 50% nos com ISS = 26 (p = 0,05. Não houve mortalidade e nem lesões de vísceras ocas despercebidas. CONCLUSÃO: O Injury Severity Score e grau da lesão esplênica relacionaram-se com a falha do tratamento não-operatório.

Tidal Control of Jet Eruptions Observed by Cassini ISS

Science.gov (United States)

Hurford, T. A.; Helfenstein, P.; Spitale, J. N.

2012-01-01

Observations by Cassini's Imaging Science Subsystem (ISS) of Enceladus' south polar region at high phase angles has revealed jets of material venting into space. Observations by Cassini's Composite Infrared Spectrometer (CIRS) have also shown that the south polar region is anomalously warm with hotspots associated with geological features called the Tiger Stripes. The Tiger Stripes are large rifts near the south pole of Enceladus, which are typically about 130 km in length, 2 km wide, with a trough 500 m deep, and are l1anked on each side by 100m tall ridges. Preliminary triangulation of jets as viewed at different times and with different viewing geometries in Cassini ISS images taken between 2005 and 2007 have constrained the locations of eight major eruptions of material and found all of them associated with the south polar fractures unofficially the 'Tiger Stripes', and found four of them coincident with the hotspots reported in 2006 by CIRS. While published ISS observations of jet activity suggest that individual eruption sites stay active on the timescale of years, any shorter temporal variability (on timescales of an orbital period, or 1.3 Earth days, for example) is more difficult to establish because of the spotty temporal coverage and the difficulty of visually isolating one jet from the forest of many seen in a typical image. Consequently, it is not known whether individual jets are continuously active, randomly active, or if they erupt on a predictable, periodic schedule. One mechanism that may control the timing of eruptions is diurnal tidal stress, which oscillates between compression/tension as well as right and left lateral shear at any given location throughout Enceladus' orbit and may allow the cracks to open and close regularly. We examine the stresses on the Tiger Stripe regions to see how well diurnal tidal stress caused by Enceladus' orbital eccentricity may possibly correlate with and thus control the observed eruptions. We then identify

Investigating the Response and Expansion of Plasma Plumes in a Mesosonic Plasma Using the Situational Awareness Sensor Suite for the ISS (SASSI)

Science.gov (United States)

Gilchrist, Brian E.; Hoegy, W. R.; Krause, L. Habash; Minow, J. I.; Coffey, V. N.

2014-01-01

To study the complex interactions between the space environment surrounding the International Space Station (ISS) and the ISS space vehicle, we are exploring a specialized suite of plasma sensors, manipulated by the Space Station Remote Manipulator System (SSRMS) to probe the near-ISS mesosonic plasma ionosphere moving past the ISS. It is proposed that SASSI consists of the NASA Marshall Space Flight Center's (MSFC's) Thermal Ion Capped Hemispherical Spectrometer (TICHS), Thermal Electron Capped Hemispherical Spectrometer (TECHS), Charge Analyzer Responsive to Local Oscillations (CARLO), the Collimated PhotoElectron Gun (CPEG), and the University of Michigan Advanced Langmuir Probe (ALP). There are multiple expected applications for SASSI. Here, we will discuss the study of fundamental plasma physics questions associated with how an emitted plasma plume (such as from the ISS Plasma Contactor Unit (PCU)) responds and expands in a mesosonic magnetoplasma as well as emit and collect current. The ISS PCU Xe plasma plume drifts through the ionosphere and across the Earth's magnetic field, resulting in complex dynamics. This is of practical and theoretical interest pertaining to contamination concerns (e.g. energetic ion scattering) and the ability to collect and emit current between the spacecraft and the ambient plasma ionosphere. This impacts, for example, predictions of electrodynamic tether current performance using plasma contactors as well as decisions about placing high-energy electric propulsion thrusters on ISS. We will discuss the required measurements and connection to proposed instruments for this study.

Feasibility Assessment of an ISS Artificial Gravity Conditioning Facility by Means of Multi-Body Approach

Science.gov (United States)

Toso, Mario; Baldesi, Gianluigi; Moratto, Claudio; De Wilde, Don; Bureo Dacal, Rafael; Castellsaguer, Joaquim

2012-07-01

Even though human exploration of Mars is a distant objective, it is well understood that, for human space voyages of several years duration, crews would be at risk of catastrophic consequences should any of the systems that provide adequate air, water, food, or thermal protection fail. Moreover, crews will face serious health and/or safety risks resulting from severe physiologic deconditioning associated with prolonged weightlessness. The principal ones are related to physical and functional deterioration of the regulation of the blood circulation, decreased aerobic capacity, impaired musculo-skeletal systems, and altered sensory- motor system performance. As the reliance of future space programmes on virtual modelling, simulation and justification has substantially grown together with the proto-flight hardware development approach, a range of simulation capabilities have become increasingly important in the requirements specification, design, verification, testing, launch and operation of new space systems. In this frame, multibody software is a key tool in providing a more coordinated and consistent approach from the preliminary development phases of the most complex systems. From a scientific prospective, an artificial gravity facility, such as the one evaluated in this paper, would be the first in-flight testing of the effectiveness and acceptability of short radius centrifuge as a countermeasure to human deconditioning on orbit. The ISS represents a unique opportunity to perform this research. From an engineering point of view, the preliminary assessment described in this paper, highlights the difficult engineering challenges of such a facility. The outcome proves that a human can be accommodated in the available volume, while respecting the human ergonomic basic requirements and preserving the global structural integrity of the hosting ISS module. In particular, analysis shows that, although the load capacity of the structural interfaces imposes a very low

Unique Capabilities of the Situational Awareness Sensor Suite for the ISS (SASSI) Mission Concept to Study the Equatorial Ionosphere

Science.gov (United States)

Habash Krause, L.; Gilchrist, B. E.; Minow, J. I.; Gallagher, D. L.; Hoegy, W. R.; Coffey, V. N.; Willis, E. M.

2014-12-01

We present an overview of a mission concept named Situational Awareness Sensor Suite for the ISS (SASSI) with a special focus here on low-latitude ionospheric plasma turbulence measurements relevant to equatorial spread-F. SASSI is a suite of sensors that improves Space Situational Awareness for the ISS local space environment, as well as unique ionospheric measurements and support active plasma experiments on the ISS. As such, the mission concept has both operational and basic research objectives. We will describe two compelling measurement techniques enabled by SASSI's unique mission architecture. That is, SASSI provides new abilities to 1) measure space plasma potentials in low Earth orbit over ~100 m relative to a common potential, and 2) to investigate multi-scale ionospheric plasma turbulence morphology simultaneously of both ~ 1 cm and ~ 10 m scale lengths. The first measurement technique will aid in the distinction of vertical drifts within equatorial plasma bubbles from the vertical motions of the bulk of the layer due to zonal electric fields. The second will aid in understanding ionospheric plasma turbulence cascading in scale sizes that affect over the horizon radar. During many years of ISS operation, we have conducted effective (but not perfect) human and robotic extravehicular activities within the space plasma environment surrounding the ISS structure. However, because of the complexity of the interaction between the ISS and the space environment, there remain important sources of unpredictable environmental situations that affect operations. Examples of affected systems include EVA safety, solar panel efficiency, and scientific instrument integrity. Models and heuristically-derived best practices are well-suited for routine operations, but when it comes to unusual or anomalous events or situations, there is no substitute for real-time monitoring. SASSI is being designed to deploy and operate a suite of low-cost, medium/high-TRL plasma sensors on

Antithrombotic agents intake prior to injury does not affect outcome after a traumatic brain injury in hospitalized elderly patients.

Science.gov (United States)

Julien, Jessica; Alsideiri, Ghusn; Marcoux, Judith; Hasen, Mohammed; Correa, José A; Feyz, Mitra; Maleki, Mohammed; de Guise, Elaine

2017-04-01

The purpose of this study is to investigate the effect of risk factors including International Normalized Ratio (INR) as well as the Partial Thromboplastin Time (PTT) scores on several outcomes, including hospital length of stay (LOS) and The Extended Glasgow Outcome Scale (GOSE) following TBI in the elderly population. Data were retrospectively collected on patients (n=982) aged 65 and above who were admitted post TBI to the McGill University Health Centre-Montreal General Hospital from 2000 to 2011. Age, Injury Severity Score (ISS), Glasgow Coma Scale score (GCS), type of trauma (isolated TBI vs polytrauma including TBI), initial CT scan results according to the Marshall Classification and the INR and PTT scores and prescriptions of antiplatelet or anticoagulant agents (AP/AC) were collected. Results also indicated that age, ISS and GSC score have an effect on the GOSE score. We also found that taking AC/AP has an effect on GOSE outcome, but that this effects depends on PTT, with lower odds of a worse outcome for those taking AC/AP agents as the PTT value goes up. However, this effect only becomes significant as the PTT value reaches 60 and above. Age and injury severity rather than antithrombotic agent intake are associated with adverse acute outcome such as GOSE in hospitalized elderly TBI patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

WetLab-2: Providing Quantitative PCR Capabilities on ISS

Science.gov (United States)

Parra, Macarena; Jung, Jimmy Kar Chuen; Almeida, Eduardo; Boone, Travis David; Schonfeld, Julie; Tran, Luan Hoang

2015-01-01

The objective of NASA Ames Research Centers WetLab-2 Project is to place on the ISS a system capable of conducting gene expression analysis via quantitative real-time PCR (qRT-PCR) of biological specimens sampled or cultured on orbit. The WetLab-2 system is capable of processing sample types ranging from microbial cultures to animal tissues dissected on-orbit. The project has developed a RNA preparation module that can lyse cells and extract RNA of sufficient quality and quantity for use as templates in qRT-PCR reactions. Our protocol has the advantage that it uses non-toxic chemicals, alcohols or other organics. The resulting RNA is transferred into a pipette and then dispensed into reaction tubes that contain all lyophilized reagents needed to perform qRT-PCR reactions. These reaction tubes are mounted on rotors to centrifuge the liquid to the reaction window of the tube using a cordless drill. System operations require simple and limited crew actions including syringe pushes, valve turns and pipette dispenses. The resulting process takes less than 30 min to have tubes ready for loading into the qRT-PCR unit.The project has selected a Commercial-Off-The-Shelf (COTS) qRT-PCR unit, the Cepheid SmartCycler, that will fly in its COTS configuration. The SmartCycler has a number of advantages including modular design (16 independent PCR modules), low power consumption, rapid thermal ramp times and four-color detection. The ability to detect up to four fluorescent channels will enable multiplex assays that can be used to normalize for RNA concentration and integrity, and to study multiple genes of interest in each module. The WetLab-2 system will have the capability to downlink data from the ISS to the ground after a completed run and to uplink new programs. The ability to conduct qRT-PCR on-orbit eliminates the confounding effects on gene expression of reentry stresses and shock acting on live cells and organisms or the concern of RNA degradation of fixed samples. The

Trauma and Injury Severity Score in Predicting Mortality of Polytrauma Patients

Directory of Open Access Journals (Sweden)

Bambang Gunawan

2018-01-01

Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Abstract TRISS (Trauma and Injury Severity Score is one of the most commonly used trauma score. Currently, there is no data about using TRISS in the care of polytrauma patients at emergency department of dr. Cipto Mangunkusumo Hospital (CMH. This research was intended to evaluate whether TRISS can predict the mortality of polytrauma patients at CMH. This was an analytic descriptive study with retrospective cohort design. Data was collected from medical records of polytrauma patients who were admitted to emergency department of CMH from 2011-201 4 then we analyzed the relationship between TRISS and patient’s prognosis. Furthermore, we conducted bivariate and multivariate analysis by SPSS 20 software. Seventy medical records were included in this study. The majority of patients were male (65% in young age. There were 69 patients who experienced blunt trauma, with the majority (94.3% were caused by motor vehicle accident. After receiving trauma care, there were 26 deaths, while other 44 patients survived. From bivariate and multivariate analysis, we found a significant difference between TRISS and patient’s prognosis. TRISS strongly predicts polytrauma patient’s mortality (AUC 0,899; IK95% 0,824-0,975. TRISS has 84,6% sensitivity and 81.8% specificity with optimal intersection point ≤ 90,5. TRISS is able to predict the mortality of polytrauma patients at CMH. TRISS untuk Memprediksi Mortalitas Pasien Politrauma Abstrak TRISS merupakan salah satu penilaian trauma yang paling sering digunakan. Namun, saat ini belum ada data penggunaan TRISS dalam penanganan pasien politrauma di Instalasi Gawat Darurat (IGD Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSUPNCM. Penelitian ini bertujuan untuk mengetahui kemampuan TRISS dalam memprediksi mortalitas pasien politrauma di IGD RSUPNCM. Penelitian ini adalah studi analitik deskriptif dengan menggunakan desain kohort retrospektif. Data diambil

International Space Station (ISS) Environmental Control and Life Support (ECLS) System Overview of Events: 2010-2014

Science.gov (United States)

Gentry, Gregory J.; Cover, John

2015-01-01

Nov 2, 2014 marked the completion of the 14th year of continuous human presence in space on board the International Space Station (ISS). After 42 expedition crews, over 115 assembly & utilization flights, over 180 combined Shuttle/Station, US & Russian Extravehicular Activities (EVAs), the post-Assembly-Complete ISS continues to fly and the engineering teams continue to learn from operating its systems, particularly the life support equipment. Problems with initial launch, assembly and activation of ISS elements have given way to more long term system operating trends. New issues have emerged, some with gestation periods measured in years. Major events and challenges for each U.S. Environmental Control and Life Support (ECLS) subsystem occurring during calendar years 2010 through 2014 are summarily discussed in this paper, along with look-aheads for what might be coming in the future for each U.S. ECLS subsystem.

Would Current International Space Station (ISS) Recycling Life Support Systems Save Mass on a Mars Transit?

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Jones, Harry W.

2017-01-01

The oxygen and water are recycled on the International Space Station (ISS) to save the cost of launching their mass into orbit. Usually recycling systems are justified by showing that their launch mass would be much lower than the mass of the oxygen or water they produce. Short missions such as Apollo or space shuttle directly provide stored oxygen and water, since the needed total mass of oxygen and water is much less than that of there cycling equipment. Ten year or longer missions such as the ISS or a future moon base easily save mass by recycling while short missions of days or weeks do not. Mars transit and long Mars surface missions have an intermediate duration, typically one to one and a half years. Some of the current ISS recycling systems would save mass if used on a Mars transit but others would not.

The impact of combined use of fall-risk medications and antithrombotics on injury severity and intracranial hemorrhage among older trauma patients.

Science.gov (United States)

Hohmann, Natalie; Hohmann, Lindsey; Kruse, Michael

2014-01-01

Use of fall-risk medications (medications that increase risk of falling in the elderly as defined by Beers criteria, STOPP/START criteria, and other literature) or antithrombotics is common in the elderly, and the impact of their concomitant use should be assessed in regards to fall injuries. The primary objective of this study is to assess the simultaneous outpatient use of fall-risk medications and antithrombotics in elderly fall-patients, and secondarily to analyze the injury severity score and occurrence of intracranial hemorrhage. Consecutive chart review at a level 2 trauma center in California, USA from August 01, 2009 to October 31, 2010. Records included 112 patients at least 65 years of age admitted with an outpatient fall. Fisher's exact and Student's t-tests were used (alpha 0.05, two-tailed) to examine prescribing patterns, intracranial hemorrhage occurrence, and injury severity score. Regression adjusted for antithrombotic and fall-risk medication type and number, opiate use, co-morbidities, age, and gender. Thirty-nine percent (44/112) of outpatients were prescribed antithrombotics plus fall-risk medications. The mean injury severity score (ISS) was 13.3 (range 1-26, standard deviation 7.2) for patients taking both medication classes versus 9.7 (range 1-25, standard deviation 7.5) for patients taking antithrombotics alone (p = 0.027). Additionally, in patients over 80 years of age, intracranial hemorrhage occurred more frequently with the use of antithrombotics plus fall-risk medications versus antithrombotics alone (18/29 = 62.1% versus 7/24 = 29.2%, p = 0.027, odds ratio = 3.974, 95% confidence interval = 1.094-15.010). Multivariate analyses showed an independent relationship between intracranial hemorrhage occurrence and type of therapy, as well as injury severity score and simultaneous therapy with fall-risk medications and antithrombotics. Simultaneous prescribing of antithrombotics and fall-risk medications is common. For

Design and Delivery of a Filter for Removal of Siloxanes from the ISS Atmosphere

Science.gov (United States)

Carter, Layne; Kayatin, Matthew; Perry, Jay; Agui, Juan; Green, Robert; Gentry, Gregory; Bowman, Elizabeth; Wilson, Mark; Rector, Tony

2016-01-01

Dimethylsilanediol (DMSD) has been identified as a problematic chemical contaminant aboard ISS. This contaminant was initially identified in the ISS condensate and in the Water Processor Assembly (WPA) product water in 2010 when an increasing total organic carbon (TOC) trend was detected in the water produced by the WPA. DMSD is not a crew health hazard at the levels observed in the product water, but it may degrade the performance of the Oxygen Generation System (OGS) which uses product produced by the WPA for electrolysis. In addition, DMSD can prevent the effective operation of the WPA catalytic reactor, and necessitates early replacement of Multifiltration Beds in the WPA. An investigation into the source of DMSD has determined that polydimethylsiloxanes (PDMSs) are hydrolyzing in the Condensing Heat Exchanger (CHX) to form DMSD. PDMSs are prevalent aboard ISS from a variety of sources, including crew hygiene products, adhesives, caulks, lubricants, and various nonmetallics. TPDMSs are also implicated in CHX hydrophilic coating degradation, rendering it hydrophobic and adversely affecting its ability to effectively transmit water to the condensate bus. Eventually this loss in performance results in water droplets in the air flow out of the CHX core, which can lead to microbial growth in the air ducts and can impact the performance of downstream systems. Design concepts have now been developed for removing PDMS in the air stream before it can reach the CHX core, thus preventing degradation of the coating and decomposition of the PDMS to DMSD. This paper summarizes the current status of the effort to deliver filters to ISS for removing PDMSs from the atmosphere before they can adversely impact the performance of the CHX coating and the WPA.

Outcomes of nonoperatively treated displaced scapular body fractures.

Science.gov (United States)

Dimitroulias, Apostolos; Molinero, Kenneth G; Krenk, Daniel E; Muffly, Matthew T; Altman, Daniel T; Altman, Gregory T

2011-05-01

Displaced scapular body fractures most commonly are treated conservatively. However there is conflicting evidence in the literature regarding the outcomes owing to retrospective design of studies, different classification systems, and diverse outcome tools. The functional outcome after nonoperative management of displaced scapular body fractures was assessed by change in the DASH (Disability of Arm, Shoulder and Hand) score; (2) the radiographic outcome was assessed by the change of the glenopolar angle (GPA); and (3) associated scapular and extrascapular injuries that may affect outcome were identified. Forty-nine consecutive patients were treated with early passive and active ROM exercises for a displaced scapular body fracture. We followed 32 of these patients (65.3%) for a minimum of 6 months (mean, 15 months; range, 6-33 months). Mean age of the patients was 46.9 years (range, 21-84 years) and the mean Injury Severity Score (ISS) was 21.5 (range, 5-50). Subjective functional results (DASH score) and radiographic assessment (fracture union, glenopolar angle) were measured. All fractures healed uneventfully. The mean change of glenopolar angle was 9° (range, 0°-20°). The mean change of the DASH score was 10.2, which is a change with minimal clinical importance. There was a correlation between the change in this score with the ISS and presence of rib fractures. Satisfactory outcomes are reported with nonoperative treatment of displaced scapular body fractures. We have shown that the severity of ISS and the presence of rib fractures adversely affect the clinical outcome.

The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system and the EORTC quality of life questionnaires

DEFF Research Database (Denmark)

Jensen, Kenneth; Bonde Jensen, Anders; Grau, Cai

2006-01-01

      toxicity scoring systems it has not been formally validated. Conversely,       the EORTC quality of life questionnaire (QLQ) has been validated as a tool       for collecting information about the consequences of disease and treatment       on the well being of cancer patients. The purpose of this study......) completed       EORTC C30, the core questionnaire concerning general symptoms and function       and EORTC H&N35 the head and neck specific questionnaire. The attending       physicians in the follow-up clinic evaluated and recorded DAHANCA toxicity       scores on the same patients. RESULTS: The DAHANCA...... low degree. The       DAHANCA toxicity scores had a low sensitivity (0.48-0.74) in detecting       equivalent subjective complaints from the questionnaires and the       observer-based scoring system severely underestimated patient complaints.       A specific patient group where the DAHANCA score had...

ISS EarthKam: Taking Photos of the Earth from Space

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Haste, Turtle

2008-01-01

NASA is involved in a project involving the International Space Station (ISS) and an Earth-focused camera called EarthKam, where schools, and ultimately students, are allowed to remotely program the EarthKAM to take images. Here the author describes how EarthKam was used to help middle school students learn about biomes and develop their…

The Atmosphere-Space Interactions Monitor (ASIM) Payload Facility on the ISS

DEFF Research Database (Denmark)

Reibaldi, Giuseppe; Nasca, Rosario; Neubert, Torsten

ASIM is a payload facility to be mounted on a Columbus external platform on the International Space Station (ISS). ASIM will study the coupling of thunderstorm processes to the upper atmosphere, ionosphere and radiation belts. ASIM is the most complex Earth Observation payload facility planned fo...

Detection and Severity Scoring of Chronic Obstructive Pulmonary Disease Using Volumetric Analysis of Lung CT Images

International Nuclear Information System (INIS)

Hosseini, Mohammad Parsa; Soltanian-Zadeh, Hamid; Akhlaghpoor, Shahram

2012-01-01

Chronic obstructive pulmonary disease (COPD) is a devastating disease.While there is no cure for COPD and the lung damage associated with this disease cannot be reversed, it is still very important to diagnose it as early as possible. In this paper, we propose a novel method based on the measurement of air trapping in the lungs from CT images to detect COPD and to evaluate its severity. Twenty-five patients and twelve normal adults were included in this study. The proposed method found volumetric changes of the lungs from inspiration to expiration. To this end, trachea CT images at full inspiration and expiration were compared and changes in the areas and volumes of the lungs between inspiration and expiration were used to define quantitative measures (features). Using these features,the subjects were classified into two groups of normal and COPD patients using a Bayesian classifier. In addition, t-tests were applied to evaluate discrimination powers of the features for this classification. For the cases studied, the proposed method estimated air trapping in the lungs from CT images without human intervention. Based on the results, a mathematical model was developed to relate variations of lung volumes to the severity of the disease. As a computer aided diagnosis (CAD) system, the proposed method may assist radiologists in the detection of COPD. It quantifies air trapping in the lungs and thus may assist them with the scoring of the disease by quantifying the severity of the disease

High energy radiation fluences in the ISS-USLab: Ion discrimination and particle abundances

International Nuclear Information System (INIS)

Zaconte, Veronica; Casolino, Marco; Di Fino, Luca; La Tessa, Chiara; Larosa, Marianna; Narici, Livio; Picozza, Piergiorgio

2010-01-01

The ALTEA (Anomalous Long Term Effects on Astronauts) detector was used to characterize the radiation environment inside the USLab of the International Space Station (ISS), where it measured the abundances of ions from Be to Fe. We compare the ALTEA results with Alteino results obtained in the PIRS module of the Russian segment of the ISS, and normalize to the high energy Si abundances given by Simpson. These are the first particle spectral measurements, which include ions up to Fe, performed in the USLab. The small differences observed between those made inside the USLab and the Simpson abundances can be attributed to the transport through the spacecraft hull. However, the low abundance of Fe cannot be attributed to only this process.

AUDIT-C scores as a scaled marker of mean daily drinking, alcohol use disorder severity, and probability of alcohol dependence in a U.S. general population sample of drinkers.

Science.gov (United States)

Rubinsky, Anna D; Dawson, Deborah A; Williams, Emily C; Kivlahan, Daniel R; Bradley, Katharine A

2013-08-01

Brief alcohol screening questionnaires are increasingly used to identify alcohol misuse in routine care, but clinicians also need to assess the level of consumption and the severity of misuse so that appropriate intervention can be offered. Information provided by a patient's alcohol screening score might provide a practical tool for assessing the level of consumption and severity of misuse. This post hoc analysis of data from the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) included 26,546 U.S. adults who reported drinking in the past year and answered additional questions about their consumption, including Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C) alcohol screening. Linear or logistic regression models and postestimation methods were used to estimate mean daily drinking, the number of endorsed alcohol use disorder (AUD) criteria ("AUD severity"), and the probability of alcohol dependence associated with each individual AUDIT-C score (1 to 12), after testing for effect modification by gender and age. Among eligible past-year drinkers, mean daily drinking, AUD severity, and the probability of alcohol dependence increased exponentially across increasing AUDIT-C scores. Mean daily drinking ranged from alcohol dependence ranged from used to estimate patient-specific consumption and severity based on age, gender, and alcohol screening score. This information could be integrated into electronic decision support systems to help providers estimate and provide feedback about patient-specific risks and identify those patients most likely to benefit from further diagnostic assessment. Copyright © 2013 by the Research Society on Alcoholism.

Visual assessment of the radiation distribution in the ISS Lab module: visualization in the human body

Science.gov (United States)

Saganti, P. B.; Zapp, E. N.; Wilson, J. W.; Cucinotta, F. A.

2001-01-01

The US Lab module of the International Space Station (ISS) is a primary working area where the crewmembers are expected to spend majority of their time. Because of the directionality of radiation fields caused by the Earth shadow, trapped radiation pitch angle distribution, and inherent variations in the ISS shielding, a model is needed to account for these local variations in the radiation distribution. We present the calculated radiation dose (rem/yr) values for over 3,000 different points in the working area of the Lab module and estimated radiation dose values for over 25,000 different points in the human body for a given ambient radiation environment. These estimated radiation dose values are presented in a three dimensional animated interactive visualization format. Such interactive animated visualization of the radiation distribution can be generated in near real-time to track changes in the radiation environment during the orbit precession of the ISS.

The Dysexecutive Questionnaire advanced: item and test score characteristics, 4-factor solution, and severity classification.

Science.gov (United States)

Bodenburg, Sebastian; Dopslaff, Nina

2008-01-01

The Dysexecutive Questionnaire (DEX, , Behavioral assessment of the dysexecutive syndrome, 1996) is a standardized instrument to measure possible behavioral changes as a result of the dysexecutive syndrome. Although initially intended only as a qualitative instrument, the DEX has also been used increasingly to address quantitative problems. Until now there have not been more fundamental statistical analyses of the questionnaire's testing quality. The present study is based on an unselected sample of 191 patients with acquired brain injury and reports on the data relating to the quality of the items, the reliability and the factorial structure of the DEX. Item 3 displayed too great an item difficulty, whereas item 11 was not sufficiently discriminating. The DEX's reliability in self-rating is r = 0.85. In addition to presenting the statistical values of the tests, a clinical severity classification of the overall scores of the 4 found factors and of the questionnaire as a whole is carried out on the basis of quartile standards.

Fast Kalman Filtering for Relative Spacecraft Position and Attitude Estimation for the Raven ISS Hosted Payload

Science.gov (United States)

Galante, Joseph M.; Van Eepoel, John; D'Souza, Chris; Patrick, Bryan

2016-01-01

The Raven ISS Hosted Payload will feature several pose measurement sensors on a pan/tilt gimbal which will be used to autonomously track resupply vehicles as they approach and depart the International Space Station. This paper discusses the derivation of a Relative Navigation Filter (RNF) to fuse measurements from the different pose measurement sensors to produce relative position and attitude estimates. The RNF relies on relative translation and orientation kinematics and careful pose sensor modeling to eliminate dependence on orbital position information and associated orbital dynamics models. The filter state is augmented with sensor biases to provide a mechanism for the filter to estimate and mitigate the offset between the measurements from different pose sensors

An Objective Fluctuation Score for Parkinson's Disease

Science.gov (United States)

Horne, Malcolm K.; McGregor, Sarah; Bergquist, Filip

2015-01-01

Introduction Establishing the presence and severity of fluctuations is important in managing Parkinson’s Disease yet there is no reliable, objective means of doing this. In this study we have evaluated a Fluctuation Score derived from variations in dyskinesia and bradykinesia scores produced by an accelerometry based system. Methods The Fluctuation Score was produced by summing the interquartile range of bradykinesia scores and dyskinesia scores produced every 2 minutes between 0900-1800 for at least 6 days by the accelerometry based system and expressing it as an algorithm. Results This Score could distinguish between fluctuating and non-fluctuating patients with high sensitivity and selectivity and was significant lower following activation of deep brain stimulators. The scores following deep brain stimulation lay in a band just above the score separating fluctuators from non-fluctuators, suggesting a range representing adequate motor control. When compared with control subjects the score of newly diagnosed patients show a loss of fluctuation with onset of PD. The score was calculated in subjects whose duration of disease was known and this showed that newly diagnosed patients soon develop higher scores which either fall under or within the range representing adequate motor control or instead go on to develop more severe fluctuations. Conclusion The Fluctuation Score described here promises to be a useful tool for identifying patients whose fluctuations are progressing and may require therapeutic changes. It also shows promise as a useful research tool. Further studies are required to more accurately identify therapeutic targets and ranges. PMID:25928634

ISS Destiny Laboratory Smoke Detection Model

Science.gov (United States)

Brooker, John E.; Urban, David L.; Ruff, Gary A.

2007-01-01

Smoke transport and detection were modeled numerically in the ISS Destiny module using the NIST, Fire Dynamics Simulator code. The airflows in Destiny were modeled using the existing flow conditions and the module geometry included obstructions that simulate the currently installed hardware on orbit. The smoke source was modeled as a 0.152 by 0.152 m region that emitted smoke particulate ranging from 1.46 to 8.47 mg/s. In the module domain, the smoke source was placed in the center of each Destiny rack location and the model was run to determine the time required for the two smoke detectors to alarm. Overall the detection times were dominated by the circumferential flow, the axial flow from the intermodule ventilation and the smoke source strength.

ISS Interface Mechanisms and their Heritage

Science.gov (United States)

Cook, John G.; Aksamentov, Valery; Hoffman, Thomas; Bruner, Wes

2011-01-01

The International Space Station, by nurturing technological development of a variety of pressurized and unpressurized interface mechanisms fosters "competition at the technology level". Such redundancy and diversity allows for the development and testing of mechanisms that might be used for future exploration efforts. The International Space Station, as a test-bed for exploration, has 4 types of pressurized interfaces between elements and 6 unpressurized attachment mechanisms. Lessons learned from the design, test and operations of these mechanisms will help inform the design for a new international standard pressurized docking mechanism for the NASA Docking System. This paper will examine the attachment mechanisms on the ISS and their attributes. It will also look ahead at the new NASA docking system and trace its lineage to heritage mechanisms.

Dedicated Slosh Dynamics Experiment on ISS using SPHERES (Advanced Space Operations in CR)

Data.gov (United States)

National Aeronautics and Space Administration — At the Kennedy Space Center (KSC) the Launch Services Program is leading an effort to conduct an experiment aboard the International Space Station (ISS) to validate...

Reliability on ISS Talk Outline

Science.gov (United States)

Misiora, Mike

2015-01-01

1. Overview of ISS 2. Space Environment and it effects a. Radiation b. Microgravity 3. How we ensure reliability a. Requirements b. Component Selection i. Note: I plan to stay away from talk about Rad Hardened components and talk about why we use older processors because they are less susceptible to SEUs. c. Testing d. Redundancy / Failure Tolerance e. Sparing strategies 4. Operational Examples a. Multiple MDM Failures on 6A due to hard drive failure In general, my plan is to only talk about data that is currently available via normal internet sources to ensure that I stay away from any topics that would be Export Controlled, ITAR, or NDA-controlled. The operational example has been well-reported on in the media and those are the details that I plan to cover. Additionally I am not planning on using any slides or showing any photos during the talk.

Assessment of demographic and pathoanatomic risk factors in recurrent patellofemoral instability.

Science.gov (United States)

Hiemstra, Laurie Anne; Kerslake, Sarah; Lafave, Mark

2017-12-01

The WARPS/STAID classification employs clinical assessment of presenting features and anatomic characteristics to identify two distinct subsets of patients within the patellofemoral instability population. The purpose of this study was to further define the specific demographics and the prevalence of risky pathoanatomies in patients classified as either WARPS or STAID presenting with recurrent patellofemoral instability. A secondary purpose was to further validate the WARPS/STAID classification with the Banff Patella Instability Instrument (BPII), the Marx activity scale and the Patellar Instability Severity Score (ISS). A convenience sample of 50 patients with recurrent patellofemoral instability, including 25 WARPS and 25 STAID subtype patients, were assessed. Clinical data were collected including assessment of demographic risk factors (sex, BMI, bilaterality of symptoms, affected limb side and age at first dislocation) and pathoanatomic risk factors (TT-TG distance, patella height, patellar tilt, grade of trochlear dysplasia, Beighton score and rotational abnormalities of the tibia or femur). Patients completed the BPII and the Marx activity scale. The ISS was calculated from the clinical assessment data. Patients were stratified into the WARPS or STAID subtypes for comparative analysis. An independent t test was used to compare demographics, the pathoanatomic risk factors and subjective measures between the groups. Convergent validity was tested with a Pearson r correlation coefficient between the WARPS/STAID and ISS scores. Demographic risk factors statistically associated with a WARPS subtype included female sex, age at first dislocation and bilaterality. Pathoanatomic risk factors statistically associated with a WARPS subtype included trochlear dysplasia, TT-TG distance, generalized ligamentous laxity, patellar tilt and rotational abnormalities. The independent t test revealed a significant difference between the ISS scores: WARPS subtype (M = 4.4, SD�

Human interactions in space: ISS vs. Shuttle/Mir

Science.gov (United States)

Kanas, N. A.; Salnitskiy, V. P.; Ritsher, J. B.; Gushin, V. I.; Weiss, D. S.; Saylor, S. A.; Kozerenko, O. P.; Marmar, C. R.

2006-07-01

This paper compares findings from two NASA-funded studies of international long-duration missions to the Mir space station (Shuttle/Mir) and to the International Space Station (ISS). American and Russian crewmembers and mission control personnel participated. Issues examined included changes in mood and group social climate over time, displacement of group tension to outside monitoring personnel, cultural differences, and leadership roles. Findings were based on the completion of a weekly questionnaire that included items from the Profile of Mood States, the Group Environment Scale, and the Work Environment Scale. An examination of issues investigated in both studies revealed much similarity in findings. There was little support for the presence of changes in levels of mood and group climate over time, and no evidence for a "3rd quarter phenomenon". Both studies also provided evidence for the displacement of negative emotions to outside personnel in both crewmembers and mission control personnel. There were similar patterns of differences between Americans and Russians and between crewmembers and mission control personnel. Finally, in both studies, the support role of the leader was related to group cohesion among crewmembers, and both the task and support roles of the leader were related to cohesion among mission control personnel. Thus, in these four areas, the ISS study substantially replicated the findings from the earlier Shuttle/Mir study, suggesting that common psychosocial issues affect people engaged in on-orbit space missions.

Brief Report: Relationship Between ADOS-2, Module 4 Calibrated Severity Scores (CSS) and Social and Non-Social Standardized Assessment Measures in Adult Males with Autism Spectrum Disorder (ASD)

Science.gov (United States)

Morrier, Michael J.; Ousley, Opal Y.; Caceres-Gamundi, Gabriella A.; Segall, Matthew J.; Cubells, Joseph F.; Young, Larry J.; Andari, Elissar

2017-01-01

The ADOS-2 Modules 1-3 now include a standardized calibrated severity score (CSS) from 1 to 10 based on the overall total raw score. Subsequent research published CSS for Module 4 (Hus, Lord, "Journal of Autism and Developmental Disorders" 44(8):1996-2012, 2014); however more research is needed to examine the psychometric properties of…

A commercial space technology testbed on ISS

Science.gov (United States)

Boyle, David R.

2000-01-01

There is a significant and growing commercial market for new, more capable communications and remote sensing satellites. Competition in this market strongly motivates satellite manufacturers and spacecraft component developers to test and demonstrate new space hardware in a realistic environment. External attach points on the International Space Station allow it to function uniquely as a space technology testbed to satisfy this market need. However, space industry officials have identified three critical barriers to their commercial use of the ISS: unpredictable access, cost risk, and schedule uncertainty. Appropriate NASA policy initiatives and business/technical assistance for industry from the Commercial Space Center for Engineering can overcome these barriers. .

ISS External Contamination Environment for Space Science Utilization

Science.gov (United States)

Soares, Carlos; Mikatarian, Ron; Steagall, Courtney; Huang, Alvin; Koontz, Steven; Worthy, Erica

2014-01-01

(1) The International Space Station is the largest and most complex on-orbit platform for space science utilization in low Earth orbit, (2) Multiple sites for external payloads, with exposure to the associated natural and induced environments, are available to support a variety of space science utilization objectives, (3) Contamination is one of the induced environments that can impact performance, mission success and science utilization on the vehicle, and (4)The ISS has been designed, built and integrated with strict contamination requirements to provide low levels of induced contamination on external payload assets.

Phase Change Material Heat Sink for an ISS Flight Experiment

Science.gov (United States)

Quinn, Gregory; Stieber, Jesse; Sheth, Rubik; Ahlstrom, Thomas

2015-01-01

A flight experiment is being constructed to utilize the persistent microgravity environment of the International Space Station (ISS) to prove out operation of a microgravity compatible phase change material (PCM) heat sink. A PCM heat sink can help to reduce the overall mass and volume of future exploration spacecraft thermal control systems (TCS). The program is characterizing a new PCM heat sink that incorporates a novel phase management approach to prevent high pressures and structural deformation that often occur with PCM heat sinks undergoing cyclic operation in microgravity. The PCM unit was made using brazed aluminum construction with paraffin wax as the fusible material. It is designed to be installed into a propylene glycol and water cooling loop, with scaling consistent with the conceptual designs for the Orion Multipurpose Crew Vehicle. This paper reports on the construction of the PCM heat sink and on initial ground test results conducted at UTC Aerospace Systems prior to delivery to NASA. The prototype will be tested later on the ground and in orbit via a self-contained experiment package developed by NASA Johnson Space Center to operate in an ISS EXPRESS rack.

3D Printing in Zero-G ISS Technology Demonstration

Science.gov (United States)

Johnston, Mallory M.; Werkheiser, Mary J.; Cooper, Kenneth G.; Snyder, Michael P.; Edmunson, Jennifer E.

2014-01-01

The National Aeronautics and Space Administration (NASA) has a long term strategy to fabricate components and equipment on-demand for manned missions to the Moon, Mars, and beyond. To support this strategy, NASA and Made in Space, Inc. are developing the 3D Printing In Zero-G payload as a Technology Demonstration for the International Space Station. The 3D Printing In Zero-G experiment will be the first machine to perform 3D printing in space. The greater the distance from Earth and the longer the mission duration, the more difficult resupply becomes; this requires a change from the current spares, maintenance, repair, and hardware design model that has been used on the International Space Station up until now. Given the extension of the ISS Program, which will inevitably result in replacement parts being required, the ISS is an ideal platform to begin changing the current model for resupply and repair to one that is more suitable for all exploration missions. 3D Printing, more formally known as Additive Manufacturing, is the method of building parts/ objects/tools layer-by-layer. The 3D Print experiment will use extrusion-based additive manufacturing, which involves building an object out of plastic deposited by a wire-feed via an extruder head. Parts can be printed from data files loaded on the device at launch, as well as additional files uplinked to the device while on-orbit. The plastic extrusion additive manufacturing process is a low-energy, low-mass solution to many common needs on board the ISS. The 3D Print payload will serve as the ideal first step to proving that process in space. It is unreasonable to expect NASA to launch large blocks of material from which parts or tools can be traditionally machined, and even more unreasonable to fly up specialized manufacturing hardware to perform the entire range of function traditionally machining requires. The technology to produce parts on demand, in space, offers unique design options that are not possible

Cosmic ray studies on the ISS using SSNTD, BRADOS projects, 2001–2003

CERN Document Server

Pálfalvia, J K; Akatov, Y; Sajó-Bohus, L; Eördögh, I

2005-01-01

The BRADOS 1–3 projects were organised by the Russian Space Agency (RZA) between 2001 and 2003. The aim was to study the contribution of the primary galactic cosmic rays and of the secondary particles to the dose received by the crew of the International Space Station (ISS). Several laboratories participated in these experiments. Two different stacks (constructed by the team of the Atomic Energy Research Institute, AERI, Budapest, Hungary) composed of solid-state nuclear track detectors (SSNTD) were exposed inside the Service Module at different locations. The calibrations were made at the CERN high-energy neutron reference field named CERF (Geneva, Swiss). Applying a multiple track etching technique (2–20 h etching time) and a sophisticated image analyser, the secondary neutron dose was deduced. The composition of stacks, the evaluation methods and the results will be presented here or referenced to previous papers.

Microgravity Science Glovebox (MSG), Space Science's Past, Present and Future Aboard the International Space Station (ISS)

Science.gov (United States)

Spivey, Reggie; Spearing, Scott; Jordan, Lee

2012-01-01

The Microgravity Science Glovebox (MSG) is a double rack facility aboard the International Space Station (ISS), which accommodates science and technology investigations in a "workbench' type environment. The MSG has been operating on the ISS since July 2002 and is currently located in the US Laboratory Module. In fact, the MSG has been used for over 10,000 hours of scientific payload operations and plans to continue for the life of ISS. The facility has an enclosed working volume that is held at a negative pressure with respect to the crew living area. This allows the facility to provide two levels of containment for small parts, particulates, fluids, and gases. This containment approach protects the crew from possible hazardous operations that take place inside the MSG work volume and allows researchers a controlled pristine environment for their needs. Research investigations operating inside the MSG are provided a large 255 liter enclosed work space, 1000 watts of dc power via a versatile supply interface (120, 28, + 12, and 5 Vdc), 1000 watts of cooling capability, video and data recording and real time downlink, ground commanding capabilities, access to ISS Vacuum Exhaust and Vacuum Resource Systems, and gaseous nitrogen supply. These capabilities make the MSG one of the most utilized facilities on ISS. MSG investigations have involved research in cryogenic fluid management, fluid physics, spacecraft fire safety, materials science, combustion, and plant growth technologies. Modifications to the MSG facility are currently under way to expand the capabilities and provide for investigations involving Life Science and Biological research. In addition, the MSG video system is being replaced with a state-of-the-art, digital video system with high definition/high speed capabilities, and with near real-time downlink capabilities. This paper will provide an overview of the MSG facility, a synopsis of the research that has already been accomplished in the MSG, and an

Road traffic accidents in children: the ‘what’, ‘how’ and ‘why’

Science.gov (United States)

Lee, Yue Yen; Fang, Eric; Weng, Yanyi; Ganapathy, Sashikumar

2018-01-01

INTRODUCTION Road traffic accidents (RTAs) in Singapore involving children were evaluated, with particular focus on the epidemiology, surrounding circumstances and outcomes of these accidents. Key factors associated with worse prognosis were identified. We proposed some measures that may be implemented to reduce the frequency and severity of such accidents. METHODS This was a retrospective study of RTAs involving children aged 0–16 years who presented to the Children’s Emergency at KK Women’s and Children’s Hospital, Singapore, from January 2011 to June 2014. Data was obtained from the National Trauma Registry and analysed in tiers based on the Injury Severity Score (ISS). RESULTS A total of 1,243 accidents were reviewed. RTA victims included motor vehicle passengers (60.4%), pedestrians (28.5%), cyclists (9.9%) and motorcycle pillion riders (1.2%). The disposition of emergency department (ED) patients was consistent with RTA severity. For serious RTAs, pedestrians accounted for 63.6% and 57.7% of Tier 1 (ISS > 15) and Tier 2 (ISS 9–15) presentations, respectively. Overall use of restraints was worryingly low (36.7%). Not restraining increased the risk of serious RTAs by 8.4 times. Young age, high ISS and low Glasgow Coma Scale score predicted a longer duration of intensive care unit stay. CONCLUSION The importance of restraints for motor vehicle passengers or helmets for motorcycle pillion riders and cyclists in reducing morbidity requires emphasis. Suggestions for future prevention and intervention include road safety education, regulation of protective restraints, use of speed enforcement devices and creation of transport policies that minimise kerbside parking. PMID:29214322

Nuclear abundance measurements inside MIR and ISS with Sileye experiments

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Casolino, M.

In this work we present measurements of cosmic ray nuclear abundances above 150 MeV/n performed inside Mir space station between 1998 and 2000. Data have been obtained with SilEye-2 detector, a 6 plane silicon strip detector telescope designed to measure environmental radiation and investigate on the Light Flash phenomenon. In standalone mode, SilEye-2 is capable to measure LET distribution spectra and identify nuclear species with energy above 100 MeV/n: a total of 100 sessions comprising more than 1000 hours of observation were perfomed in the years 1998-2000, recording also several Solar Energetic Particle (SEP) events. Cosmic ray abundances inside a spacecraft can differ from the primary component due to interaction with the interposed material of the hull and the instruments. We report on LET measurements and relative abundances from Boron to Iron measured in different regions and at different geomagnetic cutoffs, in solar quiet conditions and during SEP events, showing how the composition varies in these different situations. We also report on preliminary results on cosmic ray measurements inside ISS (27/4/2002 - 4/5/2002) obtained with Sileye-3/Alteino experiment.

Global Precipitation Measurement (GPM) and International Space Station (ISS) Coordination for Cubesat Deployments

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Pawloski, James H.; Aviles, Jorge; Myers, Ralph; Parris, Joshua; Corley, Bryan; Hehn, Garrett; Pascucci, Joseph

2016-01-01

This paper describes the specific problem of collision threat to GPM and risk to ISS CubeSat deployment and the process that was implemented to keep both missions safe from collision and maximize their project goals.