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Sample records for severity scores iss

  1. Sorting variables for each case: a new algorithm to calculate injury severity score (ISS) using SPSS-PC.

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    Linn, S

    One of the more often used measures of multiple injuries is the injury severity score (ISS). Determination of the ISS is based on the abbreviated injury scale (AIS). This paper suggests a new algorithm to sort the AISs for each case and calculate ISS. The program uses unsorted abbreviated injury scale (AIS) levels for each case and rearranges them in descending order. The first three sorted AISs representing the three most severe injuries of a person are then used to calculate injury severity score (ISS). This algorithm should be useful for analyses of clusters of injuries especially when more patients have multiple injuries.

  2. Major influence of interobserver reliability on polytrauma identification with the Injury Severity Score (ISS): Time for a centralised coding in trauma registries?

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    Maduz, Roman; Kugelmeier, Patrick; Meili, Severin; Döring, Robert; Meier, Christoph; Wahl, Peter

    2017-04-01

    The Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) find increasingly widespread use to assess trauma burden and to perform interhospital benchmarking through trauma registries. Since 2015, public resource allocation in Switzerland shall even be derived from such data. As every trauma centre is responsible for its own coding and data input, this study aims at evaluating interobserver reliability of AIS and ISS coding. Interobserver reliability of the AIS and ISS is analysed from a cohort of 50 consecutive severely injured patients treated in 2012 at our institution, coded retrospectively by 3 independent and specifically trained observers. Considering a cutoff ISS≥16, only 38/50 patients (76%) were uniformly identified as polytraumatised or not. Increasing the cut off to ≥20, this increased to 41/50 patients (82%). A difference in the AIS of ≥ 1 was present in 261 (16%) of possible codes. Excluding the vast majority of uninjured body regions, uniformly identical AIS severity values were attributed in 67/193 (35%) body regions, or 318/579 (55%) possible observer pairings. Injury severity all too often is neither identified correctly nor consistently when using the AIS. This leads to wrong identification of severely injured patients using the ISS. Improving consistency of coding through centralisation is recommended before scores based on the AIS are to be used for interhospital benchmarking and resource allocation in the treatment of severely injured patients. Copyright © 2017. Published by Elsevier Ltd.

  3. A New Weighted Injury Severity Scoring System: Better Predictive Power for Pediatric Trauma Mortality.

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    Shi, Junxin; Shen, Jiabin; Caupp, Sarah; Wang, Angela; Nuss, Kathryn E; Kenney, Brian; Wheeler, Krista K; Lu, Bo; Xiang, Henry

    2018-05-02

    An accurate injury severity measurement is essential for the evaluation of pediatric trauma care and outcome research. The traditional Injury Severity Score (ISS) does not consider the differential risks of the Abbreviated Injury Scale (AIS) from different body regions nor is it pediatric specific. The objective of this study was to develop a weighted injury severity scoring (wISS) system for pediatric blunt trauma patients with better predictive power than ISS. Based on the association between mortality and AIS from each of the six ISS body regions, we generated different weights for the component AIS scores used in the calculation of ISS. The weights and wISS were generated using the National Trauma Data Bank (NTDB). The Nationwide Emergency Department Sample (NEDS) was used to validate our main results. Pediatric blunt trauma patients less than 16 years were included, and mortality was the outcome. Discrimination (areas under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, negative predictive value, concordance) and calibration (Hosmer-Lemeshow statistic) were compared between the wISS and ISS. The areas under the receiver operating characteristic curves from the wISS and ISS are 0.88 vs. 0.86 in ISS=1-74 and 0.77 vs. 0.64 in ISS=25-74 (ppredictive value, negative predictive value, and concordance when they were compared at similar levels of sensitivity. The wISS had better calibration (smaller Hosmer-Lemeshow statistic) than the ISS (11.6 versus 19.7 for ISS=1-74 and 10.9 versus 12.6 for ISS= 25-74). The wISS showed even better discrimination with the NEDS. By weighting the AIS from different body regions, the wISS had significantly better predictive power for mortality than the ISS, especially in critically injured children.Level of Evidence and study typeLevel IV Prognostic/Epidemiological.

  4. How is the injury severity scored? a brief review of scoring systems

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    Mohsen Ebrahimi

    2015-06-01

    Full Text Available The management of injured patients is a critical issue in pre-hospital and emergency departments. Trauma victims are usually young and the injuries may lead to mortality or severe morbidities. The severity of injury can be estimated by observing the anatomic and physiologic evidences. Scoring systems are used to present a scale of describing the severity of the injuries in the victims.We reviewed the evidences of famous scoring systems, the history of their development, applications and their evolutions. We searched electronic database PubMed and Google scholar with keywords: (trauma OR injury AND (severity OR intensity AND (score OR scale.In this paper, we are going to present a definition of scoring systems and discuss the Abbreviated Injury Scale (AIS and Injury Severity Score (ISS, the most acceptable systems, their applications and their advantages and limitations.Several injury-scoring methods have been introduced. Each method has specific features, advantages and disadvantages. The AIS is an anatomical-based scoring system, which provides a standard numerical scale of ranking and comparing injuries. The ISS was established as a platform for trauma data registry. ISS is also an anatomically-based ordinal scale, with a range of 1-75. Several databases and studies are formed based on ISS and are available for trauma management research.Although the ISS is not perfect, it is established as the basic platform of health services and public health researches. The ISS registering system can provide many opportunities for the development of efficient data recording and statistical analyzing models.

  5. Mobile health technology transforms injury severity scoring in South Africa.

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    Spence, Richard Trafford; Zargaran, Eiman; Hameed, S Morad; Navsaria, Pradeep; Nicol, Andrew

    2016-08-01

    The burden of data collection associated with injury severity scoring has limited its application in areas of the world with the highest incidence of trauma. Since January 2014, electronic records (electronic Trauma Health Records [eTHRs]) replaced all handwritten records at the Groote Schuur Hospital Trauma Unit in South Africa. Data fields required for Glasgow Coma Scale, Revised Trauma Score, Kampala Trauma Score, Injury Severity Score (ISS), and Trauma Score-Injury Severity Score calculations are now prospectively collected. Fifteen months after implementation of eTHR, the injury severity scores were compared as predictors of mortality on three accounts: (1) ability to discriminate (area under receiver operating curve, ROC); (2) ability to calibrate (observed versus expected ratio, O/E); and (3) feasibility of data collection (rate of missing data). A total of 7460 admissions were recorded by eTHR from April 1, 2014 to July 7, 2015, including 770 severely injured patients (ISS > 15) and 950 operations. The mean age was 33.3 y (range 13-94), 77.6% were male, and the mechanism of injury was penetrating in 39.3% of cases. The cohort experienced a mortality rate of 2.5%. Patient reserve predictors required by the scores were 98.7% complete, physiological injury predictors were 95.1% complete, and anatomic injury predictors were 86.9% complete. The discrimination and calibration of Trauma Score-Injury Severity Score was superior for all admissions (ROC 0.9591 and O/E 1.01) and operatively managed patients (ROC 0.8427 and O/E 0.79). In the severely injured cohort, the discriminatory ability of Revised Trauma Score was superior (ROC 0.8315), but no score provided adequate calibration. Emerging mobile health technology enables reliable and sustainable injury severity scoring in a high-volume trauma center in South Africa. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. The value of the injury severity score in pediatric trauma: Time for a new definition of severe injury?

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    Brown, Joshua B; Gestring, Mark L; Leeper, Christine M; Sperry, Jason L; Peitzman, Andrew B; Billiar, Timothy R; Gaines, Barbara A

    2017-06-01

    The Injury Severity Score (ISS) is the most commonly used injury scoring system in trauma research and benchmarking. An ISS greater than 15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and Abbreviated Injury Scale (AIS) to predict mortality and define optimal thresholds of severe injury in pediatric trauma. Patients from the Pennsylvania trauma registry 2000-2013 were included. Children were defined as younger than 16 years. Logistic regression predicted mortality from ISS for children and adults. The optimal ISS cutoff for mortality that maximized diagnostic characteristics was determined in children. Regression also evaluated the association between mortality and maximum AIS in each body region, controlling for age, mechanism, and nonaccidental trauma. Analysis was performed in single and multisystem injuries. Sensitivity analyses with alternative outcomes were performed. Included were 352,127 adults and 50,579 children. Children had similar predicted mortality at ISS of 25 as adults at ISS of 15 (5%). The optimal ISS cutoff in children was ISS greater than 25 and had a positive predictive value of 19% and negative predictive value of 99% compared to a positive predictive value of 7% and negative predictive value of 99% for ISS greater than 15 to predict mortality. In single-system-injured children, mortality was associated with head (odds ratio, 4.80; 95% confidence interval, 2.61-8.84; p 0.05). For multisystem injury, all body region AIS scores were associated with mortality except extremities. Sensitivity analysis demonstrated ISS greater than 23 to predict need for full trauma activation, and ISS greater than 26 to predict impaired functional independence were optimal thresholds. An ISS greater than 25 may be a more appropriate definition of severe injury in children. Pattern of injury is important, as only head and chest injury drive mortality

  7. Model for predicting the injury severity score.

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    Hagiwara, Shuichi; Oshima, Kiyohiro; Murata, Masato; Kaneko, Minoru; Aoki, Makoto; Kanbe, Masahiko; Nakamura, Takuro; Ohyama, Yoshio; Tamura, Jun'ichi

    2015-07-01

    To determine the formula that predicts the injury severity score from parameters that are obtained in the emergency department at arrival. We reviewed the medical records of trauma patients who were transferred to the emergency department of Gunma University Hospital between January 2010 and December 2010. The injury severity score, age, mean blood pressure, heart rate, Glasgow coma scale, hemoglobin, hematocrit, red blood cell count, platelet count, fibrinogen, international normalized ratio of prothrombin time, activated partial thromboplastin time, and fibrin degradation products, were examined in those patients on arrival. To determine the formula that predicts the injury severity score, multiple linear regression analysis was carried out. The injury severity score was set as the dependent variable, and the other parameters were set as candidate objective variables. IBM spss Statistics 20 was used for the statistical analysis. Statistical significance was set at P  Watson ratio was 2.200. A formula for predicting the injury severity score in trauma patients was developed with ordinary parameters such as fibrin degradation products and mean blood pressure. This formula is useful because we can predict the injury severity score easily in the emergency department.

  8. Parthenium dermatitis severity score to assess clinical severity of disease

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    Kaushal K Verma

    2017-01-01

    Full Text Available Background: Parthenium dermatitis is the most common type of airborne contact dermatitis in India. It is a chronic disease of a remitting and relapsing course with significant morbidity and distress, but there is no scoring system to assess its severity. Aim: To design a scoring system for the assessment of clinical severity of disease in Parthenium dermatitis and to use this scoring system in various studies to determine its sensitivity, specificity, and reproducibility. Methods and Results: In our first few studies on Parthenium dermatitis, we designed and used a basic clinical severity scoring system based on itching, morphology of the lesions, and areas involved. However, in subsequent studies, we modified it to the present scoring system as Parthenium dermatitis severity score (PDSS. Our studies showed the high sensitivity of PDSS in characterization of the disease severity at the given point of time, as well as to determine the efficacy of a prescribed treatment modality which was reliable and reproducible. Conclusion: Thus, PDSS may be used by clinicians for appropriate scoring of the clinical severity of Parthenium dermatitis and in monitoring the disease response to therapy.

  9. [Predictive quality of the injury severity score in the systematic use of cranial MRI].

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    Woischneck, D; Lerch, K; Kapapa, T; Skalej, M; Firsching, R

    2010-09-01

    The ABBREVIATED INJURY SCORE (AIS) for the head is mostly coded on the basis of cranial computed tomography (CT). It defines, to a large extent, the predictive potency of the INJURY SEVERITY SCORE (ISS). The present study investigates whether the predictive capacity of the ISS can be improved by the systematic use of data from cranial MRI. 167 patients, who had been in a coma for at least 24 hours following trauma, underwent an MRI examination within 8 days. All had been found to have an intracranial injury on initial CT. 49 % had also suffered extracranial injuries. The GLASGOW OUTCOME SCALE (GOS) was determined 6 months post trauma. AIS, ISS and GOS values were rated as ordinal measurements. A contingency table was used as the statistical method of analysis, with a significance assumed as p RISC) score was improved by use of adapted MRI data. If visible brain stem lesions on MRI were coded according to the AIS guidelines, there was a significant increase in the ISS which correlated significantly to the GOS. If the AIS coding was adjusted to the prognostic significance of individual brain stem lesions, there was a further improvement in the prognostic potency of the ISS. The study encourages the inclusion of data obtained from MRI diagnostics in the ISS calculation. There are alternative ways. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Validation of dengue infection severity score

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    Pongpan S

    2014-03-01

    Full Text Available Surangrat Pongpan,1,2 Jayanton Patumanond,3 Apichart Wisitwong,4 Chamaiporn Tawichasri,5 Sirianong Namwongprom1,6 1Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Occupational Medicine, Phrae Hospital, Phrae, Thailand; 3Clinical Epidemiology Program, Faculty of Medicine, Thammasat University, Bangkok, Thailand; 4Department of Social Medicine, Sawanpracharak Hospital, Nakorn Sawan, Thailand; 5Clinical Epidemiology Society at Chiang Mai, Chiang Mai, Thailand; 6Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Objective: To validate a simple scoring system to classify dengue viral infection severity to patients in different settings. Methods: The developed scoring system derived from 777 patients from three tertiary-care hospitals was applied to 400 patients in the validation data obtained from another three tertiary-care hospitals. Percentage of correct classification, underestimation, and overestimation was compared. The score discriminative performance in the two datasets was compared by analysis of areas under the receiver operating characteristic curves. Results: Patients in the validation data were different from those in the development data in some aspects. In the validation data, classifying patients into three severity levels (dengue fever, dengue hemorrhagic fever, and dengue shock syndrome yielded 50.8% correct prediction (versus 60.7% in the development data, with clinically acceptable underestimation (18.6% versus 25.7% and overestimation (30.8% versus 13.5%. Despite the difference in predictive performances between the validation and the development data, the overall prediction of the scoring system is considered high. Conclusion: The developed severity score may be applied to classify patients with dengue viral infection into three severity levels with clinically acceptable under- or overestimation. Its impact when used in routine

  11. Development of a severity score for CRPS.

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    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.

  12. 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

  13. Severity scores in trauma patients admitted to ICU. Physiological and anatomic models.

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    Serviá, L; Badia, M; Montserrat, N; Trujillano, J

    2018-02-02

    The goals of this project were to compare both the anatomic and physiologic severity scores in trauma patients admitted to intensive care unit (ICU), and to elaborate mixed statistical models to improve the precision of the scores. A prospective study of cohorts. The combined medical/surgical ICU in a secondary university hospital. Seven hundred and eighty trauma patients admitted to ICU older than 16 years of age. Anatomic models (ISS and NISS) were compared and combined with physiological models (T-RTS, APACHE II [APII], and MPM II). The probability of death was calculated following the TRISS method. The discrimination was assessed using ROC curves (ABC [CI 95%]), and the calibration using the Hosmer-Lemeshoẃs H test. The mixed models were elaborated with the tree classification method type Chi Square Automatic Interaction Detection. A 14% global mortality was recorded. The physiological models presented the best discrimination values (APII of 0.87 [0.84-0.90]). All models were affected by bad calibration (P<.01). The best mixed model resulted from the combination of APII and ISS (0.88 [0.83-0.90]). This model was able to differentiate between a 7.5% mortality for elderly patients with pathological antecedents and a 25% mortality in patients presenting traumatic brain injury, from a pool of patients with APII values ranging from 10 to 17 and an ISS threshold of 22. The physiological models perform better than the anatomical models in traumatic patients admitted to the ICU. Patients with low scores in the physiological models require an anatomic analysis of the injuries to determine their severity. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  14. THE PANC 3 SCORE PREDICTING SEVERITY OF ACUTE PANCREATITIS.

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    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.

  15. Validation of ICDPIC software injury severity scores using a large regional trauma registry.

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    Greene, Nathaniel H; Kernic, Mary A; Vavilala, Monica S; Rivara, Frederick P

    2015-10-01

    Administrative or quality improvement registries may or may not contain the elements needed for investigations by trauma researchers. International Classification of Diseases Program for Injury Categorisation (ICDPIC), a statistical program available through Stata, is a powerful tool that can extract injury severity scores from ICD-9-CM codes. We conducted a validation study for use of the ICDPIC in trauma research. We conducted a retrospective cohort validation study of 40,418 patients with injury using a large regional trauma registry. ICDPIC-generated AIS scores for each body region were compared with trauma registry AIS scores (gold standard) in adult and paediatric populations. A separate analysis was conducted among patients with traumatic brain injury (TBI) comparing the ICDPIC tool with ICD-9-CM embedded severity codes. Performance in characterising overall injury severity, by the ISS, was also assessed. The ICDPIC tool generated substantial correlations in thoracic and abdominal trauma (weighted κ 0.87-0.92), and in head and neck trauma (weighted κ 0.76-0.83). The ICDPIC tool captured TBI severity better than ICD-9-CM code embedded severity and offered the advantage of generating a severity value for every patient (rather than having missing data). Its ability to produce an accurate severity score was consistent within each body region as well as overall. The ICDPIC tool performs well in classifying injury severity and is superior to ICD-9-CM embedded severity for TBI. Use of ICDPIC demonstrates substantial efficiency and may be a preferred tool in determining injury severity for large trauma datasets, provided researchers understand its limitations and take caution when examining smaller trauma datasets. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

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    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

  17. 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.

  18. An epistaxis severity score for hereditary hemorrhagic telangiectasia.

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    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.

  19. Scoring systems of severity in patients with multiple trauma.

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    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.

  20. 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....

  1. 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. 

  2. Prehospital severity scoring at major rock concert events.

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    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.

  3. 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

  4. Risk factors affecting injury severity determined by the MAIS score.

    Science.gov (United States)

    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

  5. 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.

  6. Patients with tattoo reactions have reduced quality of life and suffer from itch: Dermatology Life Quality Index and Itch Severity Score measurements.

    Science.gov (United States)

    Hutton Carlsen, K; Serup, J

    2015-02-01

    Tattoos are a trend with increasing side-effects. The burden of local reaction with swelling, itching and discomfort may impel sufferers to consult medical assistance. To assess tattoo reactions and their influence on quality of life and itching by utilizing the Dermatology Life Quality Index (DLQI) scoring system and Itch Severity Scale (ISS). 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. 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. 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 with itch. Tattoo reactions warrant diagnosis and treatment with same professional intent shared with other skin diseases. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. 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.

  8. Assessment of PANC3 Score in Predicting Severity of Acute ...

    African Journals Online (AJOL)

    2017-05-18

    May 18, 2017 ... us in predicting severity at the time of admission but these are time consuming or .... and Acute pancreatitis classification working group)[3] to assess the severity of ... belonged to 30–45 years age group, with mean age of.

  9. Factors influencing pediatric Injury Severity Score and Glasgow Coma Scale in pediatric automobile crashes: results from the Crash Injury Research Engineering Network.

    Science.gov (United States)

    Ehrlich, Peter F; Brown, J Kristine; Sochor, Mark R; Wang, Stewart C; Eichelberger, Martin E

    2006-11-01

    Motor vehicle crashes account for more than 50% of pediatric injuries. Triage of pediatric patients to appropriate centers can be based on the crash/injury characteristics. Pediatric motor vehicle crash/injury characteristics can be determined from an in vitro laboratory using child crash dummies. However, to date, no detailed data with respect to outcomes and crash mechanism have been presented with a pediatric in vivo model. The Crash Injury Research Engineering Network is comprised of 10 level 1 trauma centers. Crashes were examined with regard to age, crash severity (DeltaV), crash direction, restraint use, and airbag deployment. Multiple logistic regression analysis was performed with Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) as outcomes. Standard age groupings (0-4, 5-9, 10-14, and 15-18) were used. The database is biases toward a survivor population with few fatalities. Four hundred sixty-one motor vehicle crashes with 2500 injuries were analyzed (242 boys, 219 girls). Irrespective of age, DeltaV > 30 mph resulted in increased ISS and decreased GCS (eg, for 0-4 years, DeltaV 30: ISS = 19.5, GCS = 10.6; P 15) injuries than did backseat passengers (odds ratio, 1.7; 95% confidence interval, 0.7-3.4). A trend was noted for children younger than 12 years sitting in the front seat to have increased ISS and decreased GCS with airbag deployment but was limited by case number. A reproducible pattern of increased ISS and lower GCS characterized by high severity, lateral crashes in children was noted. Further analysis of the specific injuries as a function and the crash characteristic can help guide management and prevention strategies.

  10. 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

  11. 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

  12. [Rational choice, prediction, and medical decision. Contribution of severity scores].

    Science.gov (United States)

    Bizouarn, P; Fiat, E; Folscheid, D

    2001-11-01

    The aim of this study was to determine what type of representation the medical doctor adopted concerning the uncertainty about the future in critically ill patients in the context of preoperative evaluation and intensive care medicine and to explore through the representation of the patient health status the different possibilities of choice he was able to make. The role played by the severity classification systems in the process of medical decision-making under probabilistic uncertainty was assessed according to the theories of rational behaviour. In this context, a medical rationality needed to be discovered, going beyond the instrumental status of the objective and/or subjective constructions of rational choice theories and reaching a dimension where means and expected ends could be included.

  13. 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

    Science.gov (United States)

    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 <0.012. Misclassification rate for ISS was 2.77% and the value for NISS was 2.43%.

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

    Science.gov (United States)

    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.

  15. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  19. The Best Prediction Model for Trauma Outcomes of the Current Korean Population: a Comparative Study of Three Injury Severity Scoring Systems

    Directory of Open Access Journals (Sweden)

    Kyoungwon Jung

    2016-08-01

    Full Text Available Background: Injury severity scoring systems that quantify and predict trauma outcomes have not been established in Korea. This study was designed to determine the best system for use in the Korean trauma population. Methods: We collected and analyzed the data from trauma patients admitted to our institution from January 2010 to December 2014. Injury Severity Score (ISS, Revised Trauma Score (RTS, and Trauma and Injury Severity Score (TRISS were calculated based on the data from the enrolled patients. Area under the receiver operating characteristic (ROC curve (AUC for the prediction ability of each scoring system was obtained, and a pairwise comparison of ROC curves was performed. Additionally, the cut-off values were estimated to predict mortality, and the corresponding accuracy, positive predictive value, and negative predictive value were obtained. Results: A total of 7,120 trauma patients (6,668 blunt and 452 penetrating injuries were enrolled in this study. The AUCs of ISS, RTS, and TRISS were 0.866, 0.894, and 0.942, respectively, and the prediction ability of the TRISS was significantly better than the others (p < 0.001, respectively. The cut-off value of the TRISS was 0.9082, with a sensitivity of 81.9% and specificity of 92.0%; mortality was predicted with an accuracy of 91.2%; its positive predictive value was the highest at 46.8%. Conclusions: The results of our study were based on the data from one institution and suggest that the TRISS is the best prediction model of trauma outcomes in the current Korean population. Further study is needed with more data from multiple centers in Korea.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  2. 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...

  3. 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).

  4. 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.

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

    Science.gov (United States)

    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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  14. 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.

  15. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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...

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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%.

  20. 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:

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

    Science.gov (United States)

    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.

  2. ISS National Laboratory Education Project: Enhancing and Innovating the ISS as an Educational Venue

    Science.gov (United States)

    Melvin, Leland D.

    2011-01-01

    The vision is to develop the ISS National Laboratory Education Project (ISS NLE) as a national resource for Science, Technology, Engineering and Mathematics (STEM) education, utilizing the unique educational venue of the International Space Station per the NASA Congressional Authorization Act of 2005. The ISS NLE will serve as an educational resource which enables educational activities onboard the ISS and in the classroom. The ISS NLE will be accessible to educators and students from kindergarten to post-doctoral studies, at primary and secondary schools, colleges and universities. Additionally, the ISS NLE will provide ISS-related STEM education opportunities and resources for learners of all ages via informal educational institutions and venues Though U.S. Congressional direction emphasized the involvement of U.S. students, many ISS-based educational activities have international student and educator participation Over 31 million students around the world have participated in several ISS-related education activities.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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.

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

    Science.gov (United States)

    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

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  13. 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.

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

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    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.

  15. 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.

  16. 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

  17. [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.

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. 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...

  13. 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.

  14. 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)

  15. 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)

  16. 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)

  17. 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.

  18. 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)

  19. The minimal important difference of the epistaxis severity score in hereditary hemorrhagic telangiectasia.

    Science.gov (United States)

    Yin, Linda X; Reh, Douglas D; Hoag, Jeffrey B; Mitchell, Sally E; Mathai, Stephen C; Robinson, Gina M; Merlo, Christian A

    2016-05-01

    Hereditary hemorrhagic telangiectasia (HHT) is a disease of abnormal angiogenesis, causing epistaxis in over 96% of patients. The Epistaxis Severity Score (ESS) was developed as a standardized measurement of nasal symptoms among HHT patients. The minimal important difference (MID) of a disease index estimates the smallest change that a patient and clinician would identify as important. This study aims to establish the MID of the ESS in a diverse population of HHT patients. Retrospective cross-sectional study in patients with a diagnosis of HHT using Curacao criteria or genetic testing. The ESS questionnaire and Medical Outcomes Study 36-Item Short Form (SF-36) were administered to participants recruited through the HHT Foundation Web site. Demographics and relevant medical histories were collected from all participants. An anchor-based method using a change of 5 in the Physical Component Summary (PCS) of the SF-36 and a distributional method were used to estimate the MID. A total of 604 subjects were recruited between April and August 2008. All participants reported epistaxis. An increasing ESS in the study cohort showed a significant negative correlation to the PCS (r = -0.43, P < 0.001). The MID was determined to be 0.41 via the anchor-based approach and 1.01 via the distribution-based approach, giving a mean MID of 0.71. Using both the anchor-based and distribution-based approaches, the estimated MID for the ESS in HHT is 0.71. Further implications include key metrics to help guide treatment responses in clinical care and essential information to calculate power and sample size for future clinical trials. 4. Laryngoscope, 126:1029-1032, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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

    Directory of Open Access Journals (Sweden)

    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

  6. 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.

  7. 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...

  8. A Derivation and Validation Study of an Early Blood Transfusion Needs Score for Severe Trauma Patients

    OpenAIRE

    Wang, Hao; Umejiego, Johnbosco; Robinson, Richard D.; Schrader, Chet D.; Leuck, JoAnna; Barra, Michael; Buca, Stefan; Shedd, Andrew; Bui, Andrew; Zenarosa, Nestor R.

    2016-01-01

    Background There is no existing adequate blood transfusion needs determination tool that Emergency Medical Services (EMS) personnel can use for prehospital blood transfusion initiation. In this study, a simple and pragmatic prehospital blood transfusion needs scoring system was derived and validated. Methods Local trauma registry data were reviewed retrospectively from 2004 through 2013. Patients were randomly assigned to derivation and validation cohorts. Multivariate logistic regression was...

  9. 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.

  10. 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.

  11. 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.

  12. KSC ISS Logistics Support

    Science.gov (United States)

    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.

  13. 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.

  14. 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...

  15. A quantitative assessment of alkaptonuria: testing the reliability of two disease severity scoring systems.

    Science.gov (United States)

    Cox, Trevor F; Ranganath, Lakshminarayan

    2011-12-01

    Alkaptonuria (AKU) is due to excessive homogentisic acid accumulation in body fluids due to lack of enzyme homogentisate dioxygenase leading in turn to varied clinical manifestations mainly by a process of conversion of HGA to a polymeric melanin-like pigment known as ochronosis. A potential treatment, a drug called nitisinone, to decrease formation of HGA is available. However, successful demonstration of its efficacy in modifying the natural history of AKU requires an effective quantitative assessment tool. We have described two potential tools that could be used to quantitate disease burden in AKU. One tool describes scoring the clinical features that includes clinical assessments, investigations and questionnaires in 15 patients with AKU. The second tool describes a scoring system that only includes items obtained from questionnaires used in 44 people with AKU. Statistical analyses were carried out on the two patient datasets to assess the AKU tools; these included the calculation of Chronbach's alpha, multidimensional scaling and simple linear regression analysis. The conclusion was that there was good evidence that the tools could be adopted as AKU assessment tools, but perhaps with further refinement before being used in the practical setting of a clinical trial.

  16. Using acute kidney injury severity and scoring systems to predict outcome in patients with burn injury

    Directory of Open Access Journals (Sweden)

    George Kuo

    2016-12-01

    Conclusion: Our results revealed that AKI stage has considerable discriminative power for predicting mortality. Compared with other prognostic models, AKI stage is easier to use to assess outcome in patients with severe burn injury.

  17. 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.

  18. 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.

  19. 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.)

  20. 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.

  1. 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.)

  2. [Objective assessment of trauma severity in patients with spleen injuries].

    Science.gov (United States)

    Alekseev, V S; Ivanov, V A; Alekseev, S V; Vaniukov, V P

    2013-01-01

    The work presents an analysis of condition severity of 139 casualties with isolated and combined spleen injuries on admission to a surgical hospital. The assessment of condition severity was made using the traditional gradation and score scale VPH-SP. The degree of the severity of combined trauma of the spleen was determined by the scales ISS. The investigation showed that the scale ISS and VPH-SP allowed objective measurement of the condition severity of patients with spleen trauma. The score assessment facilitated early detection of the severe category of the patients, determined the diagnostic algorithm and the well-timed medical aid.

  3. 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...

  4. A scoring model for predicting prognosis of patients with severe fever with thrombocytopenia syndrome.

    Directory of Open Access Journals (Sweden)

    Bei Jia

    2017-09-01

    Full Text Available Severe fever with thrombocytopenia syndrome (SFTS is an emerging epidemic infectious disease caused by the SFTS bunyavirus (SFTSV with an estimated high case-fatality rate of 12.7% to 32.6%. Currently, the disease has been reported in mainland China, Japan, Korea, and the United States. At present, there is no specific antiviral therapy for SFTSV infection. Considering the higher mortality rate and rapid clinical progress of SFTS, supporting the appropriate treatment in time to SFTS patients is critical. Therefore, it is very important for clinicians to predict these SFTS cases who are more likely to have a poor prognosis or even more likely to decease. In the present study, we established a simple and feasible model for assessing the severity and predicting the prognosis of SFTS patients with high sensitivity and specificity. This model may aid the physicians to immediately initiate prompt treatment to block the rapid development of the illness and reduce the fatality of SFTS patients.

  5. ASSESSMENT OF SEVERITY OF PERFORATED PERITONITIS USING MODIFIED APACHE II SCORE

    Directory of Open Access Journals (Sweden)

    L. Rajeswar Reddy

    2016-06-01

    Full Text Available Acute generalised peritonitis from gastrointestinal hollow viscus perforation is a potentially life threatening condition. It is a common surgical emergency in many general surgical units in the developing countries and it is often associated with high morbidity and mortality. Grading the severity of acute peritonitis has assisted in no small way in decision making and has improved therapy in the management of severely ill patients. Empirically based risk assessment for important clinical events has been extremely useful in evaluating new therapies, in monitoring resources for effective use and improving quality of care. MATERIAL AND METHODS A prospective survey of patients with acute generalised peritonitis due to gastrointestinal perforation was carried out in general surgical wards of KIMS Hospital, Amalapuram during the period starting from July 2013-November 2016. The study population consisted of 50 consecutive patients who had laparotomy during the study period for acute peritonitis due to gastrointestinal perforation, after diagnostic conformation. RESULT AND DISCUSSION The most common cause of peritonitis in our study was perforated duodenal ulcer (31 cases, followed by appendicular perforation (7 cases, followed by stomach perforation (7 cases. Despite delay in seeking treatment, the overall mortality rate (14% was favourably comparable with other published series.

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. First CT findings and improvement in GOS and GOSE scores 6 and 12 months after severe traumatic brain injury.

    Science.gov (United States)

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

    2009-05-01

    To analyse the association between individual initial computerized tomography (CT) scan characteristics and Glasgow Outcome Scale (GOS) and Extended Glasgow Outcome Scale (GOSE) improvement between 6 months and 1 year. Two hundred and twenty-four adult patients with severe traumatic brain injury and Glasgow Coma Scale (GCS) score of 8 or less who were admitted to an intensive care unit were studied. GOS and GOSE scores were obtained 6 and 12 months after injury in 203 subjects. Patients were predominantly male (84%) and median age was 35 years. Traumatic Coma Data Bank (TCDB) CT classification was associated with GOS/GOSE improvement between 6 months and 1 year, with diffuse injury type I, type II and evacuated mass improving more than diffuse injury type III, type IV and non-evacuated mass; for GOS 43/155 (28%) vs 3/48 (6%) (chi(2) = 9.66, p GOSE 71/155 (46%) vs 7/48 (15%) (chi(2) = 15.1, p GOSE improvement, with the exception of subarachnoid haemorrhage, which showed a negative association with GOSE improvement (chi(2) = 4.08, p GOSE improvement from 6-12 months, but individual CT abnormalities were not associated.

  14. Assessing the effect of drought severity on height-for-age z-score in Kenyan children: a secondary analysis

    Directory of Open Access Journals (Sweden)

    Kate Lillepold, BScH

    2018-05-01

    Full Text Available Background: Globally, droughts are occurring more regularly and are having negative effects on population health, particularly in countries such as Kenya, where agriculture is a primary driver of the economy and a source of subsistence for many communities. Children are particularly susceptible to weather-related shocks. Previous research has shown an association between drought and cross-sectional indicators of malnutrition, such as stunting. In this study, we explored various longitudinal and spatial analysis approaches to evaluating the effect of drought on height-for-age z-scores (HAZ over time and space among young children in Kenya. Methods: Using anthropometric data from three georeferenced Kenyan Demographic and Health Surveys (KDHS and the self-calibrated Palmer Drought Severity Index, we developed multivariate linear regression and spatial lag and error models (with Moran's I calculations to investigate the association between drought severity and HAZ in children aged 0–5 years. Initial covariates included age of the child, sex, maternal age, height and education, wealth index, urban or rural location, and size at birth. We then did multilevel and geographically weighted regression modelling using frequentist or Bayesian methods and with inclusion of household-level covariates, such as livelihood zones. To assess the effect of changes in drought severity on child HAZ over time, KDHS data from 2003, 2008–09, and 2014 were analysed with spatiotemporal modelling. Findings: Preliminary results from the multivariate linear model showed a negative, non-significant association between drought severity and HAZ among Kenyan children in 2014 (β=0·033, p=0·101; however, there was a significant interaction between drought severity and age (β=–0·002, p<0·0007. The spatial lag model gave similar results. Other variables associated with HAZ included wealth index, age, sex, maternal education, and maternal height. Global Moran's I

  15. Applying an artificial neural network model for developing a severity score for patients with hereditary amyloid polyneuropathy.

    Science.gov (United States)

    Novis, Shenia; Machado, Felipe; Costa, Victor B; Foguel, Debora; Cruz, Marcia W; de Seixas, José Manoel

    2017-09-01

    Hereditary (familial) amyloid polyneuropathy (FAP) is a systemic disease that includes a sensorimotor polyneuropathy related to transthyretin (TTR) mutations. So far, a scale designed to classify the severity of this disease has not yet been validated. This work proposes the implementation of an artificial neural network (ANN) in order to develop a severity scale for monitoring the disease progression in FAP patients. In order to achieve this goal, relevant symptoms and laboratory findings were collected from 98 Brazilian patients included in THAOS - the Transthyretin Amyloidosis Outcomes Survey. Ninety-three percent of them bore Val30Met, the most prevalent variant of TTR worldwide; 63 were symptomatic and 35 were asymptomatic. These data were numerically codified for the purpose of constructing a Self-Organizing Map (SOM), which maps data onto a grid of artificial neurons. Mapped data could be clustered by similarity into five groups, based on increasing FAP severity (from Groups 1 to 5). Most symptoms were virtually absent from patients who mapped to Group 1, which also includes the asymptomatic patients. Group 2 encompasses the patients bearing symptoms considered to be initial markers of FAP, such as first signs of walking disabilities and lack of sensitivity to temperature and pain. Interestingly, the patients with cardiac symptoms, which also carry cardiac-associated mutations of the TTR gene (such as Val112Ile and Ala19Asp), were concentrated in Group 3. Symptoms such as urinary and fecal incontinence and diarrhea characterized particularly Groups 4 and 5. Renal impairment was found almost exclusively in Group 5. Model validation was accomplished by considering the symptoms from a sample with 48 additional Brazilian patients. The severity scores proposed here not only identify the current stage of a patient's disease but also offer to the physician an easy-to-read, 2D map that makes it possible to track disease progression.

  16. 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.

  17. Risk factors for mortality in fournier's gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI

    Directory of Open Access Journals (Sweden)

    Carlos Eugênio Lira Tenório

    Full Text Available ABSTRACT Objective To evaluate risk factors for mortality in patients with Fournier's gangrene (FG, with emphasis in the Simplified Fournier Gangrene Severe Index Score (SFGSI. Materials and Methods This was a cross-sectional study that was carried out from January 2010 to December 2014, with 124 patients treated for FG in a General Hospital. Several clinical and laboratory variables, including SFGSI, were evaluated and correlated with mortality through univariate analysis and logistic regression. Results Of the 124 patients, 99 were men (79.8%, the mean age was 50.8±19.5 years and the main comorbidity was diabetes mellitus (51.6%. The mortality rate was 25.8%. Variables that presented independent correlation with mortality were the extension of the lesion to the abdomen (OR=4.0, CI=1.10-14.68, p=0.03, hematocrit (OR=0.81, CI=0.73-0.90, p2 result was the largest of the independent predictors of mortality (OR=50.2; CI=13.18-191.47; p2 presented a higher correlation with mortality than any variable tested alone. It seems to be a promising alternative to evaluate predictors of mortality in Fournier's gangrene. The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient's admission.

  18. Severe obesity is a limitation for the use of body mass index standard deviation scores in children and adolescents.

    Science.gov (United States)

    Júlíusson, Pétur B; Roelants, Mathieu; Benestad, Beate; Lekhal, Samira; Danielsen, Yngvild; Hjelmesaeth, Jøran; Hertel, Jens K

    2018-02-01

    We analysed the distribution of the body mass index standard deviation scores (BMI-SDS) in children and adolescents seeking treatment for severe obesity, according to the International Obesity Task Force (IOTF), World Health Organization (WHO) and the national Norwegian Bergen Growth Study (BGS) BMI reference charts and the percentage above the International Obesity Task Force 25 cut-off (IOTF-25). This was a cross-sectional study of 396 children aged four to 17 years, who attended a tertiary care obesity centre in Norway from 2009 to 2015. Their BMI was converted to SDS using the three growth references and expressed as the percentage above IOTF-25. The percentage of body fat was assessed by bioelectrical impedance analysis. Regardless of which BMI reference chart was used, the BMI-SDS was significantly different between the age groups, with a wider range of higher values up to 10 years of age and a more narrow range of lower values thereafter. The distributions of the percentage above IOTF-25 and percentage of body fat were more consistent across age groups. Our findings suggest that it may be more appropriate to use the percentage above a particular BMI cut-off, such as the percentage above IOTF-25, than the IOTF, WHO and BGS BMI-SDS in paediatric patients with severe obesity. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Transport Risk Index of Physiologic Stability, version II (TRIPS-II): a simple and practical neonatal illness severity score.

    Science.gov (United States)

    Lee, Shoo K; Aziz, Khalid; Dunn, Michael; Clarke, Maxine; Kovacs, Lajos; Ojah, Cecil; Ye, Xiang Y

    2013-05-01

    Derive and validate a practical assessment of infant illness severity at admission to neonatal intensive care units (NICUs). Prospective study involving 17,075 infants admitted to 15 NICUs in 2006 to 2008. Logistic regression was used to derive a prediction model for mortality comprising four empirically weighted items (temperature, blood pressure, respiratory status, response to noxious stimuli). This Transport Risk Index of Physiologic Stability, version II (TRIPS-II) was then validated for prediction of 7-day and total NICU mortality. TRIPS-II discriminated 7-day (receiver operating curve [ROC] area, 0.90) and total NICU mortality (ROC area, 0.87) from survival. Furthermore, there was a direct association between changes in TRIPS-II at 12 and 24 hours and mortality. There was good calibration across the full range of TRIPS-II scores and the gestational age at birth, and addition of TRIPS-II improved performance of prediction models that use gestational age and baseline population risk variables. TRIPS-II is a validated benchmarking tool for assessing infant illness severity at admission and for up to 24 hours after. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Risk factors for mortality in fournier's gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI).

    Science.gov (United States)

    Tenório, Carlos Eugênio Lira; Lima, Salvador Vilar Correia; Albuquerque, Amanda Vasconcelos de; Cavalcanti, Mariana Pauferro; Teles, Flávio

    2018-01-01

    To evaluate risk factors for mortality in patients with Fournier's gangrene (FG), with emphasis in the Simplified Fournier Gangrene Severe Index Score (SFGSI). This was a cross-sectional study that was carried out from January 2010 to December 2014, with 124 patients treated for FG in a General Hospital. Several clinical and laboratory variables, including SFGSI, were evaluated and correlated with mortality through univariate analysis and logistic regression. Of the 124 patients, 99 were men (79.8%), the mean age was 50.8±19.5 years and the main comorbidity was diabetes mellitus (51.6%). The mortality rate was 25.8%. Variables that presented independent correlation with mortality were the extension of the lesion to the abdomen (OR=4.0, CI=1.10-14.68, p=0.03), hematocrit (OR=0.81, CI=0.73-0.90, p2 result was the largest of the independent predictors of mortality (OR=50.2; CI=13.18-191.47; p2 presented a higher correlation with mortality than any variable tested alone. It seems to be a promising alternative to evaluate predictors of mortality in Fournier's gangrene. The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient's admission. Copyright® by the International Brazilian Journal of Urology.

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

    Directory of Open Access Journals (Sweden)

    Raúl Hernández-García

    2015-07-01

    Conclusion: 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%.

  2. 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

  3. 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.

  4. Injury profiles related to mortality in patients with a low Injury Severity Score: a case-mix issue?

    Science.gov (United States)

    Joosse, Pieter; Schep, Niels W L; Goslings, J Carel

    2012-07-01

    Outcome prediction models are widely used to evaluate trauma care. External benchmarking provides individual institutions with a tool to compare survival with a reference dataset. However, these models do have limitations. In this study, the hypothesis was tested whether specific injuries are associated with increased mortality and whether differences in case-mix of these injuries influence outcome comparison. A retrospective study was conducted in a Dutch trauma region. Injury profiles, based on injuries most frequently endured by unexpected death, were determined. The association between these injury profiles and mortality was studied in patients with a low Injury Severity Score by logistic regression. The standardized survival of our population (Ws statistic) was compared with North-American and British reference databases, with and without patients suffering from previously defined injury profiles. In total, 14,811 patients were included. Hip fractures, minor pelvic fractures, femur fractures, and minor thoracic injuries were significantly associated with mortality corrected for age, sex, and physiologic derangement in patients with a low injury severity. Odds ratios ranged from 2.42 to 2.92. The Ws statistic for comparison with North-American databases significantly improved after exclusion of patients with these injuries. The Ws statistic for comparison with a British reference database remained unchanged. Hip fractures, minor pelvic fractures, femur fractures, and minor thoracic wall injuries are associated with increased mortality. Comparative outcome analysis of a population with a reference database that differs in case-mix with respect to these injuries should be interpreted cautiously. Prognostic study, level II.

  5. 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...

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. ISS Logistics Hardware Disposition and Metrics Validation

    Science.gov (United States)

    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.

  11. 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.

  12. 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

  13. Utility of the Instability Severity Index Score in Predicting Failure After Arthroscopic Anterior Stabilization of the Shoulder.

    Science.gov (United States)

    Phadnis, Joideep; Arnold, Christine; Elmorsy, Ahmed; Flannery, Mark

    2015-08-01

    The redislocation rate after arthroscopic stabilization for anterior glenohumeral instability is up to 30%. The Instability Severity Index Score (ISIS) was developed to preoperatively rationalize the risk of failure, but it has not yet been validated by an independent group. To assess the utility of the ISIS in predicting failure of arthroscopic anterior shoulder stabilization and to identify other preoperative factors for failure. Case-control study; Level of evidence, 3. A case-control study was performed on 141 consecutive patients, comparing those who suffered failure of arthroscopic stabilization with those who had successful arthroscopic stabilization. The mean follow-up time was 47 months (range, 24-132 months). The ISIS was applied retrospectively, and an analysis was performed to establish independent risk factors for failure. A receiver operator coefficient curve was constructed to set a threshold ISIS for considering alternative surgery. Of 141 patients, 19 (13.5%) suffered recurrent instability. The mean ISIS of the failed stabilization group was higher than that of the successful stabilization group (5.1 vs 1.7; P surgery (P < .001), age at first dislocation (P = .01), competitive-level participation in sports (P < .001), and participation in contact or overhead sports (P = .03). The presence of glenoid bone loss carried the highest risk of failure (70%). There was a 70% risk of failure if the ISIS was ≥4, as opposed to a 4% risk of failure if the ISIS was <4. This is the first completely independent study to confirm that the ISIS is a useful preoperative tool. It is recommended that surgeons consider alternative forms of stabilization if the ISIS is ≥4. © 2015 The Author(s).

  14. 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

  15. 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.

  16. Industry's Commercial Initiatives on ISS

    Science.gov (United States)

    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.

  17. 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.

  18. 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. .

  19. 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)

  20. 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

  1. 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...

  2. 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...

  3. 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.

  4. [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

  5. 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...

  6. 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.

  7. 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.

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

    NARCIS (Netherlands)

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

    2018-01-01

    Purpose: 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

  9. 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.

  10. Developing a cumulative anatomic scoring system for military perineal and pelvic blast injuries.

    Science.gov (United States)

    Mossadegh, Somayyeh; Midwinter, M; Parker, P

    2013-03-01

    Improvised explosive device (IED) yields in Afghanistan have increased resulting in more proximal injuries. The injury severity score (ISS) is an anatomic aggregate score of the three most severely injured anatomical areas but does not accurately predict severity in IED related pelvi-perineal trauma patients. A scoring system based on abbreviated injury score (AIS) was developed to reflect the severity of these injuries in order to better understand risk factors, develop a tool for future audit and improve performance. Using standard AIS descriptors, injury scales were constructed for the pelvis (1, minor to 6, maximal). The perineum was divided into anterior and posterior zones as relevant to injury patterns and blast direction with each soft tissue structure being allocated a score from its own severity scale. A cumulative score, from 1 to 36 for soft tissue, or a maximum of 42 if a pelvic fracture was involved, was created for all structures injured in the anterior and posterior zones. Using this new scoring system, 77% of patients survived with a pelvi-perineal trauma score (PPTS) below 5. There was a significant increase in mortality, number of pelvic fractures and amputations with increase in score when comparing the first group (score 1-5) to the second group (score 6-10). For scores between 6 and 16 survival was 42% and 22% for scores between 17 and 21. In our cohort of 62 survivors, 1 patient with an IED related pelvi-perineal injury had a 'theoretically un-survivable' maximal ISS of 75 and survived, whereas there were no survivors with a PPTS greater than 22 but this group had no-one with an ISS of 75 suggesting ISS is not an accurate reflection of the true severity of pelvi-perineal blast injury. This scoring system is the initial part of a more complex logistic regression model that will contribute towards a unique trauma scoring system to aid surgical teams in predicting fluid requirements and operative timelines. In austere environments, it may also

  11. Up-regulation of leucocytes genes implicated in telomere dysfunction and cellular senescence correlates with depression and anxiety severity scores.

    Directory of Open Access Journals (Sweden)

    Jean-Raymond Teyssier

    Full Text Available BACKGROUND: Major depressive disorder (MDD is frequently associated with chronic medical illness responsible of increased disability and mortality. Inflammation and oxidative stress are considered to be the major mediators of the allostatic load, and has been shown to correlate with telomere erosion in the leucocytes of MDD patients, leading to the model of accelerated aging. However, the significance of telomere length as an exclusive biomarker of aging has been questioned on both methodological and biological grounds. Furthermore, telomeres significantly shorten only in patients with long lasting MDD. Sensitive and dynamic functional biomarkers of aging would be clinically useful to evaluate the somatic impact of MDD. METHODOLOGY: To address this issue we have measured in the blood leucocytes of MDD patients (N=17 and controls (N=16 the expression of two genes identified as robust biomarkers of human aging and telomere dysfunction: p16(INK4a and STMN1. We have also quantified the transcripts of genes involved in the repair of oxidative DNA damage at telomeres (OGG1, telomere regulation and elongation (TERT, and in the response to biopsychological stress (FOS and DUSP1. RESULTS: The OGG1, p16(INK4a, and STMN1 gene were significantly up-regulated (25 to 100% in the leucocytes of MDD patients. Expression of p16(INK4a and STMN1 was directly correlated with anxiety scores in the depression group, and that of p16(INK4a, STMN and TERT with the depression and anxiety scores in the combined sample (MDD plus controls. Furthermore, we identified a unique correlative pattern of gene expression in the leucocytes of MDD subjects. CONCLUSIONS: Expression of p16(INK4 and STMN1 is a promising biomarker for future epidemiological assessment of the somatic impact of depressive and anxious symptoms, at both clinical and subclinical level in both depressive patients and general population.

  12. Prevalence, severity, and relationships of lung lesions, liver abnormalities, and rumen health scores measured at slaughter in beef cattle.

    Science.gov (United States)

    Rezac, D J; Thomson, D U; Bartle, S J; Osterstock, J B; Prouty, F L; Reinhardt, C D

    2014-06-01

    An array of management tools exists within the beef industry to improve animal welfare and productivity; however, the ability to assess the outcomes of these tools is needed. Deficiencies in management commonly manifest as bovine respiratory disease complex or nutritional disorders such as acidosis; therefore, lung, liver, and rumen gross pathology lesions present at slaughter were measured as part of the Harvest Audit Program (HAP) and associations with performance determined. Individual gross pathology data from 19,229 cattle at commercial packing plants in Kansas and Texas were collected. Corresponding individual preharvest and carcass data were obtained on a subset of 13,226 cattle. Associations between lesions and performance were modeled using multivariable mixed effect models. Regression coefficients were used for estimation of lesion associative effects on continuous outcomes and odds ratios for dichotomous outcomes. Across the entire population, 67.3% of the cattle had no pulmonary lesions; 22.5 and 9.8% of cattle displayed mild and severe lesions, respectively. Severe pulmonary lesions were associated with a decreased ADG of 0.07 kg and a HCW 7.1 kg less than cohorts with no pulmonary lesions (P < 0.01). Overall, 68.6% of cattle observed had normal livers. Of cattle severely affected by liver abscesses (A+; 4.6%), 14.9% also displayed severe pulmonary lesions and 28.3% displayed mild pulmonary lesions. Rumenitis lesions were observed in 24.1% of the overall study population. Of cattle with mildly abscessed livers (A-), moderately abscessed livers (A), and severely abscessed livers, 20.6, 21.6, and 9.24% displayed mild or severe rumenitis lesions at slaughter. Severe rumenitis lesions were associated with a significant decrease in ADG and HCW (0.025 and 2.20 kg, respectively; P < 0.001). Although the majority of the cattle in this population would be considered low risk, after adjustments for cattle with multiple lesions, 22.9% of cattle in the overall

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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.

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

    OpenAIRE

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

    2015-01-01

    Background: For clinicians, a practical bedside tool for severity assessment and prognosis of patients with Clostridium difficile infection is a highly desirable unmet medical need. Setting: Two general teaching hospitals in northeast Mexico. Population: Adult patients with C. difficile infection. Methods: Prospective observational study. Results: 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 genera...

  19. Performance of the hepatic encephalopathy scoring algorithm in a clinical trial of patients with cirrhosis and severe hepatic encephalopathy

    DEFF Research Database (Denmark)

    Hassanein, T.; Blei, A.T.; Perry, W.

    2009-01-01

    OBJECTIVES: The grading of hepatic encephalopathy (HE) is based on a combination of indicators that reflect the state of consciousness, intellectual function, changes in behavior, and neuromuscular alterations seen in patients with liver failure. METHODS: We modified the traditional West Haven...... criteria (WHC) to provide an objective assessment of the cognitive parameters to complement the subjective clinical ratings for the performance of extracorporeal albumin dialysis (ECAD) using a molecular adsorption recirculating system in patients with cirrhosis and severe (grade III / IV) encephalopathy...

  20. Association of Beck Depression Inventory score and Temperament and Character Inventory-125 in patients with eating disorders and severe malnutrition

    OpenAIRE

    Tanaka, Satoshi; Yoshida, Keizo; Katayama, Hiroto; Kohmura, Kunihiro; Kawano, Naoko; Imaeda, Miho; Kato, Saki; Ando, Masahiko; Aleksic, Branko; Nishioka, Kazuo; Ozaki, Norio

    2015-01-01

    The authors investigated the association between personality and physical/mental status in malnourished patients with eating disorders. A total of 45 patients with anorexia nervosa, avoidant/restrictive food intake disorder, and other specified feeding or eating disorders were included and compared with 39 healthy controls. Personality characteristics and severity of depression were assessed using the Temperament and Character Inventory-125 and Beck?s Depression Inventory. Depression correlat...

  1. 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.

  2. International inter-rater agreement in scoring acne severity utilizing cloud-based image sharing of mobile phone photographs.

    Science.gov (United States)

    Foolad, Negar; Ornelas, Jennifer N; Clark, Ashley K; Ali, Ifrah; Sharon, Victoria R; Al Mubarak, Luluah; Lopez, Andrés; Alikhan, Ali; Al Dabagh, Bishr; Firooz, Alireza; Awasthi, Smita; Liu, Yu; Li, Chin-Shang; Sivamani, Raja K

    2017-09-01

    Cloud-based image sharing technology allows facilitated sharing of images. Cloud-based image sharing technology has not been well-studied for acne assessments or treatment preferences, among international evaluators. We evaluated inter-rater variability of acne grading and treatment recommendations among an international group of dermatologists that assessed photographs. This is a prospective, single visit photographic study to assess inter-rater agreement of acne photographs shared through an integrated mobile device, cloud-based, and HIPAA-compliant platform. Inter-rater agreements for global acne assessment and acne lesion counts were evaluated by the Kendall's coefficient of concordance while correlations between treatment recommendations and acne severity were calculated by Spearman's rank correlation coefficient. There was good agreement for the evaluation of inflammatory lesions (KCC = 0.62, P cloud-based image sharing for acne assessment. Cloud-based sharing may facilitate acne care and research among international collaborators. © 2017 The International Society of Dermatology.

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

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

    Science.gov (United States)

    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.

  11. 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...

  12. Obese adolescent girls with polycystic ovary syndrome (PCOS) have more severe insulin resistance measured by HOMA-IR score than obese girls without PCOS.

    Science.gov (United States)

    Sawathiparnich, Pairunyar; Weerakulwattana, Linda; Santiprabhob, Jeerunda; Likitmaskul, Supawadee

    2005-11-01

    The prevalence of obesity in Thai children is increasing. These individuals are at increased risks of metabolic syndrome that includes insulin resistance, type 2 diabetes mellitus (T2DM), polycystic ovary syndrome (PCOS), dyslipidemia and hypertension. PCOS has been known to be associated with insulin resistance. To compare the insulin sensitivity between obese adolescent girls with PCOS and those without PCOS. We reviewed demographic and hormonal data of 6 obese adolescent girls with PCOS and compared with 6 age, weight and BMI-matched non-PCOS controls. Each subject underwent an oral glucose tolerance test. Homeostasis model assessment of insulin resistance score (HOMA-IR score) in obese adolescent girls with PCOS was significantly higher than in girls without PCOS with median and range as follows (16.5 [3.8, 21.8] vs. 4.1 [3.3, 6.9], p = 0.04). Our study demonstrates that obese adolescent girls with PCOS have more severe insulin resistance measured by HOMA-IR score than girls without PCOS independent of the degree of obesity. Since insulin resistance is a metabolic precursor of future cardiovascular diseases, obese adolescent girls with PCOS might be at greater risk of developing cardiovascular disease in later adulthood than their non-PCOS counterparts.

  13. The impact of a pain assessment intervention on pain score and analgesic use in older nursing home residents with severe dementia: A cluster randomised controlled trial.

    Science.gov (United States)

    Rostad, Hanne Marie; Utne, Inger; Grov, Ellen Karine; Småstuen, Milada Cvancarova; Puts, Martine; Halvorsrud, Liv

    2018-04-30

    Pain is highly prevalent in older adults, especially those in institutional settings such as nursing homes. The presence of dementia may increase the risk of underdiagnosed and undertreated pain. Pain assessment tools are not regularly used in clinical practice, however, there are indications that the regular use of pain assessments tools may influence the recognition of pain by nursing staff and thereby affect pain management. To assess whether regular pain assessment using a pain assessment tool is associated with changes in i) pain scores and ii) analgesic use in nursing home residents with severe dementia. Cluster-randomised controlled trial. The study was conducted in 16 nursing homes in four counties in Norway. A total of 112 nursing home residents aged 65 years and older with dementia who lacked the capacity for self-reporting pain or were non-verbal. The experimental group were regularly assessed pain with a standardised pain scale (the Doloplus-2) twice a week for a 12-week intervention period. The control group received usual care. The primary outcome was pain score measured with the Doloplus-2, and the secondary outcome was analgesic use (oral morphine equivalents and milligram/day paracetamol). Data on the outcomes were collected at baseline and at the end of week 12. The nursing staff in both the experimental and the control groups received training to collect the data. Linear mixed models were used to assess possible between-group difference over time. No overall effect of regular pain assessment was found on pain score or analgesic use. The mean score of Doloplus-2 and analgesic use remained unchanged and above the established cut-off in both groups. The current intervention did not change analgesic use or pain score compared with the control condition. However, there is not sufficient evidence to conclude that regular pain assessment using a pain assessment tool is not clinically relevant. Furthermore, our results indicated that pain continued to be

  14. Predicting mortality among older adults hospitalized for community-acquired pneumonia: an enhanced confusion, urea, respiratory rate and blood pressure score compared with pneumonia severity index.

    Science.gov (United States)

    Abisheganaden, John; Ding, Yew Yoong; Chong, Wai-Fung; Heng, Bee-Hoon; Lim, Tow Keang

    2012-08-01

    Pneumonia Severity Index (PSI) predicts mortality better than Confusion, Urea >7 mmol/L, Respiratory rate >30/min, low Blood pressure: diastolic blood pressure blood pressure 65 years (CURB-65) for community-acquired pneumonia (CAP) but is more cumbersome. The objective was to determine whether CURB enhanced with a small number of additional variables can predict mortality with at least the same accuracy as PSI. Retrospective review of medical records and administrative data of adults aged 55 years or older hospitalized for CAP over 1 year from three hospitals. For 1052 hospital admissions of unique patients, 30-day mortality was 17.2%. PSI class and CURB-65 predicted 30-day mortality with area under curve (AUC) of 0.77 (95% confidence interval (CI): 0.73-0.80) and 0.70 (95% CI: 0.66-0.74) respectively. When age and three co-morbid conditions (metastatic cancer, solid tumours without metastases and stroke) were added to CURB, the AUC improved to 0.80 (95% CI: 0.77-0.83). Bootstrap validation obtained an AUC estimate of 0.78, indicating negligible overfitting of the model. Based on this model, a clinical score (enhanced CURB score) was developed that had possible values from 5 to 25. Its AUC was 0.79 (95% CI: 0.76-0.83) and remained similar to that of PSI class. An enhanced CURB score predicted 30-day mortality with at least the same accuracy as PSI class did among older adults hospitalized for CAP. External validation of this score in other populations is the next step to determine whether it can be used more widely. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

  15. A comparative study to determine the effectiveness of three surgical techniques used in the treatment of severe congenital idiopathic club foot using the dimiglio scoring

    International Nuclear Information System (INIS)

    Dar, U.Z.; Saeed, A.; Sami, A.; Awais, S.M.

    2014-01-01

    Club foot, or congenital talipes equinovarus (CTEV), is a congenital deformity with an incidence of 1 in 1000 live births. The deformity is 3-dimensional with 4 components including cavus, forefoot adduction, heel varus and equinus (CAVE). Severity of the CTEV is determined by Dimiglio scoring system. Benign and moderate forms can be treated conservatively but severe and very severe forms require extensive posteromedial soft tissue release for its correction. The posteromedial soft tissue release can be done through medial Turco incision, Cincinnati incision, and Cincinnati incision with medial rotational fasciocutaneous flap. Objective: The objective of this study is to determine the effectiveness of three types of surgical techniques (Medial Turco, Cincinnati and Cincinnati with medial rotational fasciocutaneous flap), used in the posteromedial release of severe CTEV. Methodology: This Interventional Longitudinal study was conducted at Department of Orthopedic Surgery and Traumatology Mayo Hospital Lahore for a period of one year. A total of 45 patients were diagnosed as severe CTEV and 15 cases were randomly divided in three groups each. Patients were operated and followed-up in OPD by Dimiglio scoring and wound healing at 0, 4th and 18th week postoperatively to determine the amount of correction. Data was analyzed using SPSS 16. Results: Patients in Group-A were treated with Cincinnati with medial rotational fasciocutaneous flap, in group B with Cincinnati Technique and in group-C with Medial Turco Technique. In group A, 7 (46.7%) cases had excellent outcome while 8 (53.3%) cases had good outcome. In group B, 2 (13.3%) cases had excellent outcome, 10 (66.7%) cases had good outcome and 3 (20%) cases had fair outcome. In group C, none of the case had excellent outcome while 9 (60%) cases had good outcome and 6 (40%) cases had fair outcome depending upon Dimiglio scoring. There was significant difference among all groups for final outcome of the incision type

  16. 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

  17. Night-eating syndrome and the severity of self-reported depressive symptoms from the Korea Nurses' Health Study: analysis of propensity score matching and ordinal regression.

    Science.gov (United States)

    Kim, O-S; Kim, M S; Lee, J E; Jung, H

    2016-12-01

    The prevalence of night-eating syndrome (NES) and depression is increasing worldwide. Although nurses, in particular, are exposed to work in an environment of irregular eating, shift work, and stressful settings, limited research exist. In fact, the prevalence of NES among Korean nurses has never been reported. The aim of this study was to determine the prevalence of NES as well as the association between NES and severity of self-reported depressive symptoms among South Korean female nurses. The Korea Nurses' Health Study, following the protocols of the Nurses' Health Study led by the Harvard University, collected data on Korean female nurses. Survey responses from 3617 participants were included, and 404 responses were analyzed in this cross-sectional study using propensity score matching. Descriptive, Spearman's and Cramer's correlations, propensity score matching, and multivariable ordinal logistic regression were conducted as statistical analysis. The prevalence of both NES and self-reported depressive symptoms among Korean female nurses were higher compared with nurses in prior studies. Nurses with NES were 1.65 times more likely to have greater severity of depressive symptoms than those without NES (95% confidence interval [1.19-2.10], odds ratio = 1.65) after adjusting for covariates including sociodemographic characteristics, health behavioural factors, and shift work. This study suggests significant association between NES and the severity of self-reported depressive symptoms among Korean female nurses after adjusting for covariates. Policy makers and hospital managers need to develop strategies to reduce depression and NES among nurses for enhancement of nurses' mental and physical health as well as for improvement of care quality. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. 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

  19. Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality - a prospective study of patients admitted with infection to the emergency department.

    Science.gov (United States)

    Askim, Åsa; Moser, Florentin; Gustad, Lise T; Stene, Helga; Gundersen, Maren; Åsvold, Bjørn Olav; Dale, Jostein; Bjørnsen, Lars Petter; Damås, Jan Kristian; Solligård, Erik

    2017-06-09

    We aimed to evaluate the clinical usefulness of qSOFA as a risk stratification tool for patients admitted with infection compared to traditional SIRS criteria or our triage system; the Rapid Emergency Triage and Treatment System (RETTS). The study was an observational cohort study performed at one Emergency Department (ED) in an urban university teaching hospital in Norway, with approximately 20,000 visits per year. All patients >16 years presenting with symptoms or clinical signs suggesting an infection (n = 1535) were prospectively included in the study from January 1 to December 31, 2012. At arrival in the ED, vital signs were recorded and all patients were triaged according to RETTS vital signs, presenting infection, and sepsis symptoms. These admission data were also used to calculate qSOFA and SIRS. Treatment outcome was later retrieved from the patients' electronic records (EPR) and mortality data from the Norwegian population registry. Of the 1535 admitted patients, 108 (7.0%) fulfilled the Sepsis2 criteria for severe sepsis. The qSOFA score ≥2 identified only 33 (sensitivity 0.32, specificity 0.98) of the patients with severe sepsis, whilst the RETTS-alert ≥ orange identified 92 patients (sensitivity 0.85, specificity 0.55). Twenty-six patients died within 7 days of admission; four (15.4%) of them had a qSOFA ≥2, and 16 (61.5%) had RETTS ≥ orange alert. Of the 68 patients that died within 30 days, only eight (11.9%) scored ≥2 on the qSOFA, and 45 (66.1%) had a RETTS ≥ orange alert. In order to achieve timely treatment for sepsis, a sensitive screening tool is more important than a specific one. Our study is the fourth study were qSOFA finds few of the sepsis cases in prehospital or at arrival to the ED. We add information on the RETTS triage system, the two highest acuity levels together had a high sensitivity (85%) for identifying sepsis at arrival to the ED - and thus, RETTS should not be replaced by qSOFA as a screening and

  20. 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.

  1. Relationship between Metabolic Syndrome and Predictors for Clinical Benign Prostatic Hyperplasia Progression and International Prostate Symptom Score in Patients with Moderate to Severe Lower Urinary Tract Symptoms.

    Science.gov (United States)

    Zhao, Sicong; Chen, Chao; Chen, Zongping; Xia, Ming; Tang, Jianchun; Shao, Sujun; Yan, Yong

    2016-06-28

    To investigate the association between metabolic syndrome (MetS) and the predictors of the progression of benign prostatic hyperplasia (BPH) and the corresponding frequency and severity of lower urinary tract symptoms (LUTS). A total of 530 men with moderate to severe International Prostate Symptom Score (IPSS) > 7 were recruited in the present study. The predictors for clinical BPH progression were defined as the total prostate volume (TPV) ≥ 31 cm3, prostate-specific antigen level (PSA) ≥ 1.6 ng/mL, maximal flow rate (Qmax) < 10.6 mL/s, postvoid residual urine volume (PVR) of ≥ 39 mL, and age 62 years or older. LUTS were defined according to the IPSS and MetS with the National Cholesterol Education Program-Adult Treatment Panel III guidelines. The Mantel-Haenszel extension test and the multivariate logistic regression analyses were used to statistically examine their relationships. The percentage of subjects with ≥ 1 predictors for clinical BPH progression, the percentage of subjects with a TPV ≥ 31 cm3, the percentage of subjects with a PVR ≥ 39 mL, and the percentage of subjects with a Qmax < 10.6 mL/s increased significantly with the increasing in the number of MetS components (all P < .05). After adjusting for age and serum testosterone level, the MetS were independently associated with the presence of TPV ≥ 31 cm3 (OR = 17.030, 95% CI: 7.495-38.692). Moreover, MetS was positively associated with the severity of LUTS (P < .001) and voiding scores (P < .001), and each individual MetS component appeared as an independent risk factor for severe LUTS (IPSS > 19, all P < .001). Our data have shown that the MetS significantly associated with the predictors for clinical BPH progression and the frequency and severity of LUTS, especially the voiding symptoms. The prevention of such modifiable factors by promotion of dietary changes and regular physical activity practice may be of great importance for public health. .

  2. G-231A and G+70C polymorphisms of endothelin receptor type-A gene could affect the psoriasis area and severity index score and endothelin 1 levels

    Directory of Open Access Journals (Sweden)

    Gökhan Okan

    2015-01-01

    Full Text Available Background: The etiopathogenesis of psoriasis has not been clearly elucidated although the role of chronic inflammation, imbalance between pro- and anti-inflammatory cytokines, and many immunological events have been established. Endothelin 1 (EDN1 and endothelin receptor type-A (EDNRA are implicated in the inflammatory process. The relationships between EDN1 and EDNRA polymorphisms with several diseases have been found. Aims and Objectives: This study examined the possible association of EDN1 (G5665T and T-1370G and EDNRA (G-231A and G + 70C single nucleotide polymorphisms (SNPs with the occurence of psoriasis, and evaluated the relationship between genotypes and clinical/laboratory manifestation of psoriasis. Materials and Methods: We analyzed genotype and allele distributions of the above-mentioned polymorphisms in 151 patients with psoriasis and 152 healthy controls by real-time PCR combined with melting curve analysis. Results: We did not find significant differences in the genotype and allele distributions of EDN1 T-1370G, EDNRA G-231A, and EDNRA G+70C polymorphisms between patients with psoriasis and healthy controls. Psoriasis area and severity index (PASI score of EDNRA -231 polymorphic A allele carrying subjects (AA and AA + AG was higher than that of wild homozygotes (P = 0.044 and P = 0.027, respectively. In addition, EDN1 levels in EDNRA+70 polymorphic C allele carriers (CC + CG were elevated when compared with GG genotype; however, the difference was at borderline significance (P = 0.05. Conclusion: Although there were no associations between studied polymorphisms and psoriasis susceptibility, the PASI score and EDN1 levels seem to be affected by EDNRA G-231A and G + 70C polymorphisms.

  3. 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.

  4. Clinical use of the combined Sclarovsky Birnbaum Severity and Anderson Wilkins Acuteness scores from the pre-hospital ECG in ST-segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Fakhri, Yama; Schoos, Mikkel M; Clemmensen, Peter

    2014-01-01

    This review summarizes the electrocardiographic changes during an evolving ST segment elevation myocardial infarction and discusses associated electrocardiographic scores and the potential use of these indices in clinical practice, in particular the ECG scores developed by Anderson and Wilkins...

  5. Making it possible to measure knowledge, experience and intuition in diagnosing lung injury severity: a fuzzy logic vision based on the Murray score

    Science.gov (United States)

    2010-01-01

    Background Murray score is the result of an equation that gives all its variables the same linear contribution and weight and makes use of consented cut-offs. Everyday physicians' vocabulary is full of terms (adjectives) like: little, small, low, high, etc. that they handle in an intuitive and not always linear way to make therapeutic decisions. The purpose of this paper is to develop a fuzzy logic (FL) vision of Murray's score variables to enable the measurement of physicians' knowledge, experience and intuition in diagnosing lung injury and test if they followed Murray's equation predictions. Methods For a prospective survey carried out among a team of professionals (aged 29 to 53) in a University Hospital Intensive Care Unit, twelve physicians filled in two questionnaires. In the first one they had to define the ranks which should be categorized as normal, moderate and severe for three of four Murray variables. In another questionnaire, which represented all probable combinations of those categories, they had to tick the pulmonary condition as: no injury, mild, moderate, and ARDS. This procedure gave rise to a Fuzzy Inference System designed to provide the degree of severity as sensed by the group. Results The survey showed fuzzy frontiers for the categories and fuzzy diagnosis. In all, 45% of the hypothetical patients (n 18,013) were equally diagnosed by the survey and Murray's equation, whereas another 51% was overestimated in one level by the survey. Physicians agreed with 96.5% of ARDS cases according to Murray's test but only 11.6% of its mild cases were equally diagnosed by the survey. Nonlinearity of the survey reasoning (high relevance to gas exchange and chest film) was apparent. Conclusions The contiguous categories of the variables confirm the existence of fuzzy frontiers. An overestimation was found in the surveyed group's interpretation of severity. This overestimation was mainly due to the different weight assigned to PO2/FiO2 and chest film

  6. 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.

  7. 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.

  8. Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery.

    Directory of Open Access Journals (Sweden)

    Amos Grünebaum

    Full Text Available The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC, compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014. We report in this study outcomes of women who had one or more prior cesarean deliveries and included women who had a successful vaginal birth after a trial of labor after cesarean (TOLAC at home and in the hospital, and a repeat cesarean delivery in the hospital. We excluded preterm births (<37 weeks and infants weighing under 2500 g. Hospital VBACS were the reference. Women with a planned home birth VBAC had an approximately 10-fold and higher increase in adverse neonatal outcomes when compared to hospital VBACS and hospital repeat cesarean deliveries, a significantly higher incidence and risk of a 5-minute Apgar score of 0 of 1 in 890 (11.24/10,000, relative risk 9.04, 95% confidence interval 4-20.39, p<.0001 and an incidence of neonatal seizures or severe neurologic dysfunction of 1 in 814 (Incidence: 12.27/10,000, relative risk 11.19, 95% confidence interval 5.13-24.29, p<.0001. Because of the significantly increased neonatal risks, obstetric providers should therefore not offer or perform planned home TOLACs and for those desiring a VBAC should strongly recommend a planned TOLAC in the appropriate hospital setting. We emphasize that this stance should be accompanied by effective efforts to make TOLAC available in the appropriate hospital setting.

  9. 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.

  10. Reliability assessment of AOSpine thoracolumbar spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries: results of a multicentre study.

    Science.gov (United States)

    Kaul, Rahul; Chhabra, Harvinder Singh; Vaccaro, Alexander R; Abel, Rainer; Tuli, Sagun; Shetty, Ajoy Prasad; Das, Kali Dutta; Mohapatra, Bibhudendu; Nanda, Ankur; Sangondimath, Gururaj M; Bansal, Murari Lal; Patel, Nishit

    2017-05-01

    The aim of this multicentre study was to determine whether the recently introduced AOSpine Classification and Injury Severity System has better interrater and intrarater reliability than the already existing Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries. Clinical and radiological data of 50 consecutive patients admitted at a single centre with a diagnosis of an acute traumatic thoracolumbar spine injury were distributed to eleven attending spine surgeons from six different institutions in the form of PowerPoint presentation, who classified them according to both classifications. After time span of 6 weeks, cases were randomly rearranged and sent again to same surgeons for re-classification. Interobserver and intraobserver reliability for each component of TLICS and new AOSpine classification were evaluated using Fleiss Kappa coefficient (k value) and Spearman rank order correlation. Moderate interrater and intrarater reliability was seen for grading fracture type and integrity of posterior ligamentous complex (Fracture type: k = 0.43 ± 0.01 and 0.59 ± 0.16, respectively, PLC: k = 0.47 ± 0.01 and 0.55 ± 0.15, respectively), and fair to moderate reliability (k = 0.29 ± 0.01 interobserver and 0.44+/0.10 intraobserver, respectively) for total score according to TLICS. Moderate interrater (k = 0.59 ± 0.01) and substantial intrarater reliability (k = 0.68 ± 0.13) was seen for grading fracture type regardless of subtype according to AOSpine classification. Near perfect interrater and intrarater agreement was seen concerning neurological status for both the classification systems. Recently proposed AOSpine classification has better reliability for identifying fracture morphology than the existing TLICS. Additional studies are clearly necessary concerning the application of these classification systems across multiple physicians at different level of training and trauma centers to evaluate not

  11. 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…

  12. Parent reports of health-related quality of life and heart failure severity score independently predict outcome in children with dilated cardiomyopathy.

    Science.gov (United States)

    den Boer, Susanna L; Baart, Sara J; van der Meulen, Marijke H; van Iperen, Gabriëlle G; Backx, Ad P; Ten Harkel, Arend D; Rammeloo, Lukas A; du Marchie Sarvaas, Gideon J; Tanke, Ronald B; Helbing, Willem A; Utens, Elisabeth M; Dalinghaus, Michiel

    2017-08-01

    Dilated cardiomyopathy in children causes heart failure and has a poor prognosis. Health-related quality of life in this patient group is unknown. Moreover, results may provide detailed information of parents' sense of their child's functioning. We hypothesised that health-related quality of life, as rated by parents, and the paediatric heart failure score, as assessed by physicians, have both predictive value on outcome. Methods and results In this prospective study, health-related quality of life was assessed by parent reports: the Infant Toddler Quality of Life questionnaire (0-4 years) or Child Health Questionnaire-Parent Form 50 (4-18 years) at 3-6-month intervals. We included 90 children (median age 3.8 years, interquartile range (IQR) 0.9-12.3) whose parents completed 515 questionnaires. At the same visit, physicians completed the New York University Pediatric Heart Failure Index. Compared with Dutch normative data, quality of life was severely impaired at diagnosis (0-4 years: 7/10 subscales and 4-18 years: 8/11 subscales) and ⩾1 year after diagnosis (3/10 and 6/11 subscales). Older children were more impaired (pFailure Index were independently predictive of the risk of death and heart transplantation (hazard ratio 1.24 per 10% decrease of predicted, 95% confidence interval (CI) 1.06-1.47 and hazard ratio 1.38 per unit, 95% CI 1.19-1.61, respectively). Physical impairment rated by parents and heart failure severity assessed by physicians independently predicted the risk of death or heart transplantation in children with dilated cardiomyopathy.

  13. Use of the Trauma Embolic Scoring System (TESS) to predict symptomatic deep vein thrombosis and fatal and non-fatal pulmonary embolism in severely injured patients.

    Science.gov (United States)

    Ho, K M; Rao, S; Rittenhouse, K J; Rogers, F B

    2014-11-01

    Fatal pulmonary embolism is the third most common cause of death after major trauma. We hypothesised that the Trauma Embolic Scoring System (TESS) would have adequate calibration and discrimination in a group of severely injured trauma patients in predicting venous thromboembolism (VTE), and could be used to predict fatal and non-fatal symptomatic pulmonary embolism. Calibration and discrimination of the TESS were assessed by the slope and intercept of the calibration curve and the area under the receiver operating characteristic curve, respectively. Of the 357 patients included in the study, 74 patients (21%) developed symptomatic VTE after a median period of 14 days following injury. The TESS predicted risks of VTE were higher among patients who developed VTE than those who did not (14 versus 9%, P=0.001) and had a moderate ability to discriminate between patients who developed VTE and those who did not (area under the receiver operating characteristic curve 0.71, 95% confidence interval 0.65 to 0.77). The slope and intercept of the calibration curve were 2.76 and 0.34, respectively, suggesting that the predicted risks of VTE were not sufficiently extreme and overall, underestimated the observed risks of VTE. Using 5% predicted risk of VTE as an arbitrary cut-point, TESS had a high sensitivity and negative predictive value (both ≥0.97) in excluding fatal and non-fatal pulmonary embolism. The TESS had a reasonable ability to discriminate between patients who developed VTE and those who did not and may be useful to select different strategies to prevent VTE in severely injured patients.

  14. 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

  15. Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Jeong; Hwang, Jung Hwa [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

    2011-09-15

    We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV{sub 1}/FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV{sub 1}/FVC and the dyspnea score.

  16. Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

    International Nuclear Information System (INIS)

    Park, Hyun Jeong; Hwang, Jung Hwa

    2011-01-01

    We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. A low attenuation lung volume below -950 HU was well correlated with the DLco and FEV 1 /FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the FEV 1 /FVC and the dyspnea score.

  17. 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.

  18. 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.

  19. Intraobserver and interobserver variability of the bone marrow burden (BMB) score for the assessment of disease severity in Gaucher disease. Possible impact of reporting experience.

    Science.gov (United States)

    Lai, Jeffrey K C; Robertson, Patricia L; Goh, Christine; Szer, Jeff

    2018-02-01

    To evaluate the intraobserver and interobserver agreement for bone marrow burden (BMB) scores for individual examinations and for the change in BMB score over time in the same patient. A total of 119 sets of MR images of the lumbar spine and femora from 60 patients with Gaucher disease were included. Each set of MR images was scored using the BMB score independently by two experienced MSK radiologists. One radiologist performed a second read four weeks later. Intraobserver and interobserver agreement was assessed using Bland-Altman analysis and weighted kappa scores. BMB scores (n=119) demonstrated fair intraobserver agreement (weighted kappa=0.53) with a mean difference of -0.20 and 95% limits of agreement (LOA) of (-3.41, 3.01). Inter observer agreement was poor with weighted kappa 0.28 with mean difference of -0.16 and 95% LOA of (-4.45, 4.11). Change in BMB scores over time (n=59) demonstrated poor/fair intraobserver agreement (weighted kappa 0.41, mean difference-0.20 and 95% LOA (-4.35, 3.94)). Interobserver agreement was poor (weighted kappa 0.25, mean difference -0.12 with wide 95% LOA (-6.23, 5.99)). Significant interobserver, and to a lesser extent intraobserver, variation occurs with blinded BMB scoring of Gaucher disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Status of ISS Water Management and Recovery

    Science.gov (United States)

    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.

  1. 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.

  2. Lower levels of insulin-like growth factor-1 standard deviation score are associated with histological severity of non-alcoholic fatty liver disease.

    Science.gov (United States)

    Sumida, Yoshio; Yonei, Yoshikazu; Tanaka, Saiyu; Mori, Kojiroh; Kanemasa, Kazuyuki; Imai, Shunsuke; Taketani, Hiroyoshi; Hara, Tasuku; Seko, Yuya; Ishiba, Hiroshi; Okajima, Akira; Yamaguchi, Kanji; Moriguchi, Michihisa; Mitsuyoshi, Hironori; Yasui, Kohichiroh; Minami, Masahito; Itoh, Yoshito

    2015-07-01

    Growth hormone (GH) deficiency may be associated with histological progression of non-alcoholic fatty liver disease (NAFLD) which includes non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH). Insulin-like growth factor 1 (IGF-1) is mainly produced by hepatocytes and its secretion is stimulated by GH. Our aim was to determine whether more histologically advanced NAFLD is associated with low circulating levels of IGF-1 in Japanese patients. Serum samples were obtained in 199 Japanese patients with biopsy-proven NAFLD and in 2911 sex- and age-matched healthy people undergoing health checkups. The serum levels of IGF-1 were measured using a commercially available immunoradiometric assay. The standard deviation scores (SDS) of IGF-1 according to age and sex were also calculated in NAFLD patients. The serum IGF-1 levels in NAFLD patients were significantly lower (median, 112 ng/mL) compared with the control population (median, 121 ng/mL, P < 0.0001). IGF-1 SDS less than -2.0 SD from median were found in 11.6% of 199 patients. NASH patients exhibited significantly lower levels of IGF-1 SDS (n = 130; median, -0.7) compared with NAFL patients (n = 69; median, -0.3; P = 0.026). The IGF-1 SDS values decreased significantly with increasing lobular inflammation (P < 0.001) and fibrosis (P < 0.001). In multiple regressions, the association between the IGF-1 SDS values and the severity of NAFLD persisted after adjusting for age, sex and insulin resistance. Low levels of circulating IGF-1 may have a role in the development of advanced NAFLD, independent of insulin resistance. Supplementation with GH/IGF-1 may be a candidate for the treatment of NASH. © 2014 The Japan Society of Hepatology.

  3. Urinary growth hormone level and insulin-like growth factor-1 standard deviation score (IGF-SDS) can discriminate adult patients with severe growth hormone deficiency.

    Science.gov (United States)

    Hirohata, Toshio; Saito, Nobuhito; Takano, Koji; Yamada, So; Son, Jae-Hyun; Yamada, Shoko M; Nakaguchi, Hiroshi; Hoya, Katsumi; Murakami, Mineko; Mizutani, Akiko; Okinaga, Hiroko; Matsuno, Akira

    2013-01-01

    Adult growth hormone (GH) deficiency (AGHD) in Japan is diagnosed based on peak GH concentrations during GH provocative tests such as GHRP-2 stimulation test. In this study, we aimed to evaluate the ability of serum insulin-like growth factor-1 (sIGF-1) and urinary GH (uGH) at the time of awakening to diagnose AGHD. Fifty-nine patients with pituitary disease (32 men and 27 women; age 20-85 y (57.5 ± 15.5, mean ± SD) underwent GHRP-2 stimulation and sIGF-1 testing. Thirty-six and 23 patients were diagnosed with and without severe AGHD, respectively based on a peak GH response of standard deviation score (IGF-1 SDS) based on age and sex. We determined whether uGH levels in urine samples from 42 of the 59 patients at awakening were above or below the sensitivity limit. We evaluated IGF-1 SDS and uGH levels in a control group of 15 healthy volunteers. Values for IGF-1 SDS were significantly lower in patients with, than without (-2.07 ± 1.77 vs.-0.03 ± 0.92, mean ± SD; p -1.4. IGF-1 SDS discriminated AGHD more effectively in patients aged ≤60 years. The χ2 test revealed a statistical relationship between uGH and AGHD (test statistic: 7.0104 ≥ χ2 (1; 0.01) = 6.6349). When IGF-1 SDS is < -1.4 or uGH is below the sensitivity limit, AGHD can be detected with high sensitivity.

  4. A Novel Murine Candidiasis Model with Severe Colonization in the Stomach Induced by N-acetylglucosamine-treatment and Its Scoring System Based on Local Characteristic Stomach Symptoms.

    Science.gov (United States)

    Ishijima, Sanae A; Abe, Shigeru

    2015-01-01

    We developed a novel murine candidiasis model of the gastrointestinal tract using N-acetylglucosamine ( GlcNAc ) as a tool to aggravate symptoms. Forty-eight hours after intragastrically inoculating Candida albicans cells to immunosuppressed and GlcNAc-treated mice, vigorously accumulating patchy whitish plaques were observed on their inner stomach surface. Candida cells colonizing the plaques consisted of both yeast and mycelia, and were directly stained with Calcofluor White M2R. Aggravation of the candidiasis symptoms was dependent on GlcNAc concentration in drinking water, wherein administration of 50 mM GlcNAc not only severely worsened stomach symptoms, but also significantly increased Candida cell number in the stomach and small intestine. The aggravation effect of GlcNAc was enhanced by addition of sedative chemical chlorpromazine chloride after inoculation. In order to semi-quantitatively assess colonization by Candida in the stomach, we devised a new symptom scoring system that represents the extent of the patchy whitish plaques on the mucosal epithelium of the stomach. Histochemical analysis of Candida-infected tissues revealed not only a large amount of thick Candida mycelia invading mucosal epithelial stomach tissues but also infiltrating inflammatory cells. These results suggest that this murine gastrointestinal candidiasis model could serve as a useful tool for evaluating the protective activity of antifungal agents, probiotics, or functional foods against gastrointestinal candidiasis. Furthermore, from another point of view, this novel murine model could also be used to analyze the pathological mechanisms behind the translocation of C. albicans across intestinal barriers, which results in systemic Candida dissemination and infection.

  5. Relationships among measurements obtained by use of computed tomography and radiography and scores of cartilage microdamage in hip joints with moderate to severe joint laxity of adult dogs.

    Science.gov (United States)

    Lopez, Mandi J; Lewis, Brooke P; Swaab, Megan E; Markel, Mark D

    2008-03-01

    To evaluate correlations among measurements on radiographic and computed tomography (CT) images with articular cartilage microdamage in lax hip joints of dogs. 12 adult mixed-breed hounds. Pelvic CT and radiography were performed. Hip joints were harvested following euthanasia. Orthopedic Foundation for Animals (OFA) and PennHIP radiograph reports were obtained. Norberg angle (NA) and radiographic percentage femoral head coverage (RPC) were determined. Center-edge angle (CEA), horizontal toit externe angle (HTEA), ventral acetabular sector angle (VASA), dorsal acetabular sector angle (DASA), horizontal acetabular sector angle (HASA), acetabular index (AI), and CT percentage femoral head coverage (CPC) were measured on 2-dimensional CT images. Femoral head-acetabular shelf percentage was measured on sagittal 3-dimensional CT (SCT) and transverse 3-dimensional CT (TCT) images. Light microscopy was used to score joint cartilage. Relationships of OFA confirmation and PennHIP osteoarthritis scores with radiography, CT, and cartilage variables and relationships of cartilage scores with radiography and CT measurements were evaluated with Spearman rank correlations. Pearson correlation was used for relationships of distraction index (DI) with radiography, CT, and cartilage variables. Significant relationships included PennHIP osteoarthritis score with cartilage score, CEA, HTEA, DASA, AI, CPC, and TCT; OFA confirmation score with cartilage score, NA, RPC, CEA, HTEA, DASA, AI, CPC, and TCT; cartilage score with NA, RPC, CEA, HTEA, DASA, HASA, AI, and TCT; and DI with cartilage score, CEA, HTEA, DASA, HASA, AI, and CPC. CT appeared to be a valuable imaging modality for predicting cartilage microdamage in canine hip joints.

  6. Raising test scores vs. teaching higher order thinking (HOT): senior science teachers' views on how several concurrent policies affect classroom practices

    Science.gov (United States)

    Zohar, Anat; Alboher Agmon, Vered

    2018-04-01

    This study investigates how senior science teachers viewed the effects of a Raising Test Scores policy and its implementation on instruction of higher order thinking (HOT), and on teaching thinking to students with low academic achievements.

  7. Space Flight Resource Management for ISS Operations

    Science.gov (United States)

    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

  8. 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.

  9. 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

  10. The predictive value of an adjusted COPD assessment test score on the risk of respiratory-related hospitalizations in severe COPD patients.

    Science.gov (United States)

    Barton, Christopher A; Bassett, Katherine L; Buckman, Julie; Effing, Tanja W; Frith, Peter A; van der Palen, Job; Sloots, Joanne M

    2017-02-01

    We evaluated whether a chronic obstructive pulmonary disease (COPD) assessment test (CAT) with adjusted weights for the CAT items could better predict future respiratory-related hospitalizations than the original CAT. Two focus groups (respiratory nurses and physicians) generated two adjusted CAT algorithms. Two multivariate logistic regression models for infrequent (≤1/year) versus frequent (>1/year) future respiratory-related hospitalizations were defined: one with the adjusted CAT score that correlated best with future hospitalizations and one with the original CAT score. Patient characteristics related to future hospitalizations ( p ≤ 0.2) were also entered. Eighty-two COPD patients were included. The CAT algorithm derived from the nurse focus group was a borderline significant predictor of hospitalization risk (odds ratio (OR): 1.07; 95% confidence interval (CI): 1.00-1.14; p = 0.050) in a model that also included hospitalization frequency in the previous year (OR: 3.98; 95% CI: 1.30-12.16; p = 0.016) and anticholinergic risk score (OR: 3.08; 95% CI: 0.87-10.89; p = 0.081). Presence of ischemic heart disease and/or heart failure appeared 'protective' (OR: 0.17; 95% CI: 0.05-0.62; p = 0.007). The original CAT score was not significantly associated with hospitalization risk. In conclusion, as a predictor of respiratory-related hospitalizations, an adjusted CAT score was marginally significant (although the original CAT score was not). 'Previous respiratory-related hospitalizations' was the strongest factor in this equation.

  11. Scintigraphic scoring system for grading severity of gastro-esophageal reflux on 99mTc sulfur colloid gastro-esophageal reflux scintigraphy: a prospective study of 39 cases with pre and post treatment assessment

    International Nuclear Information System (INIS)

    Puranik, Ameya D.; Nair, Gopinathan; Bandyopadhyay, Abhijit; Shinto, Ajit; Zade, Anand; Aggarwal, Rajiv

    2013-01-01

    The study aimed at developing a scoring system for scintigraphic grading of gastro-esophageal reflux (GER), on gastro-esophageal reflux scintigraphy (GERS) and comparison of clinical and scintigraphic scores, pre- and post-treatment. A total of 39 cases with clinically symptomatic GER underwent 99m Tc sulfur colloid GERS; scores were assigned based on the clinical and scintigraphic parameters. Post domperidone GERS was performed after completion of treatment. Follow up GERS was performed and clinical and scintigraphic parameters were compared with baseline parameters. Paired t-test on pre and post domperidone treatment clinical scores showed that the decline in post-treatment scores was highly significant, with P value < 0.001. The scintigraphic scoring system had a sensitivity of 93.9% in assessing treatment response to domperidone, specificity of 83.3% i.e., 83.3% of children with no decline in scintigraphic scores show no clinical response to Domperidone. The scintigraphic scoring system had a positive predictive value of 96.9% and a negative predictive value of 71.4%. GERS with its quantitative parameters is a good investigation for assessing the severity of reflux and also for following children post-treatment. (author)

  12. Raising Test Scores vs. Teaching Higher Order Thinking (HOT): Senior Science Teachers' Views on How Several Concurrent Policies Affect Classroom Practices

    Science.gov (United States)

    Zohar, Anat; Alboher Agmon, Vered

    2018-01-01

    Purpose: This study investigates how senior science teachers viewed the effects of a Raising Test Scores policy and its implementation on instruction of higher order thinking (HOT), and on teaching thinking to students with low academic achievements. Background: The study was conducted in the context of three concurrent policies advocating: (a)…

  13. Abnormal Gastroesophageal Flap Valve Is Associated With High Gastresophageal Reflux Disease Questionnaire Score and the Severity of Gastroesophageal Reflux Disease in Vietnamese Patients With Upper Gastrointestinal Symptoms.

    Science.gov (United States)

    Quach, Duc T; Nguyen, Trang T; Hiyama, Toru

    2018-04-30

    There have been no studies investigating the distribution of abnormal gastroesophageal flap valve (GEFV) among patients with dyspepsia, non-erosive reflux disease (NERD), and reflux esophagitis (RE) in the same set of patients. The aims of this study are to investigate (1) the association between GEFV and gastroesophageal reflux disease questionnaire (GERDQ) score, and (2) the distribution of abnormal GEFV in Vietnamese patients presenting with upper gastrointestinal symptoms. Three hundred and thirty-one patients recruited in this prospective cross-sectional study were classified into 3 groups: reflux esophagitis (RE), non-erosive reflux disease (NERD) (GERDQ score ≥ 8, no endoscopic mucosal injury), and dyspepsia (GERDQ score < 8, no endoscopic mucosal injury). The GEFV was graded endoscopically according to the Hill classification. GEFV grades I and II were regarded as normal, while grades III and IV were regarded as abnormal GEFV. There were 215 (65.0%) patients with dyspepsia, 55 (16.6%) patients with NERD, and 61 (18.4%) patients with RE. Abnormal GEFV was an independent risk factor for GERD (OR, 2.93; CI 95%, 1.76-4.88) and RE (OR, 3.41; CI 95%, 1.78-6.53). The mean GERDQ score of patients with abnormal GEFV was significantly higher than that of patients with normal GEFV (5.7 ± 2.4 vs 4.9 ± 2.7, P = 0.011). The prevalence of abnormal GEFV gradually increased in patients with dyspepsia (27.4%), NERD (43.6%), grade A RE (56.8%), and grades B/C RE (80.0%) ( P < 0.001). Abnormal GEFV was significantly associated with high GERDQ score. Its prevalence gradually increased in patients with dyspepsia, NERD, and RE, respectively.

  14. Using Trauma and Injury Severity Score (TRISS)-based analysis in the development of regional risk adjustment tools to trend quality in a voluntary trauma system: the experience of the Trauma Foundation of Northeast Ohio.

    Science.gov (United States)

    Mancuso, C; Barnoski, A; Tinnell, C; Fallon, W

    2000-04-01

    Presently, no trauma system exists in Ohio. Since 1993, all hospitals in Cuyahoga County (CUY), northeast Ohio (n = 22) provide data to a trauma registry. In return, each received hospital-specific data, comparison data by trauma care level and a county-wide aggregate summary. This report describes the results of this approach in our region. All cases were entered by paper abstract or electronic download. Interrater reliability audits and z score analysis was performed by using the Major Trauma Outcome Study and the CUY 1994 baseline groups. Risk adjustment of mortality data was performed using statistical modeling and logistic regression (Trauma and Injury Severity Score, Major Trauma Outcome Study, CUY). Trauma severity measures were defined. In 1995, 3,375 patients were entered. Two hundred ninety-one died (8.6%). Severity measures differed by level of trauma care, indicating differences in case mix. Probability of survival was lowest in the Level I centers, highest in the acute care hospitals. Outcomes z scores demonstrated survival differences for all levels. In a functioning trauma system, the most severely injured patients should be cared for at the trauma centers. A low volume at acute care hospitals is desirable. By using Trauma and Injury Severity Score with community-specific constants, NE Ohio is accomplishing these goals. The Level I performance data are an interesting finding compared with the data from the Level II centers in the region

  15. NASA ISS Portable Fan Assembly Acoustics

    Science.gov (United States)

    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.

  16. 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.

  17. Major clinical events, signs and severity assessment scores related to actual survival in patients who died from primary biliary cirrhosis. A long-term historical cohort study

    NARCIS (Netherlands)

    van Dam, GM; Gips, CH; Reisman, Y; Maas, KW; Purmer, IM; Huizenga, [No Value; Verbaan, BW

    1999-01-01

    BACKGROUND/AIMS: One of the prognostic methods for survival in primary biliary cirrhosis (PBC) is the Mayo model, with a time-scale limited to 7 years. The aim of our study was to assess how major clinical events, signs, several severity assessment methods and Mayo survival probabilities fit in with

  18. 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

  19. Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery

    OpenAIRE

    Gr?nebaum, Amos; McCullough, Laurence B.; Arabin, Birgit; Chervenak, Frank A.

    2017-01-01

    The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infa...

  20. 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

  1. Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Chervenak, Frank A

    2017-01-01

    The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014. We report in this study outcomes of women who had one or more prior cesarean deliveries and included women who had a successful vaginal birth after a trial of labor after cesarean (TOLAC) at home and in the hospital, and a repeat cesarean delivery in the hospital. We excluded preterm births (home birth VBAC had an approximately 10-fold and higher increase in adverse neonatal outcomes when compared to hospital VBACS and hospital repeat cesarean deliveries, a significantly higher incidence and risk of a 5-minute Apgar score of 0 of 1 in 890 (11.24/10,000, relative risk 9.04, 95% confidence interval 4-20.39, phome TOLACs and for those desiring a VBAC should strongly recommend a planned TOLAC in the appropriate hospital setting. We emphasize that this stance should be accompanied by effective efforts to make TOLAC available in the appropriate hospital setting.

  2. 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.

  3. 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.

  4. ISS Hygiene Activities - Issues and Resolutions

    Science.gov (United States)

    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.

  5. 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.

  6. 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

  7. Use of Ganga Hospital Open Injury Severity Scoring for determination of salvage versus amputation in open type IIIB injuries of lower limbs in children-An analysis of 52 type IIIB open fractures.

    Science.gov (United States)

    Venkatadass, K; Grandhi, Tarani Sai Prasanth; Rajasekaran, S

    2017-11-01

    Open injuries in children are rare compared to adults. In children with major open injuries, there is no specific scoring system to guide when to amputate or salvage the limb. The use of available adult scoring systems may lead to errors in management. The role of Ganga Hospital Open Injury Severity Scoring (GHOISS) for open injuries in adults is well established and its applicability for pediatric open injuries has not been studied. This study was done to analyse the usefulness of GHOISS in pediatric open injuries and to compare it with MESS(Mangled Extremity Severity Score). All children (0-18 years) who were admitted with Open type IIIB injuries of lower limbs between January 2008 and March 2015 were included. MESS and GHOISS were calculated for all the patients. There were 50 children with 52 type IIIB Open injuries of which 39 had open tibial fractures and 13 had open femur fractures. Out of 52 type IIIB open injuries, 48 were salvaged and 4 were amputated. A MESS score of 7 and above had sensitivity of 25% for amputation while GHOISS of 17 and above was found to be more accurate for determining amputation with sensitivity of 75% and specificity of 93.75%. GHOISS is a reliable predictor of injury severity in type IIIB open fractures in children and can be used as a guide for decision-making. The use of MESS score in children has a lower predictive value compared to GHOISS in deciding amputation versus salvage. A GHOISS of 17 or more has the highest sensitivity and specificity to predict amputation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Usefulness of modified Pulmonary Index Score (mPIS as a quantitative tool for the evaluation of severe acute exacerbation in asthmatic children

    Directory of Open Access Journals (Sweden)

    Takeshi Koga

    2015-04-01

    Conclusions: mPIS could be a useful tool for several aspects during acute 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.

  9. Trauma outcome analysis of a Jakarta University Hospital using the TRISS method: validation and limitation in comparison with the major trauma outcome study. Trauma and Injury Severity Score

    NARCIS (Netherlands)

    Joosse, P.; Soedarmo, S.; Luitse, J. S.; Ponsen, K. J.

    2001-01-01

    In this prospective study, the TRISS methodology is used to compare trauma care at a University Hospital in Jakarta, Indonesia, with the standards reported in the Major Trauma Outcome Study (MTOS). Between February 24, 1999, and July 1, 1999, all consecutive patients with multiple and severe trauma

  10. 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.

  11. Psychosocial interactions during ISS missions

    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.

    2007-02-01

    Based on anecdotal reports from astronauts and cosmonauts, studies of space analog environments on Earth, and our previous research on the Mir Space Station, a number of psychosocial issues have been identified that can lead to problems during long-duration space expeditions. Several of these issues were studied during a series of missions to the International Space Station. Using a mood and group climate questionnaire that was completed weekly by crewmembers in space and personnel in mission control, we found no evidence to support the presence of predicted decrements in well-being during the second half or in any specific quarter of the missions. The results did support the predicted displacement of negative feelings to outside supervisors among both crew and ground subjects. There were several significant differences in mood and group perceptions between Americans and Russians and between crewmembers and mission control personnel. Crewmembers related cohesion to the support role of their leader, and mission control personnel related cohesion to both the task and support roles of their leader. These findings are discussed with reference to future space missions.

  12. 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.

  13. 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

  14. Association between renin-angiotensin system antagonist use and mortality in heart failure with severe renal insufficiency: a prospective propensity score-matched cohort study.

    Science.gov (United States)

    Edner, Magnus; Benson, Lina; Dahlström, Ulf; Lund, Lars H

    2015-09-07

    In heart failure (HF) with reduced ejection fraction (EF), renin-angiotensin receptor (RAS) antagonists reduce mortality. However, severe renal insufficiency was an exclusion criterion in trials. We tested the hypothesis that RAS antagonists are associated with reduced mortality also in HF with severe renal insufficiency. We studied patients with EF ≤39% registered in the prospective Swedish Heart Failure Registry. In patients with creatinine >221 µmol/L or creatinine clearance renal insufficiency. Between 2000 and 2013, there were 24 283 patients of which 2410 [age, mean (SD), 82 (9), 45% women] had creatinine >221 µmol/L or creatinine clearance renal insufficiency [n = 21 873; age 71 (12), 27% women], the matched HR was 0.79 (95% CI 0.72-0.86, P renal insufficiency, the use of RAS antagonists was associated with lower all-cause mortality. Prospective randomized trials are needed before these findings can be applied to clinical practice. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  15. Evaluation of several two-step scoring functions based on linear interaction energy, effective ligand size, and empirical pair potentials for prediction of protein-ligand binding geometry and free energy.

    Science.gov (United States)

    Rahaman, Obaidur; Estrada, Trilce P; Doren, Douglas J; Taufer, Michela; Brooks, Charles L; Armen, Roger S

    2011-09-26

    The performances of several two-step scoring approaches for molecular docking were assessed for their ability to predict binding geometries and free energies. Two new scoring functions designed for "step 2 discrimination" were proposed and compared to our CHARMM implementation of the linear interaction energy (LIE) approach using the Generalized-Born with Molecular Volume (GBMV) implicit solvation model. A scoring function S1 was proposed by considering only "interacting" ligand atoms as the "effective size" of the ligand and extended to an empirical regression-based pair potential S2. The S1 and S2 scoring schemes were trained and 5-fold cross-validated on a diverse set of 259 protein-ligand complexes from the Ligand Protein Database (LPDB). The regression-based parameters for S1 and S2 also demonstrated reasonable transferability in the CSARdock 2010 benchmark using a new data set (NRC HiQ) of diverse protein-ligand complexes. The ability of the scoring functions to accurately predict ligand geometry was evaluated by calculating the discriminative power (DP) of the scoring functions to identify native poses. The parameters for the LIE scoring function with the optimal discriminative power (DP) for geometry (step 1 discrimination) were found to be very similar to the best-fit parameters for binding free energy over a large number of protein-ligand complexes (step 2 discrimination). Reasonable performance of the scoring functions in enrichment of active compounds in four different protein target classes established that the parameters for S1 and S2 provided reasonable accuracy and transferability. Additional analysis was performed to definitively separate scoring function performance from molecular weight effects. This analysis included the prediction of ligand binding efficiencies for a subset of the CSARdock NRC HiQ data set where the number of ligand heavy atoms ranged from 17 to 35. This range of ligand heavy atoms is where improved accuracy of predicted ligand

  16. 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.

  17. 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

  18. Orion Handling Qualities During ISS Rendezvous and Docking

    Science.gov (United States)

    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

  19. Classification of the severe trauma patient with the Abbreviated Injury Scale: degree of correlation between versions 98 and 2005 (2008 update).

    Science.gov (United States)

    Abajas Bustillo, Rebeca; Leal Costa, César; Ortego Mate, María Del Carmen; Zonfrillo, Mark R; Seguí Gómez, María; Durá Ros, María Jesús

    2018-02-01

    To explore differences in severity classifications according to 2 versions of the Abbreviated Injury Scale (AIS): version 2005 (the 2008 update) and the earlier version 98. To determine whether possible differences might have an impact on identifying severe trauma patients. Descriptive study and cross-sectional analysis of a case series of patients admitted to two spanish hospitals with out-of-hospital injuries between February 2012 and February 2013. For each patient we calculated the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the AIS scores according to versions 98 and 2005. The sample included 699 cases. The mean Severity (SD) age of patients was 52.7 (29.2) years, and 388 (55.5%) were males. Version 98 of the AIS correlated more strongly with both the ISS (2.6%) and the NISS (2.9%). The 2008 update of the AIS (version 2005) classified fewer trauma patients than version 98 at the severity levels indicated by the ISS and NISS.

  20. 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

  1. 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 

  2. 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.

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

    Science.gov (United States)

    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.

  4. Measuring patients’ satisfaction with their anti-TNF treatment in severe Crohn’s disease: scoring and psychometric validation of the Satisfaction for PAtients in Crohn’s diseasE Questionnaire (SPACE-Q©

    Directory of Open Access Journals (Sweden)

    Gilet H

    2014-12-01

    Full Text Available Hélène Gilet,1 Benoit Arnould,1 Fatoumata Fofana,1 Pierre Clerson,2 Jean-Frédéric Colombel,10 Olivier D’Hondt,2 Patrick Faure,4 Hervé Hagège,5 Maria Nachury,3 Stéphane Nahon,6 Gilbert Tucat,7 Luc Vandromme,8 Ines Cazala-Telinge,9 Emmanuel Thibout9 1HEOR and Strategic Market Access, Mapi, Lyon, France; 2Orgamétrie, Roubaix, France; 3Hôpital Claude Huriez, Lille, France; 4Clinique Saint-Jean du Languedoc, Toulouse, France; 5Centre Hospitalier Intercommunal, Créteil, France; 6Centre Hospitalier Intercommunal, Le Raincy Montfermeil, France; 7Gastroenterologist, Private Clinical Practice, Paris, France; 8Gastroenterologist, Private Clinical Practice, Reims, France; 9Abbvie France, Rungis, France; 10Icahn School of Medicine at Mount Sinai, New York, NY, USA Background: Severe Crohn’s disease management includes anti-tumor necrosis factor (anti-TNF drugs that differ from early-stage treatments regarding efficacy, safety, and convenience. This study aimed to finalize and psychometrically validate the Satisfaction for PAtients in Crohn’s diseasE Questionnaire (SPACE-Q©, developed to measure satisfaction with anti-TNF treatment in patients with severe Crohn’s disease. Methods: A total of 279 patients with severe Crohn’s disease receiving anti-TNF therapy completed the SPACE-Q 62-item pilot version at inclusion and 12 and 13 weeks after first anti-TNF injection. The final SPACE-Q scoring was defined using multitrait and regression analyses and clinical relevance considerations. Psychometric validation included clinical validity against Harvey–Bradshaw score, concurrent validity against Treatment Satisfaction Questionnaire for Medication (TSQM, internal consistency reliability, test–retest reliability, and responsiveness against the patient global impression of change (PGIC.Results: Quality of completion was good (55%–67% of patients completed all items. Four items were removed from the questionnaire. Eleven scores were defined

  5. 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.

  6. 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. .

  7. 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 ...

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. 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...

  11. The Brain and Spinal Injury Center score: a novel, simple, and reproducible method for assessing the severity of acute cervical spinal cord injury with axial T2-weighted MRI findings.

    Science.gov (United States)

    Talbott, Jason F; Whetstone, William D; Readdy, William J; Ferguson, Adam R; Bresnahan, Jacqueline C; Saigal, Rajiv; Hawryluk, Gregory W J; Beattie, Michael S; Mabray, Marc C; Pan, Jonathan Z; Manley, Geoffrey T; Dhall, Sanjay S

    2015-10-01

    Previous studies that have evaluated the prognostic value of abnormal changes in signals on T2-weighted MRI scans of an injured spinal cord have focused on the longitudinal extent of this signal abnormality in the sagittal plane. Although the transverse extent of injury and the degree of spared spinal cord white matter have been shown to be important for predicting outcomes in preclinical animal models of spinal cord injury (SCI), surprisingly little is known about the prognostic value of altered T2 relaxivity in humans in the axial plane. The authors undertook a retrospective chart review of 60 patients who met the inclusion criteria of this study and presented to the authors' Level I trauma center with an acute blunt traumatic cervical SCI. Within 48 hours of admission, all patients underwent MRI examination, which included axial and sagittal T2 images. Neurological symptoms, evaluated with the grades according to the American Spinal Injury Association (ASIA) Impairment Scale (AIS), at the time of admission and at hospital discharge were correlated with MRI findings. Five distinct patterns of intramedullary spinal cord T2 signal abnormality were defined in the axial plane at the injury epicenter. These patterns were assigned ordinal values ranging from 0 to 4, referred to as the Brain and Spinal Injury Center (BASIC) scores, which encompassed the spectrum of SCI severity. The BASIC score strongly correlated with neurological symptoms at the time of both hospital admission and discharge. It also distinguished patients initially presenting with complete injury who improved by at least one AIS grade by the time of discharge from those whose injury did not improve. The authors' proposed score was rapid to apply and showed excellent interrater reliability. The authors describe a novel 5-point ordinal MRI score for classifying acute SCIs on the basis of axial T2-weighted imaging. The proposed BASIC score stratifies the SCIs according to the extent of transverse T2

  12. 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.

  13. 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)

  14. 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...

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. Development of the ISS EMU Dashboard Software

    Science.gov (United States)

    Bernard, Craig; Hill, Terry R.

    2011-01-01

    The EMU (Extra-Vehicular Mobility Unit) Dashboard was developed at NASA s Johnson Space Center to aid in real-time mission support for the ISS (International Space Station) and Shuttle EMU space suit by time synchronizing down-linked video, space suit data and audio from the mission control audio loops. Once the input streams are synchronized and recorded, the data can be replayed almost instantly and has proven invaluable in understanding in-flight hardware anomalies and playing back information conveyed by the crew to missions control and the back room support. This paper will walk through the development from an engineer s idea brought to life by an intern to real time mission support and how this tool is evolving today and its challenges to support EVAs (Extra-Vehicular Activities) and human exploration in the 21st century.

  2. 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.

  3. 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.

  4. A planetary telescope at the ISS

    Science.gov (United States)

    Korablev, O.; Moroz, V.; Avanesov, G.; Rodin, V.; Bellucci, G.; Vid Machenko, A.; Tejfel, V.

    We present the development of a 40-cm telescope to be deployed at the Russian segment of International Space Station (ISS) dedicated to the observations of planets of Solar system, which primary goal will be tracking climate-related changes and other variable phenomena on planets. The most effective will be the observations of Venus, Mars, Jupiter, Saturn, and comets, while other interesting targets will be certainly considered. This space-based observatory will perform monitoring of Solar System objects on regular basis The observatory includes the 40-cm narrow-field (f:20) telescope at a pointing platform with guidance system assuring pointing accuracy of ~10", and an internal tracking system with an accuracy inferior to 1" during tens of minutes. Four focal plane instruments, a camera, two spectrometers and a spectropolarimeter, will perform imaging and spectral observations in the range from ~200 nm to ~3 μm.

  5. MRI interrReader and intra-reader reliabilities for assessing injury morphology and posterior ligamentous complex integrity of the spine according to the thoracolumbar injury classification system and severity score

    International Nuclear Information System (INIS)

    Lee, Guen Young; Lee, Joon Woo; Choi, Seung Woo; Lim, Hyun Jin; Sun, Hye Young; Kang, Yu Suhn; Kang, Heung Sik; Chai, Jee Won; Kim, Su Jin

    2015-01-01

    To evaluate spine magnetic resonance imaging (MRI) inter-reader and intra-reader reliabilities using the thoracolumbar injury classification system and severity score (TLICS) and to analyze the effects of reader experience on reliability and the possible reasons for discordant interpretations. Six radiologists (two senior, two junior radiologists, and two residents) independently scored 100 MRI examinations of thoracolumbar spine injuries to assess injury morphology and posterior ligamentous complex (PLC) integrity according to the TLICS. Inter-reader and intra-reader agreements were determined and analyzed according to the number of years of radiologist experience. Inter-reader agreement between the six readers was moderate (k = 0.538 for the first and 0.537 for the second review) for injury morphology and fair to moderate (k = 0.440 for the first and 0.389 for the second review) for PLC integrity. No significant difference in inter-reader agreement was observed according to the number of years of radiologist experience. Intra-reader agreements showed a wide range (k = 0.538-0.822 for injury morphology and 0.423-0.616 for PLC integrity). Agreement was achieved in 44 for the first and 45 for the second review about injury morphology, as well as in 41 for the first and 38 for the second review of PLC integrity. A positive correlation was detected between injury morphology score and PLC integrity. The reliability of MRI for assessing thoracolumbar spinal injuries according to the TLICS was moderate for injury morphology and fair to moderate for PLC integrity, which may not be influenced by radiologist' experience

  6. 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.

  7. A comparison between the administration of oral prolonged-release oxycodone-naloxone and transdermal fentanyl in patients with moderate-to-severe cancer pain: a propensity score analysis

    Directory of Open Access Journals (Sweden)

    Roberto A

    2017-09-01

    Full Text Available A Roberto,1 MT Greco,2 L Legramandi,3 F Galli,3 M Galli,4 O Corli1 1Pain and Palliative Care Research Unit, Oncology Department, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy, 2Department of Clinical Sciences and Community, University of Milan, Milan, Italy, 3Methodology for Clinical Research Laboratory, Oncology Department, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy, 4Scientific Medical Communication srl, Novara, Italy Background: Opioids are the most important pharmacological treatment for moderate-to-severe cancer pain, but side effects limit their use. Transdermal fentanyl (TDF and oral prolonged-release oxycodone-naloxone (OXN-PR are effective in controlling chronic pain, with less constipation compared to other opioids. However, TDF and OXN-PR have never been directly compared.Patients and methods: Cancer patients with moderate-to-severe chronic pain were consecutively enrolled in two prospective 28-day trials, received either TDF or OXN-PR, and were assessed at baseline and after 7, 14, 21, and 28 days. The primary endpoint was 28-day analgesic response rate (average pain intensity decrease ≥30% from baseline. Other outcome measures included opioid daily dose changes over time; need for adjuvant analgesics; number of switches; premature discontinuation; presence and severity of constipation; and other adverse drug reactions. To compare the efficacy and the safety of TDF and OXN-PR, we used the propensity score analysis to adjust for heterogeneity between the two patient groups.Results: Three hundred ten out of 336 patients originally treated (119 TDF and 191 OXN-PR were included in the comparative analysis. The amount of responders was comparable after TDF (75.3% and OXN-PR administration (82.9%, not significant [NS]. The final opioid daily dose expressed as morphine equivalent was 113.6 mg for TDF and 44.5 mg for OXN-PR (p<0.0001. A daily opioid dose escalation >5% was less common after

  8. Stress-Induced Hyperglycemia, but Not Diabetic Hyperglycemia, Is Associated with Higher Mortality in Patients with Isolated Moderate and Severe Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population.

    Science.gov (United States)

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

    2017-11-03

    Background : Admission hyperglycemia is associated with higher morbidity and mortality in patients with traumatic brain injury (TBI). Stress-induced hyperglycemia (SIH), a form of hyperglycemia induced by the stress response, is associated with increased patient mortality following TBI. However, admission hyperglycemia occurs not only in SIH but also in patients with diabetic hyperglycemia (DH). Current information regarding whether trauma patients with SIH represent a distinct group with differential outcomes compared to those with DH remains limited. Methods : Serum glucose concentration ≥200 mg/dL upon arrival at the emergency department was defined as hyperglycemia. Presence of diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) level ≥6.5%. In the present study, the patient cohort included those with moderate and severe TBI, as defined by an Abbreviated Injury Scale (AIS) score ≥3 points in the head, and excluded those who had additional AIS scores ≥3 points in any other region of the body. A total of 1798 adult patients with isolated moderate to severe TBI were allocated into four groups: SIH ( n = 140), DH ( n = 187), diabetic normoglycemia (DN, n = 186), and non-diabetic normoglycemia (NDN, n = 1285). Detailed patient information was retrieved from the Trauma Registry System at a level I trauma center between 1 January 2009, and 31 December 2015. 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 the Pearson chi-square or two-sided Fisher's exact tests. Matched patient populations were allocated in a 1:1 ratio according to propensity scores calculated by NCSS software. Logistic regression was used to evaluate the effect of SIH and DH on the adjusted mortality outcome. Results : In patients with isolated moderate to severe TBI, the presence of SIH and DH led to 9.1-fold and 2

  9. Effects of memantine on cognition in patients with moderate to severe Alzheimer's disease: post-hoc analyses of ADAS-cog and SIB total and single-item scores from six randomized, double-blind, placebo-controlled studies.

    Science.gov (United States)

    Mecocci, Patrizia; Bladström, Anna; Stender, Karina

    2009-05-01

    The post-hoc analyses reported here evaluate the specific effects of memantine treatment on ADAS-cog single-items or SIB subscales for patients with moderate to severe AD. Data from six multicentre, randomised, placebo-controlled, parallel-group, double-blind, 6-month studies were used as the basis for these post-hoc analyses. All patients with a Mini-Mental State Examination (MMSE) score of less than 20 were included. Analyses of patients with moderate AD (MMSE: 10-19), evaluated with the Alzheimer's disease Assessment Scale (ADAS-cog) and analyses of patients with moderate to severe AD (MMSE: 3-14), evaluated using the Severe Impairment Battery (SIB), were performed separately. The mean change from baseline showed a significant benefit of memantine treatment on both the ADAS-cog (p ADAS-cog single-item analyses showed significant benefits of memantine treatment, compared to placebo, for mean change from baseline for commands (p < 0.001), ideational praxis (p < 0.05), orientation (p < 0.01), comprehension (p < 0.05), and remembering test instructions (p < 0.05) for observed cases (OC). The SIB subscale analyses showed significant benefits of memantine, compared to placebo, for mean change from baseline for language (p < 0.05), memory (p < 0.05), orientation (p < 0.01), praxis (p < 0.001), and visuospatial ability (p < 0.01) for OC. Memantine shows significant benefits on overall cognitive abilities as well as on specific key cognitive domains for patients with moderate to severe AD. (c) 2009 John Wiley & Sons, Ltd.

  10. 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.; hide

    2015-01-01

    There exist several core science applications of LIS lightning observations, that range from weather and climate to atmospheric chemistry and lightning physics due to strong quantitative connections that can be made between lightning and other geophysical processes of interest. The space-base vantage point, such as provided by ISS LIS, still remains an ideal location to obtain total lightning observations on a global basis.

  11. 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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  14. 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.

  15. 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

  16. 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.

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. 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

  2. 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)

  3. ISS Microgravity Research Payload Training Methodology

    Science.gov (United States)

    Schlagheck, Ronald; Geveden, Rex (Technical Monitor)

    2001-01-01

    The NASA Microgravity Research Discipline has multiple categories of science payloads that are being planned and currently under development to operate on various ISS on-orbit increments. The current program includes six subdisciplines; Materials Science, Fluids Physics, Combustion Science, Fundamental Physics, Cellular Biology and Macromolecular Biotechnology. All of these experiment payloads will require the astronaut various degrees of crew interaction and science observation. With the current programs planning to build various facility class science racks, the crew will need to be trained on basic core operations as well as science background. In addition, many disciplines will use the Express Rack and the Microgravity Science Glovebox (MSG) to utilize the accommodations provided by these facilities for smaller and less complex type hardware. The Microgravity disciplines will be responsible to have a training program designed to maximize the experiment and hardware throughput as well as being prepared for various contingencies both with anomalies as well as unexpected experiment observations. The crewmembers will need various levels of training from simple tasks as power on and activate to extensive training on hardware mode change out to observing the cell growth of various types of tissue cultures. Sample replacement will be required for furnaces and combustion type modules. The Fundamental Physics program will need crew EVA support to provide module change out of experiment. Training will take place various research centers and hardware development locations. It is expected that onboard training through various methods and video/digital technology as well as limited telecommunication interaction. Since hardware will be designed to operate from a few weeks to multiple research increments, flexibility must be planned in the training approach and procedure skills to optimize the output as well as the equipment maintainability. Early increment lessons learned

  4. 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

  5. ``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

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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

  8. Nuclear abundance measurements inside MIR and ISS with Sileye experiments

    Science.gov (United States)

    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.

  9. 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.

  10. 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

  11. 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....

  12. ISS Ammonia Leak Detection Through X-Ray Fluorescence

    Science.gov (United States)

    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

  13. Scintigraphic scoring system for grading severity of gastro-esophageal reflux on 99mTc sulfur colloid gastro-esophageal reflux scintigraphy: A prospective study of 39 cases with pre and post treatment assessment.

    Science.gov (United States)

    Puranik, Ameya D; Nair, Gopinathan; Aggarwal, Rajiv; Bandyopadhyay, Abhijit; Shinto, Ajit; Zade, Anand

    2013-04-01

    The study aimed at developing a scoring system for scintigraphic grading of gastro-esophageal reflux (GER), on gastro-esophageal reflux scintigraphy (GERS) and comparison of clinical and scintigraphic scores, pre- and post-treatment. A total of 39 cases with clinically symptomatic GER underwent 99mTc sulfur colloid GERS; scores were assigned based on the clinical and scintigraphic parameters. Post domperidone GERS was performed after completion of treatment. Follow up GERS was performed and clinical and scintigraphic parameters were compared with baseline parameters. Paired t-test on pre and post domperidone treatment clinical scores showed that the decline in post-treatment scores was highly significant, with P value reflux and also for following children post-treatment.

  14. Space Science Investigation: NASA ISS Stowage Simulator

    Science.gov (United States)

    Crawford, Gary

    2017-01-01

    During this internship the opportunity was granted to work with the Integrated, Graphics, Operations and Analysis Laboratory (IGOAL) team. The main assignment was to create 12 achievement patches for the Space Station training simulator called the "NASA ISS Stowage Training Game." This project was built using previous IGOAL developed software. To accomplish this task, Adobe Photoshop and Adobe Illustrator were used to craft the badges and other elements required. Blender, a 3D modeling software, was used to make the required 3D elements. Blender was a useful tool to make things such as a CTB bag for the "No More Bob" patch which shows a gentleman kicking a CTB bag into the distance. It was also used to pose characters to the positions that was optimal for their patches as in the "Station Sanitation" patch which portrays and astronaut waving on a U.S module on a truck. Adobe Illustrator was the main piece of software for this task. It was used to craft the badges and upload them when they were completed. The style of the badges were flat, meaning that they shouldn't look three dimensional in any way, shape or form. Adobe Photoshop was used when any pictures need brightening and was where the texture for the CTB bag was made. In order for the patches to be ready for the game's next major release, they have to go under some critical reviewing, revising and re-editing to make sure the other artists and the rest of the staff are satisfied with the final products. Many patches were created and revamped to meet the flat setting and incorporate suggestions from the IGOAL team. After the three processes were completed, the badges were implemented into the game (reference fig1 for badges). After a month of designing badges, the finished products were placed into the final game build via the programmers. The art was the final piece in showcasing the latest build to the public for testing. Comments from the testers were often exceptional and the feedback on the badges were

  15. A Case for Hypogravity Studies Aboard ISS

    Science.gov (United States)

    Paloski, William H.

    2014-01-01

    Future human space exploration missions being contemplated by NASA and other spacefaring nations include some that would require long stays upon bodies having gravity levels much lower than that of Earth. While we have been able to quantify the physiological effects of sustained exposure to microgravity during various spaceflight programs over the past half-century, there has been no opportunity to study the physiological adaptations to gravity levels between zero-g and one-g. We know now that the microgravity environment of spaceflight drives adaptive responses of the bone, muscle, cardiovascular, and sensorimotor systems, causing bone demineralization, muscle atrophy, reduced aerobic capacity, motion sickness, and malcoordination. All of these outcomes can affect crew health and performance, particularly after return to a one-g environment. An important question for physicians, scientists, and mission designers planning human exploration missions to Mars (3/8 g), the Moon (1/6 g), or asteroids (likely negligible g) is: What protection can be expected from gravitational levels between zero-g and one-g? Will crewmembers deconditioned by six months of microgravity exposure on their way to Mars experience continued deconditioning on the Martian surface? Or, will the 3/8 g be sufficient to arrest or even reverse these adaptive changes? The implications for countermeasure deployment, habitat accommodations, and mission design warrant further investigation into the physiological responses to hypogravity. It is not possible to fully simulate hypogravity exposure on Earth for other than transient episodes (e.g., parabolic flight). However, it would be possible to do so in low Earth orbit (LEO) using the centrifugal forces produced in a live-aboard centrifuge. As we're not likely to launch a rotating human spacecraft into LEO anytime in the near future, we could take advantage of rodent subjects aboard the ISS if we had a centrifuge that could accommodate the rodent

  16. 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.

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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

  2. 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

  3. 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

  4. 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.

  5. Thermally-Constrained Fuel-Optimal ISS Maneuvers

    Science.gov (United States)

    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.

  6. 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.

  7. 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

  8. Comparative Study between Sequential Automatic and Manual Home Respiratory Polygraphy Scoring Using a Three-Channel Device: Impact of the Manual Editing of Events to Identify Severe Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Glenda Ernst

    2015-01-01

    Full Text Available Objective. According to current guidelines, autoscoring of respiratory events in respiratory polygraphy requires manual scoring. The aim of this study was to evaluate the agreement between automatic analysis and manual scoring to identify patients with suspected OSA. Methods. This retrospective study analyzed 791 records from respiratory polygraphy (RP performed at home. The association grade between automatic scoring and manual scoring was evaluated using Kappa coefficient and the agreement using Bland and Altman test and intraclass correlation coefficient (CCI. To determine the accuracy in the identification of AHI≥30 eV/h, the ROC curve analysis was used. Results. The population analyzed consisted of 493 male (62.3% and 298 female patients, with an average age of 54.7±14.20 years and BMI of 32.7±8.21 kg/m2. There was no significant difference between automatic and manual apnea/hypopnea indexes (aAHI, mAHI: aAHI 17.25 (SD: 17.42 versus mAHI 21.20±7.96 (p; NS. The agreement between mAHI and aAHI to AHI≥30 was 94%, with a Kappa coefficient of 0.83 (p<0.001 and a CCI of 0.83. The AUC-ROC, sensitivity, and specificity were 0.99 (CI 95%: 0.98-0.99, p<0.001, 86% (CI 95%: 78.7–91.4, and 97% (CI 95%: 96–98.3, respectively. Conclusions. We observed good agreement between automatic scoring and sequential manual scoring to identify subjects with AHI≥30 eV/h.

  9. 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

  10. 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.

  11. Allegheny County Walk Scores

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Walk Score measures the walkability of any address using a patented system developed by the Walk Score company. For each 2010 Census Tract centroid, Walk Score...

  12. The ISS 2B PVTCS Ammonia Leak: An Operational History

    Science.gov (United States)

    Vareha, Anthony

    2014-01-01

    In 2006, the Photovoltaic Thermal Control System (PVTCS) for the International Space Station's 2B power channel began leaking ammonia at a rate of approximately 1.5lbm/year (out of a starting approximately 53lbm system ammonia mass). Initially, the operations strategy was "feed the leak," a strategy successfully put into action via Extra Vehicular Activity during the STS-134 mission. During this mission the system was topped off with ammonia piped over from a separate thermal control system. This recharge was to have allowed for continued power channel operation into 2014 or 2015, at which point another EVA would have been required. Without these periodic EVAs to refill the 2B coolant system, the channel would eventually leak enough fluid as to risk pump cavitation and system failure, resulting in the loss of the 2B power channel - the most critical of the Space Station's 8 power channels. In mid-2012, the leak rate increased to approximately 5lbm/year. Once discovered, an EVA was planned and executed within a 5 week timeframe to drastically alter the architecture of the PVTCS via connection to a dormant thermal control system not intended to be utilized as anything other than spare components. The purpose of this rerouting of the TCS was to increase system volume and to isolate the photovoltaic radiator, thought to be the likely leak source. This EVA was successfully executed on November 1st, 2012 and left the 2B PVTCS in a configuration where the system was now being adequately cooled via a totally different radiator than what the system was designed to utilize. Unfortunately, data monitoring over the next several months showed that the isolated radiator was not leaking, and the system itself continued to leak steadily until May 9th, 2013. It was on this day that the ISS crew noticed the visible presence of ammonia crystals escaping from the 2B channel's truss segment, signifying a rapid acceleration of the leak from 5lbm/year to 5lbm/day. Within 48 hours of the

  13. 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.

  14. "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

  15. 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.

  16. 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.

  17. 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.; hide

    2009-01-01

    Microorganisms within spacecraft have traditionally been monitored with culture-based techniques. These techniques involve growth of environmental samples (cabin water, air or surfaces) on agar-type media for several days, followed by visualization of resulting colonies or return of samples to Earth for ground-based analysis. Data obtained over the past 4 decades have enhanced our understanding of the microbial ecology within space stations. However, the approach has been limited by the following factors: i) Many microorganisms (estimated > 95%) in the environment cannot grow on conventional growth media; ii) Significant time lags (3-5 days for incubation and up to several months to return samples to ground); iii) Condensation in contact slides hinders colony counting by crew; and iv) Growth of potentially harmful microorganisms, which must then be disposed of safely. This report describes the operation of a new culture-independent technique onboard the ISS for rapid analysis (within minutes) of endotoxin and beta-1, 3-glucan, found in the cell walls of gramnegative bacteria and fungi, respectively. The technique involves analysis of environmental samples with the Limulus Amebocyte Lysate (LAL) assay in a handheld device, known as the Lab-On-a-Chip Application Development Portable Test System (LOCAD-PTS). LOCADPTS was launched to the ISS in December 2006, and here we present data obtained from Mach 2007 until the present day. These data include a comparative study between LOCADPTS analysis and existing culture-based methods; and an exploratory survey of surface endotoxin and beta-1, 3-glucan throughout the ISS. While a general correlation between LOCAD-PTS and traditional culture-based methods should not be expected, we will suggest new requirements for microbial monitoring based upon culture-independent parameters measured by LOCAD-PTS.

  18. 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.

  19. 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...

  20. 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...

  1. 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.

  2. 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)

  3. 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

  4. 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

  5. The long-term outcome after severe trauma of children in Flanders (Belgium): A population-based cohort study using the International Classification of Functioning-related outcome score

    NARCIS (Netherlands)

    P. van de Voorde (Patrick); M. Sabbe (Marc); R. Tsonaka (Roula); D. Rizopoulos (Dimitris); P. Calle (Paul); A. de De Jaeger (Annick); E.M.E.H. Lesaffre (Emmanuel); D. Matthys (Dirk)

    2011-01-01

    textabstractImportant long-term health problems have been described after severe paediatric trauma. The International Classification of Functioning (ICF) was developed as a universal framework to describe that health. We evaluated outcome in children after 'severe' trauma (defined as: hospitalised

  6. 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.

  7. 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.

  8. 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.

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

    Science.gov (United States)

    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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.)

  15. 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.)

  16. The Zhongshan Score

    Science.gov (United States)

    Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

    2015-01-01

    Abstract In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P RENAL and PADUA scores. ZS score could be used to reflect the surgical complexity and predict the risk of surgical complications in patients undergoing NSS. PMID:25654399

  17. 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

  18. 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.

  19. 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...

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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...

  7. 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

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. How to score questionnaires

    NARCIS (Netherlands)

    Hofstee, W.K.B.; Ten Berge, J.M.F.; Hendriks, A.A.J.

    The standard practice in scoring questionnaires consists of adding item scores and standardizing these sums. We present a set of alternative procedures, consisting of (a) correcting for the acquiescence variance that disturbs the structure of the questionnaire; (b) establishing item weights through

  13. SCORE - A DESCRIPTION.

    Science.gov (United States)

    SLACK, CHARLES W.

    REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…

  14. 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.

  15. 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

  16. 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...

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. Maximizing Science Return from Future Rodent Experiments on the International Space Station (ISS): Tissue Preservation

    Science.gov (United States)

    Choi, S. Y.; Lai, S.; Klotz, R.; Popova, Y.; Chakravarty, K.; Beegle, J. E.; Wigley, C. L.; Globus, R. K.

    2014-01-01

    experiments will support science return despite delayed preservation post-euthanasia or prolonged storage, and 2) Many additional tissues for gene expression analysis can be obtained by dissection following prolonged storage of the tissue in situ at -80 C. These findings have relevance both to high value, ground-based experiments when sample collection capability is severely constrained, and to all future spaceflight experiments that entail on-orbit sample recovery by the ISS crew.

  4. 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.

  5. 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

  6. 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.

  7. Volleyball Scoring Systems.

    Science.gov (United States)

    Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

    2002-01-01

    The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

  8. 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

  9. 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

  10. 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

  11. Orbital Hub: a concept for human spaceflight beyond ISS operations

    Science.gov (United States)

    Jahnke, Stephan S.; Maiwald, Volker; Philpot, Claudia; Quantius, Dominik; Romberg, Oliver; Seboldt, Wolfgang; Vrakking, Vincent; Zeidler, Conrad

    2018-04-01

    The International Space Station (ISS) is the greatest endeavour in low-Earth orbit since the beginning of the space age and the culmination of human outposts like Skylab and Mir. While a clear schedule has yet to be drafted, it is expected that ISS will cease operation in the 2020s. What could be the layout for a human outpost in LEO with lessons learnt from ISS? What are the use cases and applications of such an outpost in the future? The System Analysis Space Segment group of the German Aerospace Center investigated these and other questions and developed the Orbital Hub concept. In this paper an overview is presented of how the overall concept has been derived and its properties and layouts are described. Starting with a workshop involving the science community, the scientific requirements have been derived and Strawman payloads have been defined for use in further design activities. These design activities focused on Concurrent Engineering studies, where besides DLR employees participants from the industry and astronauts were involved. The result is an expandable concept that is composed of two main parts, the Base Platform, home for a permanent crew of up to three astronauts, and the Free Flyer, an uncrewed autonomous research platform. This modular approach provides one major advantage: the decoupling of the habitat and payload leading to increased quality of the micro-gravity environment. The former provides an environment for human physiology experiments, while the latter allows science without the perturbations caused by a crew, e.g. material experiments or Earth observation. The Free Flyer is designed to operate for up to 3 months on its own, but can dock with the space station for maintenance and experiment servicing. It also has a hybrid propulsion system, chemical and electrical, for different applications. The hub's design allows launch with just three launches, as the total mass of all the hub parts is about 60,000 kg. The main focus of the design is

  12. Selection of an Alternate Biocide for the ISS Internal Thermal Control System Coolant, Phase 2

    Science.gov (United States)

    Wilson, Mark E.; Cole, Harold; Weir, Natalee; Oehler, Bill; Steele, John; Varsik, Jerry; Lukens, Clark

    2004-01-01

    The ISS (International Space Station) ITCS (Internal Thermal Control System) includes two internal coolant loops that utilize an aqueous based coolant for heat transfer. A silver salt biocide had previously been utilized as an additive in the coolant formulation to control the growth and proliferation of microorganisms within the coolant loops. Ground-based and in-flight testing demonstrated that the silver salt was rapidly depleted, and did not act as an effective long-term biocide. Efforts to select an optimal alternate biocide for the ITCS coolant application have been underway and are now in the final stages. An extensive evaluation of biocides was conducted to down-select to several candidates for test trials and was reported on previously. Criteria for that down-select included: the need for safe, non-intrusive implementation and operation in a functioning system; the ability to control existing planktonic and biofilm residing microorganisms; a negligible impact on system-wetted materials of construction; and a negligible reactivity with existing coolant additives. Candidate testing to provide data for the selection of an optimal alternate biocide is now in the final stages. That testing has included rapid biocide effectiveness screening using Biolog MT2 plates to determine minimum inhibitory concentration (amount that will inhibit visible growth of microorganisms), time kill studies to determine the exposure time required to completely eliminate organism growth, materials compatibility exposure evaluations, coolant compatibility studies, and bench-top simulated coolant testing. This paper reports the current status of the effort to select an alternate biocide for the ISS ITCS coolant. The results of various test results to select the optimal candidate are presented.

  13. Cross-sectional evaluation of the Bronchitis Severity Score in ...

    African Journals Online (AJOL)

    of infectious diseases and frequent use of antibiotics are reported from low ... to their age into three groups: group 1 (infants), group 2 (preschool ... to age. All patients were evaluated three times during the bronchitis episode (days 0, 5 and 7).

  14. Bayesian averaging over Decision Tree models for trauma severity scoring.

    Science.gov (United States)

    Schetinin, V; Jakaite, L; Krzanowski, W

    2018-01-01

    Health care practitioners analyse possible risks of misleading decisions and need to estimate and quantify uncertainty in predictions. We have examined the "gold" standard of screening a patient's conditions for predicting survival probability, based on logistic regression modelling, which is used in trauma care for clinical purposes and quality audit. This methodology is based on theoretical assumptions about data and uncertainties. Models induced within such an approach have exposed a number of problems, providing unexplained fluctuation of predicted survival and low accuracy of estimating uncertainty intervals within which predictions are made. Bayesian method, which in theory is capable of providing accurate predictions and uncertainty estimates, has been adopted in our study using Decision Tree models. Our approach has been tested on a large set of patients registered in the US National Trauma Data Bank and has outperformed the standard method in terms of prediction accuracy, thereby providing practitioners with accurate estimates of the predictive posterior densities of interest that are required for making risk-aware decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Using the Revised Trauma Score to Predict Outcome in Severely ...

    African Journals Online (AJOL)

    Conclusion: The results in this study revealed that though the weighted RTS was effective in determining mortality outcome in head injured patients, the mortality rate in this study was high because of delayed transfer of patients due to poor ambulance services, associated cervical spine injuries and gunshot injuries to the ...

  16. 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.

  17. 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

  18. ISS-NIH Collaborative Programme: final report of the projects

    International Nuclear Information System (INIS)

    2009-01-01

    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 [it

  19. Simulations of MATROSHKA experiments at ISS using PHITS

    CERN Document Server

    Sihver, L; Puchalska, M; Reitz, G

    2010-01-01

    Concerns about the biological effects of space radiation are increasing rapidly due to the perspective of long-duration manned missions, both in relation to the International Space Station (ISS) and to manned interplanetary missions to Moon and Mars in the future. As a preparation for these long duration space missions it is important to ensure an excellent capability to evaluate the impact of space radiation on human health in order to secure the safety of the astronauts/cosmonauts and minimize their risks. It is therefore necessary to measure the radiation load on the personnel both inside and outside the space vehicles and certify that organ and tissue equivalent doses can be simulated as accurate as possible. In this paper we will present simulations using the three-dimensional Monte Carlo Particle and Heavy Ion Transport code System (PHITS) of long term dose measurements performed with the ESA supported experiment MATROSHKA (MTR), which is an anthropomorphic phantom containing over 6000 radiation detecto...

  20. 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

  1. Saturn's equatorial jet structure from Cassini/ISS

    Science.gov (United States)

    García-Melendo, Enrique; Legarreta, Jon; Sánchez-Lavega, Agustín.; Pérez-Hoyos, Santiago; Hueso, Ricardo

    2010-05-01

    Detailed wind observations of the equatorial regions of the gaseous giant planets, Jupiter and Saturn, are crucial for understanding the basic problem of the global circulation and obtaining new detailed information on atmospheric phenomena. In this work we present high resolution data of Saturn's equatorial region wind profile from Cassini/ISS images. To retrieve wind measurements we applied an automatic cross correlator to image pairs taken by Cassini/ISS with the MT1, MT2, MT3 filters centred at the respective three methane absorbing bands of 619nm, 727nm, and 889nm, and with the adjacent continuum CB1, CB2, and CB3 filters. We obtained a complete high resolution coverage of Saturn's wind profile in the equatorial region. The equatorial jet displays an overall symmetric structure similar to that shown the by same region in Jupiter. This result suggests that, in accordance to some of the latest compressible atmosphere computer models, probably global winds in gaseous giants are deeply rooted in the molecular hydrogen layer. Wind profiles in the methane absorbing bands show the effect of strong vertical shear, ~40m/s per scale height, confirming previous results and an important decay in the wind intensity since the Voyager era (~100 m/s in the continuum and ~200 m/s in the methane absorbing band). We also report the discovery of a new feature, a very strong and narrow jet on the equator, about only 5 degrees wide, that despite the vertical shear maintains its intensity (~420 m/s) in both, the continuum and methane absorbing band filters. Acknowledgements: Work supported by the Spanish MICIIN AYA2009-10701 with FEDER and Grupos Gobierno Vasco IT-464-07.

  2. Sensitivity Analysis of the Integrated Medical Model for ISS Programs

    Science.gov (United States)

    Goodenow, D. A.; Myers, J. G.; Arellano, J.; Boley, L.; Garcia, Y.; Saile, L.; Walton, M.; Kerstman, E.; Reyes, D.; Young, M.

    2016-01-01

    Sensitivity analysis estimates the relative contribution of the uncertainty in input values to the uncertainty of model outputs. Partial Rank Correlation Coefficient (PRCC) and Standardized Rank Regression Coefficient (SRRC) are methods of conducting sensitivity analysis on nonlinear simulation models like the Integrated Medical Model (IMM). The PRCC method estimates the sensitivity using partial correlation of the ranks of the generated input values to each generated output value. The partial part is so named because adjustments are made for the linear effects of all the other input values in the calculation of correlation between a particular input and each output. In SRRC, standardized regression-based coefficients measure the sensitivity of each input, adjusted for all the other inputs, on each output. Because the relative ranking of each of the inputs and outputs is used, as opposed to the values themselves, both methods accommodate the nonlinear relationship of the underlying model. As part of the IMM v4.0 validation study, simulations are available that predict 33 person-missions on ISS and 111 person-missions on STS. These simulated data predictions feed the sensitivity analysis procedures. The inputs to the sensitivity procedures include the number occurrences of each of the one hundred IMM medical conditions generated over the simulations and the associated IMM outputs: total quality time lost (QTL), number of evacuations (EVAC), and number of loss of crew lives (LOCL). The IMM team will report the results of using PRCC and SRRC on IMM v4.0 predictions of the ISS and STS missions created as part of the external validation study. Tornado plots will assist in the visualization of the condition-related input sensitivities to each of the main outcomes. The outcomes of this sensitivity analysis will drive review focus by identifying conditions where changes in uncertainty could drive changes in overall model output uncertainty. These efforts are an integral

  3. Public Participation in Earth Science from the Iss

    Science.gov (United States)

    Willis, K. J.; Runco, S.; Stefanov, W. L.

    2010-12-01

    The Gateway to Astronaut Photography of Earth (GAPE) is an online database (http://eol.jsc.nasa.gov) of terrestrial astronaut photography that enables the public to experience the astronaut’s view from orbit. This database of imagery includes all NASA human-directed missions from the Mercury program of the early 1960’s to the current International Space Station (ISS). To date, the total number of images taken by astronauts is 1,025,333. Of the total, 621,316 images have been “cataloged” (image geographic center points determined and descriptive metadata added). The remaining imagery provides an opportunity for the citizen-scientist to become directly involved with NASA through cataloging of astronaut photography, while simultaneously experiencing the wonder and majesty of our home planet as seen by astronauts on board the ISS every day. We are currently developing a public cataloging interface for the GAPE website. When complete, the citizen-scientist will be able to access a selected subset of astronaut imagery. Each candidate will be required to pass a training tutorial in order to receive certification as a cataloger. The cataloger can then choose from a selection of images with basic metadata that is sorted by difficulty levels. Some guidance will be provided (template/pull down menus) for generation of geographic metadata required from the cataloger for each photograph. Each cataloger will also be able to view other contributions and further edit that metadata if they so choose. After the public inputs their metadata the images will be posted to an internal screening site. Images with similar geographic metadata and centerpoint coordinates from multiple catalogers will be reviewed by NASA JSC Crew Earth Observations (CEO) staff. Once reviewed and verified, the metadata will be entered into the GAPE database with the contributors identified by their chosen usernames as having cataloged the frame.

  4. Discovery Of B Ring Propellers In Cassini UVIS, And ISS

    Science.gov (United States)

    Sremcevic, Miodrag; Stewart, G. R.; Albers, N.; Esposito, L. W.

    2012-10-01

    We present evidence for the existence of propellers in Saturn's B ring by combining data from Cassini Ultraviolet Imaging Spectrograph (UVIS) and Imaging Science Subsystem (ISS) experiments. We identify two propeller populations: (1) tens of degrees wide propellers in the dense B ring core, and (2) smaller, more A ring like, propellers populating the inner B ring. The prototype of the first population is an object observed at 18 different epochs between 2005 and 2010. The ubiquitous propeller "S" shape is seen both in UVIS occultations as an optical depth depletion and in ISS as a 40 degrees wide bright stripe in unlit geometries and dark in lit geometries. Combining the available Cassini data we infer that the object is a partial gap embedded in the high optical depth region of the B ring. The gap moves at orbital speed consistent with its radial location. From the radial separation of the propeller wings we estimate that the embedded body, which causes the propeller structure, is about 1.5km in size located at a=112,921km. The UVIS occultations indicate an asymmetric propeller "S" shape. Since the object is located at an edge between high and relatively low optical depth, this asymmetry is most likely a consequence of the strong surface mass density gradient. We estimate that there are possibly dozen up to 100 other propeller objects in Saturn's B ring. The location of the discovered body, at an edge of a dense ringlet within the B ring, suggests a novel mechanism for the up to now illusive B ring irregular large-scale structure of alternating high and low optical depth ringlets. We propose that this B ring irregular structure may have its cause in the presence of many embedded bodies that shepherd the individual B ring ringlets.

  5. Cassini ISS Observations of Jupiter: An Exoplanet Perspective

    Science.gov (United States)

    West, Robert A.; Knowles, Benjamin

    2017-10-01

    Understanding the optical and physical properties of planets in our solar system can guide our approach to the interpretation of observations of exoplanets. Although some work has already been done along these lines, there remain low-hanging fruit. During the Cassini Jupiter encounter, the Imaging Science Subsystem (ISS) obtained an extensive set of images over a large range of phase angles (near-zero to 140 degrees) and in filters from near-UV to near-IR, including three methane bands and nearby continuum. The ISS also obtained images using polarizers. Much later in the mission we also obtained distant images while in orbit around Saturn. Some of these data have already been studied to reveal phase behavior (Dyudina et al., Astrophys. J.822, DOI: 10.3847/0004-637X/822/2/76; Mayorga et al., 2016, Astron. J. 152, DOI: 10.3847/0004-6256/152/6/209). Here we examine rotational modulation to determine wavelength and phase angle dependence, and how these may depend on cloud and haze vertical structure and optical properties. The existence of an optically thin forward-scattering and longitudinally-homogeneous haze overlying photometrically-variable cloud fields tends to suppress rotational modulation as phase angle increases, although in the strong 890-nm methane band cloud vertical structure is important. Cloud particles (non-spherical ammonia ice, mostly) have very small polarization signatures at intermediate phase angles and rotational modulation is not apparent above the noise level of our instrument. Part of this work was performed by the Jet Propulsion Lab, Cal. Inst. Of Technology.

  6. The Thompson Encephalopathy Score and Short-Term Outcomes in Asphyxiated Newborns Treated With Therapeutic Hypothermia

    NARCIS (Netherlands)

    Thorsen, Patricia; Jansen-van der Weide, Martine C.; Groenendaal, Floris; Onland, Wes; van Straaten, Henrika L. M.; Zonnenberg, Inge; Vermeulen, Jeroen R.; Dijk, Peter H.; Dudink, Jeroen; Rijken, Monique; van Heijst, Arno; Dijkman, Koen P.; Cools, Filip; Zecic, Alexandra; van Kaam, Anton H.; de Haan, Timo R.

    2016-01-01

    The Thompson encephalopathy score is a clinical score to assess newborns suffering from perinatal asphyxia. Previous studies revealed a high sensitivity and specificity of the Thompson encephalopathy score for adverse outcomes (death or severe disability). Because the Thompson encephalopathy score

  7. Instant MuseScore

    CERN Document Server

    Shinn, Maxwell

    2013-01-01

    Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. Instant MuseScore is written in an easy-to follow format, packed with illustrations that will help you get started with this music composition software.This book is for musicians who would like to learn how to notate music digitally with MuseScore. Readers should already have some knowledge about musical terminology; however, no prior experience with music notation software is necessary.

  8. 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...

  9. 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...

  10. The lod score method.

    Science.gov (United States)

    Rice, J P; Saccone, N L; Corbett, J

    2001-01-01

    The lod score method originated in a seminal article by Newton Morton in 1955. The method is broadly concerned with issues of power and the posterior probability of linkage, ensuring that a reported linkage has a high probability of being a true linkage. In addition, the method is sequential, so that pedigrees or lod curves may be combined from published reports to pool data for analysis. This approach has been remarkably successful for 50 years in identifying disease genes for Mendelian disorders. After discussing these issues, we consider the situation for complex disorders, where the maximum lod score (MLS) statistic shares some of the advantages of the traditional lod score approach but is limited by unknown power and the lack of sharing of the primary data needed to optimally combine analytic results. We may still learn from the lod score method as we explore new methods in molecular biology and genetic analysis to utilize the complete human DNA sequence and the cataloging of all human genes.

  11. The Bayesian Score Statistic

    NARCIS (Netherlands)

    Kleibergen, F.R.; Kleijn, R.; Paap, R.

    2000-01-01

    We propose a novel Bayesian test under a (noninformative) Jeffreys'priorspecification. We check whether the fixed scalar value of the so-calledBayesian Score Statistic (BSS) under the null hypothesis is aplausiblerealization from its known and standardized distribution under thealternative. Unlike

  12. South African Scoring System

    African Journals Online (AJOL)

    2014-11-18

    Nov 18, 2014 ... for 80% (SASS score) and 75% (NOT) of the variation in the regression model. Consequently, SASS ... further investigation: spatial analyses of macroinvertebrate assemblages; and the use of structural and functional metrics. Keywords: .... conductivity levels was assessed using multiple linear regres- sion.

  13. Developing Scoring Algorithms

    Science.gov (United States)

    We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

  14. The ISS Fluids Integrated Rack (FIR): a Summary of Capabilities

    Science.gov (United States)

    Gati, F.; Hill, M. E.

    2002-01-01

    The Fluids Integrated Rack (FIR) is a modular, multi-user scientific research facility that will fly in the U.S. laboratory module, Destiny, of the International Space Station (ISS). The FIR will be one of the two racks that will make up the Fluids and Combustion Facility (FCF) - the other being the Combustion Integrated Rack (CIR). The ISS will provide the FCF with the necessary resources, such as power and cooling. While the ISS crew will be available for experiment operations, their time will be limited. The FCF is, therefore, being designed for autonomous operations and remote control operations. Control of the FCF will be primarily through the Telescience Support Center (TSC) at the Glenn Research Center. The FCF is being designed to accommodate a wide range of combustion and fluids physics experiments within the ISS resources and constraints. The primary mission of the FIR, however, is to accommodate experiments from four major fluids physics disciplines: Complex Fluids; Multiphase Flow and Heat Transfer; Interfacial Phenomena; and Dynamics and Stability. The design of the FIR is flexible enough to accommodate experiments from other science disciplines such as Biotechnology. The FIR flexibility is a result of the large volume dedicated for experimental hardware, easily re-configurable diagnostics that allow for unique experiment configurations, and it's customizable software. The FIR will utilize six major subsystems to accommodate this broad scope of fluids physics experiments. The major subsystems are: structural, environmental, electrical, gaseous, command and data management, and imagers and illumination. Within the rack, the FIR's structural subsystem provides an optics bench type mechanical interface for the precise mounting of experimental hardware; including optical components. The back of the bench is populated with FIR avionics packages and light sources. The interior of the rack is isolated from the cabin through two rack doors that are hinged near

  15. 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

  16. 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.

  17. 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.

  18. Thermal Modeling Method Improvements for SAGE III on ISS

    Science.gov (United States)

    Liles, Kaitlin; Amundsen, Ruth; Davis, Warren; McLeod, Shawn

    2015-01-01

    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. A detailed thermal model of the SAGE III payload, which consists of multiple subsystems, has been developed in Thermal Desktop (TD). Many innovative analysis methods have been used in developing this model; these will be described in the paper. This paper builds on a paper presented at TFAWS 2013, which described some of the initial developments of efficient methods for SAGE III. The current paper describes additional improvements that have been made since that time. To expedite the correlation of the model to thermal vacuum (TVAC) testing, the chambers and GSE for both TVAC chambers at Langley used to test the payload were incorporated within the thermal model. This allowed the runs of TVAC predictions and correlations to be run within the flight model, thus eliminating the need for separate models for TVAC. In one TVAC test, radiant lamps were used which necessitated shooting rays from the lamps, and running in both solar and IR wavebands. A new Dragon model was incorporated which entailed a change in orientation; that change was made using an assembly, so that any potential additional new Dragon orbits could be added in the future without modification of the model. The Earth orbit parameters such as albedo and Earth infrared flux were incorporated as time-varying values that change over the course of the orbit; despite being required in one of the ISS documents, this had not been done before by any previous payload. All parameters such as initial temperature, heater voltage, and location of the payload are defined based on the case definition. For one component, testing was performed in both air and vacuum; incorporating the air convection in a submodel that was

  19. Credit scoring methods

    Czech Academy of Sciences Publication Activity Database

    Vojtek, Martin; Kočenda, Evžen

    2006-01-01

    Roč. 56, 3-4 (2006), s. 152-167 ISSN 0015-1920 R&D Projects: GA ČR GA402/05/0931 Institutional research plan: CEZ:AV0Z70850503 Keywords : banking sector * credit scoring * discrimination analysis Subject RIV: AH - Economics Impact factor: 0.190, year: 2006 http://journal.fsv.cuni.cz/storage/1050_s_152_167.pdf

  20. Credit scoring for individuals

    Directory of Open Access Journals (Sweden)

    Maria DIMITRIU

    2010-12-01

    Full Text Available Lending money to different borrowers is profitable, but risky. The profits come from the interest rate and the fees earned on the loans. Banks do not want to make loans to borrowers who cannot repay them. Even if the banks do not intend to make bad loans, over time, some of them can become bad. For instance, as a result of the recent financial crisis, the capability of many borrowers to repay their loans were affected, many of them being on default. That’s why is important for the bank to monitor the loans. The purpose of this paper is to focus on credit scoring main issues. As a consequence of this, we presented in this paper the scoring model of an important Romanian Bank. Based on this credit scoring model and taking into account the last lending requirements of the National Bank of Romania, we developed an assessment tool, in Excel, for retail loans which is presented in the case study.

  1. 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

  2. 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.

  3. 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.

  4. [The diagnostic and the exclusion scores for pulmonary embolism].

    Science.gov (United States)

    Junod, A

    2015-05-27

    Several clinical scores for the diagnosis of pulmonary embolism (PE) have been published. The most popular ones are the Wells score and the revised Geneva score; simplified versions exist for these two scores; they have been validated. Both scores have common properties, but there is a major difference for the Wells score, namely the inclusion of a feature based on clinical judgment. These two scores in combination with D-dimers measurement have been used to rule out PE. An important improvement in this process has recently taken place with the use of an adjustable, age-dependent threshold for DD for patients over 50 years.

  5. 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.; hide

    2014-01-01

    The International Space Station (ISS) vehicle undergoes spacecraft charging as it interacts with Earth's ionosphere and magnetic field. The interaction can result in a large potential difference developing between the ISS metal chassis and the local ionosphere plasma environment. If an astronaut conducting extravehicular activities (EVA) is exposed to the potential difference, then a possible electrical shock hazard arises. The control of this hazard was addressed by a number of documents within the ISS Program (ISSP) including Catastrophic Safety Hazard for Astronauts on EVA (ISS-EVA-312-4A_revE). The safety hazard identified the risk for an astronaut to experience an electrical shock in the event an arc was generated on an extravehicular mobility unit (EMU) surface. A catastrophic safety hazard, by the ISS requirements, necessitates mitigation by a two-fault tolerant system of hazard controls. Traditionally, the plasma contactor units (PCUs) on the ISS have been used to limit the charging and serve as a "ground strap" between the ISS structure and the surrounding ionospheric plasma. In 2009, a previous NASA Engineering and Safety Center (NESC) team evaluated the PCU utilization plan (NESC Request #07-054-E) with the objective to assess whether leaving PCUs off during non-EVA time periods presented risk to the ISS through assembly completion. For this study, in situ measurements of ISS charging, covering the installation of three of the four photovoltaic arrays, and laboratory testing results provided key data to underpin the assessment. The conclusion stated, "there appears to be no significant risk of damage to critical equipment nor excessive ISS thermal coating damage as a result of eliminating PCU operations during non- EVA times." In 2013, the ISSP was presented with recommendations from Boeing Space Environments for the "Conditional" Marginalization of Plasma Hazard. These recommendations include a plan that would keep the PCUs off during EVAs when the

  6. SAGE III on ISS Lessons Learned on Thermal Interface Design

    Science.gov (United States)

    Davis, Warren

    2015-01-01

    The Stratospheric Aerosol and Gas Experiment III (SAGE III) instrument - the fifth in a series of instruments developed for monitoring vertical distribution of aerosols, ozone, and other trace gases in the Earth's stratosphere and troposphere - is currently scheduled for delivery to the International Space Station (ISS) via the SpaceX Dragon vehicle in 2016. The Instrument Adapter Module (IAM), one of many SAGE III subsystems, continuously dissipates a considerable amount of thermal energy during mission operations. Although a portion of this energy is transferred via its large radiator surface area, the majority must be conductively transferred to the ExPRESS Payload Adapter (ExPA) to satisfy thermal mitigation requirements. The baseline IAM-ExPA mechanical interface did not afford the thermal conductance necessary to prevent the IAM from overheating in hot on-orbit cases, and high interfacial conductance was difficult to achieve given the large span between mechanical fasteners, less than stringent flatness specifications, and material usage constraints due to strict contamination requirements. This paper will examine the evolution of the IAM-ExPA thermal interface over the course of three design iterations and will include discussion on design challenges, material selection, testing successes and failures, and lessons learned.

  7. ISS Internal Active Thermal Control System (IATCS) Coolant Remediation Project

    Science.gov (United States)

    Morrison, Russell H.; Holt, Mike

    2005-01-01

    The IATCS coolant has experienced a number of anomalies in the time since the US Lab was first activated on Flight 5A in February 2001. These have included: 1) a decrease in coolant pH, 2) increases in inorganic carbon, 3) a reduction in phosphate buffer concentration, 4) an increase in dissolved nickel and precipitation of nickel salts, and 5) increases in microbial concentration. These anomalies represent some risk to the system, have been implicated in some hardware failures and are suspect in others. The ISS program has conducted extensive investigations of the causes and effects of these anomalies and has developed a comprehensive program to remediate the coolant chemistry of the on-orbit system as well as provide a robust and compatible coolant solution for the hardware yet to be delivered. The remediation steps include changes in the coolant chemistry specification, development of a suite of new antimicrobial additives, and development of devices for the removal of nickel and phosphate ions from the coolant. This paper presents an overview of the anomalies, their known and suspected system effects, their causes, and the actions being taken to remediate the coolant.

  8. Measuring CMB polarization from ISS: the SPOrt experiment

    International Nuclear Information System (INIS)

    Colombo, L.P.L.

    2004-01-01

    The SPOrt (Sky Polarization Observatory) experiment aims to measure CMBP (cosmic microwave background polarization) on about 80% of the sky from space. Selected by ESA to fly on board the ISS in 2006, it is funded by the Italian Space Agency (ASI). As shown also by the recent WMAP release, CMBP data, besides of removing various degeneracies among cosmological parameters, provided new and important information on the cosmic opacity τ and, therefore, on very early cosmic objects which reionized the world at z ∼ 15. Most such information is obtained from low-l spectral components, that SPOrt, with its HPBW resolution of 7 degrees will explore with a high level of sensitivity. The 4 polarimeters of SPOrt work at 22, 32 and (2x) 90 GHz. At lower frequencies they will provide a (nearly) all-sky survey of Galactic synchrotron polarized emission, while data at the higher frequency will measure the CMBP signal. Correlating SPOrt with anisotropy data, by other experiments, shall therefore provide significant cosmological information. We performed a number of simulations of SPOrt performance, aimed to determine how far τ and/or other parameter(s) concerning reionization are constrained by the expected data. We also considered a possible interplay between reionization histories and Dark Energy nature. Besides of information on technological developments for systematics reduction, long term stability and observing time efficiency, we report here recent outputs on the expected SPOrt performance in constraining cosmological models

  9. Longitudinal Ionospheric Variability Observed by LITES on the ISS

    Science.gov (United States)

    Stephan, A. W.; Finn, S. C.; Cook, T.; Geddes, G.; Chakrabarti, S.; Budzien, S. A.

    2017-12-01

    The Limb-Imaging Ionospheric and Thermospheric Extreme-Ultraviolet Spectrograph (LITES) is an imaging spectrograph designed to measure altitude profiles (150-350 km) of extreme- and far-ultraviolet airglow emissions that originate from photochemical processes in the ionosphere and thermosphere. During the daytime, LITES observes the bright O+ 83.4 nm emission from which the ionospheric profile can be inferred. At night, recombination emissions at 91.1 and 135.6 nm provide a direct measure of the electron content along the line of sight. LITES was launched and installed on the International Space Station (ISS) in late February 2017 where it has been operating along with the highly complementary GPS Radio Occultation and Ultraviolet Photometry - Colocated (GROUP-C) experiment. We will present some of the first observations from LITES in April 2017 that show longitudinal patterns in ionospheric density and the daily variability in those patterns. LITES vertical imaging from a vantage point near 410 km enables a particularly unique perspective on the altitude of the ionospheric peak density at night that can complement and inform other ground- and space-based measurements, and track the longitude-altitude variability that is reflective of changes in equatorial electrodynamics.

  10. Radiation measured for ISS-Expedition 12 with different dosimeters

    International Nuclear Information System (INIS)

    Zhou, D.; Semones, E.; Gaza, R.; Johnson, S.; Zapp, N.; Weyland, M.

    2007-01-01

    Radiation in low Earth orbit (LEO) is mainly from Galactic Cosmic Rays (GCR), solar energetic particles and particles in South Atlantic Anomaly (SAA). These particles' radiation impact to astronauts depends strongly on the particles' linear energy transfer (LET) and is dominated by high LET radiation. It is important to investigate the LET spectrum for the radiation field and the influence of radiation on astronauts. At present, the best active dosimeters used for all LET are the tissue equivalent proportional counter (TEPC) and silicon detectors; the best passive dosimeters are thermoluminescence dosimeters (TLDs) or optically stimulated luminescence dosimeters (OSLDs) for low LET and CR-39 plastic nuclear track detectors (PNTDs) for high LET. TEPC, CR-39 PNTDs, TLDs and OSLDs were used to investigate the radiation for space mission Expedition 12 (ISS-11S) in LEO. LET spectra and radiation quantities (fluence, absorbed dose, dose equivalent and quality factor) were measured for the mission with these different dosimeters. This paper introduces the operation principles for these dosimeters, describes the method to combine the results measured by CR-39 PNTDs and TLDs/OSLDs, presents the experimental LET spectra and the radiation quantities

  11. 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

  12. College Math Assessment: SAT Scores vs. College Math Placement Scores

    Science.gov (United States)

    Foley-Peres, Kathleen; Poirier, Dawn

    2008-01-01

    Many colleges and university's use SAT math scores or math placement tests to place students in the appropriate math course. This study compares the use of math placement scores and SAT scores for 188 freshman students. The student's grades and faculty observations were analyzed to determine if the SAT scores and/or college math assessment scores…

  13. Estimating NHL Scoring Rates

    OpenAIRE

    Buttrey, Samuel E.; Washburn, Alan R.; Price, Wilson L.; Operations Research

    2011-01-01

    The article of record as published may be located at http://dx.doi.org/10.2202/1559-0410.1334 We propose a model to estimate the rates at which NHL teams score and yield goals. In the model, goals occur as if from a Poisson process whose rate depends on the two teams playing, the home-ice advantage, and the manpower (power-play, short-handed) situation. Data on all the games from the 2008-2009 season was downloaded and processed into a form suitable for the analysis. The model...

  14. Robotic, MEMS-based Multi Utility Sample Preparation Instrument for ISS Biological Workstation, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This project will develop a multi-functional, automated sample preparation instrument for biological wet-lab workstations on the ISS. The instrument is based on a...

  15. Synchronized Position and Hold Reorient Experimental Satellites - International Space Station (SPHERES-ISS), Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Payload Systems Inc. (PSI) and the MIT Space Systems Laboratory (MIT-SSL) propose an innovative research program entitled SPHERES-ISS that uses their satellite...

  16. Režissöör Jaini film on omasuguste seas ainus / Berit Toodo

    Index Scriptorium Estoniae

    Toodo, Berit

    2008-01-01

    Pärnu 22. dokumentaal- ja antropoloogiafilmide festivalil esilinastus india režissööri Rajele Jaini dokumentaalfilm "Silmalau üheksa liikumist". Filmis tegi oma viimase esinemise ka kuulus koreograaf Pina Bausch

  17. 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...

  18. Global Precipitation Measurement (GPM) and International Space Station (ISS) Coordination for Cubesat Deployments

    Science.gov (United States)

    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.

  19. Observation Platform for Dynamic Biomedical and Biotechnology Experiments using the ISS Light Microscopy Module, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed "Observation platform for dynamic biomedical and biotechnology experiments using the ISS Light Microscopy Module" consists of a platen sized to fit the...

  20. 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...

  1. Microbial Observatory (ISS-MO): Study of BSL-2 bacterial isolates from the International Space Station

    Data.gov (United States)

    National Aeronautics and Space Administration — In an on-going Microbial Observatory experimental investigation on the International Space Station (ISS) multiple bacterial isolates of Biosafety Level 2 (BSL-2)...

  2. 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...

  3. Näitleja Tommy Lee Jonesi meditatsioon režissööritoolis / Andris Feldmanis

    Index Scriptorium Estoniae

    Feldmanis, Andris, 1982-

    2007-01-01

    Vestern "Melquiades Estrada kolm matust" ("The Three Burials of Melquiades Estrada") : stsenarist Guillermo Arriaga : režissöör ja osatäitja Tommy Lee Jones : operaator Chris Menges : Ameerika Ühendriigid, 2005

  4. 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

  5. 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.

  6. 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

  7. 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

  8. The International Bleeding Risk Score

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Laine, L.; Dalton, H.

    2017-01-01

    The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding.......The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding....

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Tidally modulated eruptions on Enceladus: Cassini ISS observations and models

    International Nuclear Information System (INIS)

    Nimmo, Francis; Porco, Carolyn; Mitchell, Colin

    2014-01-01

    We use images acquired by the Cassini Imaging Science Subsystem (ISS) to investigate the temporal variation of the brightness and height of the south polar plume of Enceladus. The plume's brightness peaks around the moon's apoapse, but with no systematic variation in scale height with either plume brightness or Enceladus' orbital position. We compare our results, both alone and supplemented with Cassini near-infrared observations, with predictions obtained from models in which tidal stresses are the principal control of the eruptive behavior. There are three main ways of explaining the observations: (1) the activity is controlled by right-lateral strike slip motion; (2) the activity is driven by eccentricity tides with an apparent time delay of about 5 hr; (3) the activity is driven by eccentricity tides plus a 1:1 physical libration with an amplitude of about 0.°8 (3.5 km). The second hypothesis might imply either a delayed eruptive response, or a dissipative, viscoelastic interior. The third hypothesis requires a libration amplitude an order of magnitude larger than predicted for a solid Enceladus. While we cannot currently exclude any of these hypotheses, the third, which is plausible for an Enceladus with a subsurface ocean, is testable by using repeat imaging of the moon's surface. A dissipative interior suggests that a regional background heat source should be detectable. The lack of a systematic variation in plume scale height, despite the large variations in plume brightness, is plausibly the result of supersonic flow; the details of the eruption process are yet to be understood.

  15. Multi-User Hardware Solutions to Combustion Science ISS Research

    Science.gov (United States)

    Otero, Angel M.

    2001-01-01

    In response to the budget environment and to expand on the International Space Station (ISS) Fluids and Combustion Facility (FCF) Combustion Integrated Rack (CIR), common hardware approach, the NASA Combustion Science Program shifted focus in 1999 from single investigator PI (Principal Investigator)-specific hardware to multi-user 'Minifacilities'. These mini-facilities would take the CIR common hardware philosophy to the next level. The approach that was developed re-arranged all the investigations in the program into sub-fields of research. Then common requirements within these subfields were used to develop a common system that would then be complemented by a few PI-specific components. The sub-fields of research selected were droplet combustion, solids and fire safety, and gaseous fuels. From these research areas three mini-facilities have sprung: the Multi-user Droplet Combustion Apparatus (MDCA) for droplet research, Flow Enclosure for Novel Investigations in Combustion of Solids (FEANICS) for solids and fire safety, and the Multi-user Gaseous Fuels Apparatus (MGFA) for gaseous fuels. These mini-facilities will develop common Chamber Insert Assemblies (CIA) and diagnostics for the respective investigators complementing the capability provided by CIR. Presently there are four investigators for MDCA, six for FEANICS, and four for MGFA. The goal of these multi-user facilities is to drive the cost per PI down after the initial development investment is made. Each of these mini-facilities will become a fixture of future Combustion Science NASA Research Announcements (NRAs), enabling investigators to propose against an existing capability. Additionally, an investigation is provided the opportunity to enhance the existing capability to bridge the gap between the capability and their specific science requirements. This multi-user development approach will enable the Combustion Science Program to drive cost per investigation down while drastically reducing the time

  16. Determine ISS Soyuz Orbital Module Ballistic Limits for Steel Projectiles Hypervelocity Impact Testing

    Science.gov (United States)

    Lyons, Frankel

    2013-01-01

    A new orbital debris environment model (ORDEM 3.0) defines the density distribution of the debris environment in terms of the fraction of debris that are low-density (plastic), medium-density (aluminum) or high-density (steel) particles. This hypervelocity impact (HVI) program focused on assessing ballistic limits (BLs) for steel projectiles impacting the enhanced Soyuz Orbital Module (OM) micrometeoroid and orbital debris (MMOD) shield configuration. The ballistic limit was defined as the projectile size on the threshold of failure of the OM pressure shell as a function of impact speeds and angle. The enhanced OM shield configuration was first introduced with Soyuz 30S (launched in May 2012) to improve the MMOD protection of Soyuz vehicles docked to the International Space Station (ISS). This test program provides HVI data on U.S. materials similar in composition and density to the Russian materials for the enhanced Soyuz OM shield configuration of the vehicle. Data from this test program was used to update ballistic limit equations used in Soyuz OM penetration risk assessments. The objective of this hypervelocity impact test program was to determine the ballistic limit particle size for 440C stainless steel spherical projectiles on the Soyuz OM shielding at several impact conditions (velocity and angle combinations). This test report was prepared by NASA-JSC/ HVIT, upon completion of tests.

  17. Haze and cloud structure of Saturn's North Pole and Hexagon Wave from Cassini/ISS imaging

    Science.gov (United States)

    Sanz-Requena, J. F.; Pérez-Hoyos, S.; Sánchez-Lavega, A.; Antuñano, A.; Irwin, Patrick G. J.

    2018-05-01

    In this paper we present a study of the vertical haze and cloud structure in the upper two bars of Saturn's Northern Polar atmosphere using the Imaging Science Subsystem (ISS) instrument onboard the Cassini spacecraft. We focus on the characterization of latitudes from 53° to 90° N. The observations were taken during June 2013 with five different filters (VIO, BL1, MT2, CB2 and MT3) covering spectral range from the 420 nm to 890 nm (in a deep methane absorption band). Absolute reflectivity measurements of seven selected regions at all wavelengths and several illumination and observation geometries are compared with the values produced by a radiative transfer model. The changes in reflectivity at these latitudes are mostly attributed to changes in the tropospheric haze. This includes the haze base height (from 600 ± 200 mbar at the lowest latitudes to 1000 ± 300 mbar in the pole), its particle number density (from 20 ± 2 particles/cm3 to 2 ± 0.5 particles/cm3 at the haze base) and its scale height (from 18 ± 0.1 km to 50 ± 0.1 km). We also report variability in the retrieved particle size distribution and refractive indices. We find that the Hexagonal Wave dichotomizes the studied stratospheric and tropospheric hazes between the outer, equatorward regions and the inner, Polar Regions. This suggests that the wave or the jet isolates the particle distribution at least at tropospheric levels.

  18. [The use of scores in general medicine].

    Science.gov (United States)

    Huber, Ursula; Rösli, Andreas; Ballmer, Peter E; Rippin, Sarah Jane

    2013-10-01

    Scores are tools to combine complex information into a numerical value. In General Medicine, there are scores to assist in making diagnoses and prognoses, scores to assist therapeutic decision making and to evaluate therapeutic results and scores to help physicians when informing and advising patients. We review six of the scoring systems that have the greatest utility for the General Physician in hospital-based care and in General Practice. The Nutritional Risk Screening (NRS 2002) tool is designed to identify hospital patients in danger of malnutrition. The aim is to improve the nutritional status of these patients. The CURB-65 score predicts 30-day mortality in patients with community acquired pneumonia. Patients with a low score can be considered for home treatment, patients with an elevated score require hospitalisation and those with a high score should be treated as having severe pneumonia; treatment in the intensive care unit should be considered. The IAS-AGLA score of the Working Group on Lipids and Atherosclerosis of the Swiss Society of Cardiology calculates the 10-year risk of a myocardial infarction for people living in Switzerland. The working group makes recommendations for preventative treatment according to the calculated risk status. The Body Mass Index, which is calculated by dividing the body weight in kilograms by the height in meters squared and then divided into weight categories, is used to classify people as underweight, of normal weight, overweight or obese. The prognostic value of this classification is discussed. The Mini-Mental State Examination allows the physician to assess important cognitive functions in a simple and standardised form. The Glasgow Coma Scale is used to classify the level of consciousness in patients with head injury. It can be used for triage and correlates with prognosis.

  19. Assessment of lnternational Space Station (ISS) Lithium-ion Battery Thermal Runaway (TR)

    Science.gov (United States)

    Graika, Jason

    2017-01-01

    This task was developed in the wake of the Boeing 787 Dreamliner lithium-ion battery TR incidents of January 2013 and January 2014. The Electrical Power Technical Discipline Team supported the Dreamliner investigations and has followed up by applying lessons learned to conduct an introspective evaluation of NASA's risk of similar incidents in its own lithium-ion battery deployments. This activity has demonstrated that historically NASA, like Boeing and others in the aerospace industry, has emphasized the prevention of TR in a single cell within the battery (e.g., cell screening) but has not considered TR severity-reducing measures in the event of a single-cell TR event. center dotIn the recent update of the battery safety standard (JSC 20793) to address this paradigm shift, the NASA community included requirements for assessing TR severity and identifying simple, low-cost severity reduction measures. This task will serve as a pathfinder for meeting those requirements and will specifically look at a number of different lithium-ion batteries currently in the design pipeline within the ISS Program batteries that, should they fail in a Dreamliner-like incident, could result in catastrophic consequences. This test is an abuse test to understand the heat transfer properties of the cell and ORU in thermal runaway, with radiant barriers in place in a flight like test in on orbit conditions. This includes studying the heat flow and distribution in the ORU. This data will be used to validate the thermal runaway analysis. This test does not cover the ambient pressure case. center dotThere is no pass/ fail criteria for this test.

  20. Rust scoring guide

    NARCIS (Netherlands)

    Anonymous,

    1986-01-01

    This brief guide for identifying rust diseases of smaill grain cereals contains color photos depicting the growth stages of small grain cereal crops and provides instructions for recording rust severity and field response for stripe rust (Puccinia striiformis), stem rust (P. graminis), and leaf rust

  1. Rust scoring guide

    OpenAIRE

    Anonymous

    1986-01-01

    This brief guide for identifying rust diseases of smaill grain cereals contains color photos depicting the growth stages of small grain cereal crops and provides instructions for recording rust severity and field response for stripe rust (Puccinia striiformis), stem rust (P. graminis), and leaf rust (P. recondita).

  2. 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 poss