Engineering Papers⌕ Search

SEARCH · Engineering Papers

Results for “Case Reports”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15

Interaction of genetic predisposition and environmental factors in the pathogenesis of idiopathic orthostatic intolerance

BACKGROUND: The hemodynamic and autonomic abnormalities in idiopathic orthostatic intolerance (IOI) have been studied extensively. However, the mechanisms underlying these abnormalities are not understood. If genetic predisposition were important in the pathogenesis of IOI, monozygotic twins of patients with IOI should have similar hemodynamic and autonomic abnormalities. METHODS: We studied two patients with IOI and their identical twins. Both siblings in the first twin pair had orthostatic symptoms, significant orthostatic tachycardia, increased plasma norepinephrine levels with standing, and a greater than normal decrease in systolic blood pressure with trimethaphan infusion. RESULTS: Both siblings had a normal response of plasma renin activity to upright posture. In the second twin pair, only one sibling had symptoms of orthostatic intolerance, an orthostatic tachycardia, and raised plasma catecholamines with standing. The affected sibling had inappropriately low plasma renin activity with standing and was 8-fold more sensitive to the pressor effect of phenylephrine than the unaffected sibling. CONCLUSIONS: We conclude that in some patients, IOI seems to be strongly influenced by genetic factors. In others, however, IOI may be mainly caused by nongenetic factors. These findings suggest that IOI is heterogenous, and that both genetic and environmental factors contribute individually or collectively to create the IOI phenotype.

NASA Discipline Regulatory Physiology↗

Clinical use of three-dimensional video measurements of eye movements

Noninvasive measurements of three-dimensional eye position can be accurately achieved with video methods. A case study showing the potential clinical benefit of these enhanced measurements is presented along with some thoughts about technological advances, essential for clinical application, that are likely to occur in the next several years.

Non-NASA Center↗

Subacute diabetic proximal neuropathy

OBJECTIVE: To evaluate the clinical, electrophysiologic, autonomic, and neuropathologic characteristics and the natural history of subacute diabetic proximal neuropathy and its response to immunotherapy. MATERIAL AND METHODS: For the 12-year period from 1983 to 1995, we conducted a retrospective review of medical records of Mayo Clinic patients with diabetes who had subacute onset and progression of proximal weakness. The responses of treated versus untreated patients were compared statistically. RESULTS: During the designated study period, 44 patients with subacute diabetic proximal neuropathy were encountered. Most patients were middle-aged or elderly, and no sex preponderance was noted. The proximal muscle weakness often was associated with reduced or absent lower extremity reflexes. Associated weight loss was a common finding. Frequently, patients had some evidence of demyelination on nerve conduction studies, but it invariably was accompanied by concomitant axonal degeneration. The cerebrospinal fluid protein concentration was usually increased. Diffuse and substantial autonomic failure was generally present. In most cases, a sural nerve biopsy specimen suggested demyelination, although evidence of an inflammatory infiltrate was less common. Of 12 patients who received treatment (with prednisone, intravenous immune globulin, or plasma exchange), 9 had improvement of their conditions, but 17 of 29 untreated patients (59%) with follow-up also eventually had improvement, albeit at a much slower rate. Improvement was usually incomplete. CONCLUSION: We suggest that the entity of subacute diabetic proximal neuropathy is an extensive and severe variant of bilateral lumbosacral radiculoplexopathy, with some features suggestive of an immune-mediated cause. It differs from chronic inflammatory demyelinating polyradiculoneuropathy in that most cases have a more restricted distribution and seem to be monophasic and self-limiting. The efficacy of immunotherapy is unproved, but such intervention may be considered in the severe and progressive cases or ones associated with severe neuropathic pain.

Non-NASA Center↗

Malignant vagotonia due to selective baroreflex failure

Baroreflex failure is characterized by dramatic fluctuations of sympathetic activity and paroxysms of hypertension and tachycardia. In contrast, unopposed parasympathetic activity has not been described in patients with baroreflex failure because of concurrent parasympathetic denervation of the heart. We describe the unusual case of a patient with baroreflex failure in a setting of preserved parasympathetic control of HR manifesting episodes of severe bradycardia and asystole. Thus, parasympathetic control of the HR may be intact in occasional patients with baroreflex failure. Patients with this selective baroreflex failure require a unique therapeutic strategy for the control of disease manifestations.

Case Reports↗

The role of clinical pharmacology in molecular genetics

PROBLEM: Discovering the causes of unusual phenotypes in human subjects is an important aspect of patient-oriented research. MATERIAL: The tools of clinical pharmacology are uniquely useful in addressing these problems. PATIENTS, SUBJECTS, OR CASE HISTORIES: We evaluated a 42-year-old patient with lifelong orthostatic hypotension and ptosis of the eyelids. He underwent a series of biochemical, physiological, and pharmacological tests outlined in this article. RESULTS: These studies indicated that sympathetic innervation was intact but that the sympathetic neurotransmitter was dopamine rather than norepinephrine. These results demonstrated that dopamine-beta-hydroxylase deficiency underlies the clinical abnormalities of this patient. CONCLUSION: In selected individuals with unusual phenotypes, the techniques of clinical chemistry and clinical pharmacology can define the nature of the defect at almost the resolution of the human genome.

NASA Discipline Regulatory Physiology↗

Heart rate and respiratory rhythm dynamics on ascent to high altitude

OBJECTIVE--To investigate the alterations in autonomic control of heart rate at high altitude and to test the hypothesis that hypoxaemic stress during exposure to high altitude induces non-linear, periodic heart rate oscillations, similar to those seen in heart failure and the sleep apnoea syndrome. SUBJECTS--11 healthy subjects aged 24-64. MAIN OUTCOME MEASURES--24 hour ambulatory electrocardiogram records obtained at baseline (1524 m) and at 4700 m. Simultaneous heart rate and respiratory dynamics during 2.5 hours of sleep by fast Fourier transform analysis of beat to beat heart rate and of an electrocardiographically derived respiration signal. RESULTS--All subjects had resting hypoxaemia at high altitude, with an average oxyhaemoglobin saturation of 81% (5%). There was no significant change in mean heart rate, but low frequency (0.01-0.05 Hz) spectral power was increased (P < 0.01) at high altitude. Time series analysis showed a complex range of non-linear sinus rhythm dynamics. Striking low frequency (0.04-0.06 Hz) heart rate oscillations were observed during sleep in eight subjects at high altitude. Analysis of the electrocardiographically derived respiration signal indicated that these heart rate oscillations correlated with low frequency respiratory oscillations. CONCLUSIONS--These data suggest (a) that increased low frequency power during high altitude exposure is not simply attributable to increased sympathetic modulation of heart rate, but relates to distinctive cardiopulmonary oscillations at approximately 0.05 Hz and (b) that the emergence of periodic heart rate oscillations at high altitude is consistent with an unstable cardiopulmonary control system that may develop on acute exposure to hypoxaemic stress.

Non-NASA Center↗

Compartment syndrome of the thigh complicating surgical treatment of ipsilateral femur and ankle fractures

A 26-year-old man presented with ipsilateral femur and ankle fractures. The patient was treated with interlocking nail of his femur fracture, followed by open reduction and internal fixation of his ankle fracture under tourniquet control. Postoperatively, the patient developed compartment syndrome of his thigh with elevated pressures, requiring decompressive fasciotomies. This case illustrates the possible complication of treating a femur fracture with intramedullary nailing and then immediately applying a tourniquet to treat an ipsilateral extremity fracture. Because of the complication with this patient, we feel the procedure should be staged, or a tourniquet should be avoided if possible.

Case Reports↗

The Council on Aviation Accreditation: Part One - Historical Foundation

The Council on Aviation Accreditation (CAA) was established in 1988 in response to the need for formal, specialized accreditation of aviation academic programs, as expressed by institutional members of the University Aviation Association (UAA). The first aviation programs were accredited by the CAA in 1992, and today, the CAA lists 60 accredited programs at 21 institutions nationwide. Although the number of accredited programs has steadily grown, there are currently only 20 percent of UAA member institutions with CAA accredited programs. In an effort to further understand this issue, a case study of the CAA was performed, which resulted in a two-part case study report. Part one focuses on the following questions: (a) why was the CAA established and how has it evolved; (b) what is the purpose of the CAA; (c) how does a program become accredited by the CAA; and (d) what is the current environment in which the CAA operates. In answering these questions, various sources of data (such as CAA documents, magazine and journal articles, email inquiries, and an on-line survey) were utilized. Part one of this study resulted in a better understanding of the CAA, including its history, purpose, and the entire accreditation process. Part two will both examine the contemporary issues being faced by the CAA and provide recommendations to enhance the future growth of the organization.

Prather, C. Daniel↗

The Council on Aviation Accreditation: Contemporary Issues - Part 2

The Council on Aviation Accreditation (CAA) was established in 1988 in response to the need for formal, specialized accreditation of aviation academic programs, as expressed by institutional members of the University Aviation Association (UAA). The first aviation programs were accredited by the CAA in 1992, and today, the CAA lists 60 accredited programs at 21 institutions nationwide. Although the number of accredited programs has steadily grown, there are currently only 20 percent of UAA member institutions with CAA accredited programs. In an effort to further understand this issue, a case study of the CAA was performed, which resulted in a two-part case study report. Part one addressed the historical foundation of the organization and the current environment in which the CAA functions. Part two focuses on the following questions: (a) what are some of the costs to a program seeking CAA accreditation (b) what are some fo the benefits of being CAA accredited; (c) why do programs seek CAA accreditation; (d) why do programs choose no to seek CAA accreditation; (e) what role is the CAA playing in the international aviation academic community; and (f) what are some possible strategies the CAA may adopt to enhance the benefits of CAA accreditation and increase the number of CAA accredited programs. This second part allows for a more thorough understanding of the contemporary issued faced by the organization, as well as alternative strategies for the CAA to consider in an effort to increase the number of CAA accredited programs and more fully fulfill the role of the CAA in the collegiate aviation community.

Prather, C. Daniel↗

Formal methods for test case generation

The invention relates to the use of model checkers to generate efficient test sets for hardware and software systems. The method provides for extending existing tests to reach new coverage targets; searching *to* some or all of the uncovered targets in parallel; searching in parallel *from* some or all of the states reached in previous tests; and slicing the model relative to the current set of coverage targets. The invention provides efficient test case generation and test set formation. Deep regions of the state space can be reached within allotted time and memory. The approach has been applied to use of the model checkers of SRI's SAL system and to model-based designs developed in Stateflow. Stateflow models achieving complete state and transition coverage in a single test case are reported.

Rushby, John↗

Shuttle Case Study Collection Website Development

As a continuation from summer 2012, the Shuttle Case Study Collection has been developed using lessons learned documented by NASA engineers, analysts, and contractors. Decades of information related to processing and launching the Space Shuttle is gathered into a single database to provide educators with an alternative means to teach real-world engineering processes. The goal is to provide additional engineering materials that enhance critical thinking, decision making, and problem solving skills. During this second phase of the project, the Shuttle Case Study Collection website was developed. Extensive HTML coding to link downloadable documents, videos, and images was required, as was training to learn NASA's Content Management System (CMS) for website design. As the final stage of the collection development, the website is designed to allow for distribution of information to the public as well as for case study report submissions from other educators online.

Ransom, Khadijah S.↗

Assessing Disparities of Dengue Virus Transmission Risk across the US-Mexican Border Using a Climate Driven Vector-Epidemiological Model

Dengue fever is a mosquito‐borne viral disease reemerging throughout much of the tropical Americas. Dengue virus transmission is explicitly influenced by climate and the environment through its primary vector, Aedes aegypti. Temperature regulates Ae. aegypti development, survival, and replication rates as well as the incubation period of the virus within the mosquito. Precipitation provides water for many of the preferred breeding habitats of the mosquito, including buckets, old tires, and other places water can collect. Although transmission regularly occurs along the border region in Mexico, dengue virus transmission in bordering Arizona has not occurred. Using NASA's TRMM (Tropical Rainfall Measuring Mission) satellite for precipitation input and Daymet for temperature and supplemental precipitation input, we modeled dengue transmission along a US‐Mexico transect using a dynamic dengue transmission model that includes interacting vector ecology and epidemiological components. Model runs were performed for 5 cities in Sonora, Mexico and southern Arizona. Employing a Monte Carlo approach, we performed ensembles of several thousands of model simulations in order to resolve the model uncertainty arising from using different combinations of parameter values that are not well known. For cities with reported dengue case data, the top model simulations that best reproduced dengue case numbers were retained and their parameter values were extracted for comparison. These parameter values were used to run simulations in areas where dengue virus transmission does not occur or where dengue fever case data was unavailable. Additional model runs were performed to reveal how changes in climate or parameter values could alter transmission risk along the transect. The relative influence of climate variability and model parameters on dengue virus transmission is assessed to help public health workers prepare location specific infection prevention strategies.

Morin, Cory↗

Exploring the Frequency Stability Limits of Whispering Gallery Mode Resonators for Metrological Applications

Whispering gallery mode resonators are attracting increasing interest as promising frequency reference cavities. Unlike commonly used Fabry-Perot cavities, however, they are filled with a bulk medium whose properties have a significant impact on the stability of its resonance frequencies. In this context that has to be reduced to a minimum. On the other hand, a small monolithic resonator provides opportunity for better stability against vibration and acceleration. this feature is essential when the cavity operates in a non-laboratory environment. In this paper, we report a case study for a crystalline resonator, and discuss the a pathway towards the inhibition of vibration-and acceleration-induced frequency fluctuations.

meterology↗

Comprehensive Lifecycle for Assuring System Safety

CLASS is a novel approach to the enhancement of system safety in which the system safety case becomes the focus of safety engineering throughout the system lifecycle. CLASS also expands the role of the safety case across all phases of the system's lifetime, from concept formation to decommissioning. As CLASS has been developed, the concept has been generalized to a more comprehensive notion of assurance becoming the driving goal, where safety is an important special case. This report summarizes major aspects of CLASS and contains a bibliography of papers that provide additional details.

Knight, John C.↗

Modeling of Guided Waves for Aerospace Applications

Advancements in computer hardware has led to new possibilities for rapid modeling and simulation capabilities across many scientific fields. Nondestructive evaluation (NDE) can benefit from increased use of simulation tools to guide optimization of inspection and health monitoring methods, enhance understanding of data, aid in development of defect characterization methods, and generate data sets for use with machine learning and model-assisted probability of detection. Recent work at NASA has entailed development and benchmarking of both custom simulation codes and commercial simulation tools for ultrasonic wave propagation. This paper describes recent work at NASA in modeling of guided waves in composites and other aerospace materials. Results and computational speeds for a composite benchmark case are reported for a custom finite difference Rotated Staggered Grid code and for the commercial finite element software package, Pogo. Recent progress in linking NDE models to parametric analysis tools is also discussed.

Nondestructive evaluation↗

Peru Health & Air Quality: Land Use Change in the Rapidly Developing Peruvian Amazon and Implications on Zoonotic Disease Incidence

In the Madre de Dios region of the Peruvian Amazon, forests are being cleared for mining, timber harvesting, road construction, and hydroelectric dam development. These rapid land use changes are increasing human presence in previously sparsely populated areas, disrupting ecosystems and increasing the proximity of human settlement to zoonotic disease vectors. Dengue fever and leishmaniasis are two neglected tropical diseases which are prevalent in Madre de Dios and have been associated with urbanization and road construction. In partnership with the Peruvian Ministries of Health (MINSA) and the Environment (MINAM) and other in-country collaborators, our team examined Land Use Land Cover (LULC) correlations with reported dengue and leishmaniasis incidence in the Madre de Dios region to help partners understand the spatial relationship between land use change and zoonotic disease incidence. We created a LULC classification script using Google Earth Engine with Landsat 5 Thematic Mapper and Landsat 8 Operational Land Imager imagery to classify land cover in 2010, 2015, and 2020 and evaluate changes over this time period. We then used the quantified results of the LULC assessment in conjunction with reported disease cases to evaluate correlations between disease incidence and key land cover changes across Madre de Dios’s 11 districts. In the second term, the team will use these products to develop more detailed disease incidence risk maps and models. High risk areas will then be classified, using PeruSat-1 that allow for even higher resolution mapping at less than 3 meters. These products will allow the partners to understand hotspots of land cover change in Peru and the relationship with outbreaks to inform public health decision making and environmental policy.

Elizabeth Stapleton↗