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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.

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At least 343 records · Page 19
All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

Modeling the transmission of community-associated methicillin-resistant Staphylococcus aureus: a dynamic agent-based simulation

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has been a deadly pathogen in healthcare settings since the 1960s, but MRSA epidemiology changed since 1990 with new genetically distinct strain types circulating among previously healthy people outside healthcare settings. Community-associated (CA) MRSA strains primarily cause skin and soft tissue infections, but may also cause life-threatening invasive infections. First seen in Australia and the U.S., it is a growing problem around the world. The U.S. has had the most widespread CA-MRSA epidemic, with strain type USA300 causing the great majority of infections. Individuals with either asymptomatic colonization or infection may transmit CA-MRSA to others, largely by skin-to-skin contact. Control measures have focused on hospital transmission. Limited public health education has focused on care for skin infections. Methods: We developed a fine-grained agent-based model for Chicago to identify where to target interventions to reduce CA-MRSA transmission. An agent-based model allows us to represent heterogeneity in population behavior, locations and contact patterns that are highly relevant for CA-MRSA transmission and control. Drawing on nationally representative survey data, the model represents variation in sociodemographics, locations, behaviors, and physical contact patterns. Transmission probabilities are based on a comprehensive literature review. Results: Over multiple 10-year runs with one-hour ticks, our model generates temporal and geographic trends in CA-MRSA incidence similar to Chicago from 2001 to 2010. On average, a majority of transmission events occurred in households, and colonized rather than infected agents were the source of the great majority (over 95%) of transmission events. The key findings are that infected people are not the primary source of spread. Rather, the far greater number of colonized individuals must be targeted to reduce transmission. Conclusions: Our findings suggest that current paradigms in MRSA control in the United States cannot be very effective in reducing the incidence of CA-MRSA infections. Furthermore, the control measures that have focused on hospitals are unlikely to have much population-wide impact on CA-MRSA rates. New strategies need to be developed, as the incidence of CA-MRSA is likely to continue to grow around the world.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2019

Safety of Single-Site Laparoscopic Surgery Requiring Perioperative Heparinization in Colorectal Cancer: Propensity Score-Matched Analysis

Background: We assessed the feasibility and safety of single-site laparoscopic surgery for patients with colorectal cancer who required perioperative heparinization. Methods: This retrospective study reviewed the medical records of 390 patients who underwent single-site laparoscopic surgery for colorectal cancer from January 2010 to December 2016. Antithrombotic drugs were stopped preoperatively and heparin was administered according to the operative risk of each patient, based on consultation with the cardiologist physician or neurosurgeon. Propensity score modeling was utilized to adjust for baseline characteristics. Results: Of 390 patients, 29 were treated with standard bridging intravenous heparin therapy. Propensity matching identified 119 patients: 22 patients in the heparinization group and 97 in the control group. The matched groups were not significantly different in operation times, bleeding volumes, or conversion rate. The mean postoperative hospital stay was 17.9 days in the heparinization group and 9.5 days in the control group (p = 0.034). Postoperative bleeding was observed in 4 patients (18.2%) in the heparinization group and 11 patients (11.4%) in the control group (p = 0.646), while other complications were similar in the two study groups (p = 0.502). Of these other complications, thromboembolic events were observed in two patients in the heparinization group and one patient in the control group. Conclusions: We found that single-site laparoscopic surgery for colorectal cancer with heparinization was feasible and safe. Heparinization did not increase the risk of postoperative bleeding complications, but postoperative hospital stay was prolonged.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2022

Six-Month Outcomes of Infants Born to People With SARS-CoV-2 in Pregnancy

OBJECTIVES To assess the 6-month incidence of laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, postnatal care, hospitalization, and mortality among infants born to people with laboratory-confirmed SARS-CoV-2 infection during pregnancy by timing of maternal infection. METHODS Using a cohort of liveborn infants from pregnancies with SARS-CoV-2 infections in the year 2020 from 10 United States jurisdictions in the Surveillance for Emerging Threats to Mother and Babies Network, we describe weighted estimates of infant outcomes from birth through 6 months of age from electronic health and laboratory records. RESULTS Of 6601 exposed infants with laboratory information through 6 months of age, 1.0% (95% confidence interval: 0.8–1.1) tested positive, 19.1% (17.5–20.6) tested negative, and 80.0% (78.4–81.6) were not known to be tested for SARS-CoV-2. Among those ≤14 days of age, SARS-CoV-2 infection occurred only with maternal infection ≤14 days before delivery. Of 3967 infants with medical record abstraction, breastmilk feeding initiation was lower when maternal infection occurred ≤14 days before delivery compared with >14 days (77.6% [72.5–82.6] versus 88.3% [84.7–92.0]). Six-month all-cause hospitalization was 4.1% (2.0–6.2). All-cause mortality was higher among infants born to people with infection ≤14 days (1.0% [0.4–1.6]) than >14 days (0.3% [0.1–0.5]) before delivery. CONCLUSIONS Results are reassuring, with low incidences of most health outcomes examined. Incidence of infant SARS-CoV-2, breastmilk feeding initiation, and all-cause mortality differed by timing of maternal infection. Strategies to prevent infections and support pregnant people with coronavirus disease 2019 may improve infant outcomes.

Pediatrics↗
DOE OSTI2020

Improving radiograph analysis throughput through transfer learning and object detection

SIGN Fracture Care International partners with surgeons in low-resource hospitals worldwide to provide access to effective orthopedic care by donating educational materials and innovatively designed surgical implants. Over two decades, SIGN’s Online Surgical Database (SOSD) has grown to contain over 500,000 medical images, with radiographs holding the majority share. One challenge in working with hospitals worldwide is that both the radiographs uploaded to the SOSD and the data entry accompanying the uploads vary in quality. To improve the accuracy of data in the SOSD, we trained a model to detect surgical implants in radiographs. We first developed a tool to automatically detect radiographs, then trained an object detection model to determine the number and placement of surgical implants visible in the radiograph. Active learning was used to generate a training set containing 2,510 radiographs with screws, nails, and plates labeled by bounding boxes. Training a model to simultaneously recognize all three classes of implants gave a low average precision (AP) for the plate class, likely due to the low number of plate instances in our training set and the large variety of surgical plates used by SIGN-partnered surgeons. Applying standard image augmentation techniques to increase the plate count in our training set did not appreciably increase the AP of plate detection. To improve plate detection, we redrew the bounding boxes to account for correlations between the screw and plate classes. Training one model to detect nails and screws and a separate model to detect plates increased the AP of plate detection by 78.8 percentage points. The AP of each class was 80.7% for screws, 93.6% for nails, and 92.6% for plates; meanwhile, the sensitivity was 92% for screws, 86% for nails, and 81% for plates. We show that object detection methods can be used to detect surgical implants in radiographs of varying quality; however, the detection ability is dependent on the type of implant, and some implants, in our case plates, must be treated differently than others. Such tools can improve the throughput of radiograph analysis, assisting physicians and surgeons with the treatment of bone fractures.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

Emergency response agencies in most US communities are organized, sized, and equipped to manage those emergencies normally expected. Hospitals in particular do not typically have significant excess capacity to handle massive numbers of casualties, as hospital space is an expensive luxury if not needed. Unfortunately this means that in the event of a mass casualty chemical incident the emergency response system will be overwhelmed. This document provides a self-assessment means for emergency managers to examine their response system and identify shortfalls. It also includes lessons from a detailed analysis of five communities: Baltimore, Boise, Houston, Nassau County, and New Orleans. These lessons provide a list of potential critical decisions to allow for pre-planning and a library of best practices that may be helpful in reducing casualties in the event of an incident.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
DOE OSTI2018

MR-Compatible Surgical Instruments Final Report CRADA No. TSB-0847-94

ITI is a California-based company formed in February 1994 to design, manufacture and market premium quality magnetic resonance imaging (MRI) medical devices and instruments. These products are for use in existing MR irnagers, as well as for emerging applications in reaI-tirne MRI-guided surgery and interventional radiology. Such application require products that are MR biocompatible and in many cases MR visible. In an era of managed health care, purchasing decisions by hospitals, medical centers and insurers emphasize cost-effectiveness. Since minimally invasive therapy reduces surgical costs, shortens hospital stay and post-operative rehabilitation, this segment of the health care industry is expected to grow rapidly. Many experts believe that high-speed MRI-guided therapy offers the best opportunity to maximize the benefits of minimally invasive procedures because MIH enables the clearest differentiation of normal from abnormal tissues. Manufacturers of conventional imagers, including General Electric, Siemens, and Philips, have aleady made substantial investments aid produced prototype high-speed MRI.imagers to permit continuous real-time visualization of tissues during surgical and endovascular procedures. According to forecasts published by the National Electrical Manufacturers Association (1993) and the Medical and Healthcare Marketplace Guide (1992), the average world~wide growth rate of MN installations is expected to be about 7% annually for the next three years, increasing 12-15% annually thereafter as developing countries buy increasing numbers of MM units. The same forecasters project 17,000- 20,000 MRI irnagers world-wide by the year 2000, with a throughput of 2,300-6,000 patients per machine per year, at an.average examination cost.of $560-780-per-patient.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Power System Resilience Metrics Augmentation for Critical Load Prioritization

One of the major goals of new grid operation regimes, such as transactive energy systems (TESs), is to make the power grid more resilient to withstand natural or man-made disasters and potential reliability events, and to continue to serve the maximum number of its customers. But it is a well-known fact to system operators that not all customers are the same. This implies that any discussion of TESs’ impacts on the resilience of the power system should consider the needs of its critical customers (such as the power system operation centers, fire and police stations, and hospitals) over those of other customers. When evaluating the resilience of the system, bonus points must be awarded to any system that could maintain its power supply to critical customers during a disturbance that may cause an outage. This report discusses critical infrastructure (CI) as found in the literature and then categorizes it based on the field to which the operations belong (such as human life/safety-related, operations management, necessary city operation, industrial customers, etc.). Each of these CI categories is further divided into types of critical customers (e.g., the human life/safety-related category has different types of customers like hospitals, fire and police stations, etc.). The entire demand of each of the critical customer types is not categorized as critical load (CL); instead, only a portion of the total load of these critical customers is characterized as critical load. This is done based on the categories of equipment, the function of which is crucial in the operation of the overall facility. CL categorization is performed to provide the ratio of the critical load portion to the overall load , so that it can serve as a parameter in the resilience evaluation of the grid through a metrics-based approach. Such categorization is important as it helps to augment the existing quantifiable resilience metrics with CL categorization. The metrics for a power system need to not only consider how well a system performed during a disturbance event, but also how it reduced strain and supplied power to its CLs. The first step in this process is characterize CLs in the system. After CL characterization, the next step is the inclusion of these loads in the resilience metrics. To that end, in this report weight-based augmentation of resilience metrics is proposed, where certain customers (the ones that are categorized as critical) are assigned higher weights than others. Though an overview of assigning weights to customers is discussed, there is no one-size-fits-all approach for every power system. The decisions made about assigning such weights to customers vary greatly from one operator to another, based on their unique systems and the current and predicted states of critical customers. This decision-making can include the type of disturbance event, which might only affect certain parts of the system. In general, analyzing critical customers before an event helps understand system vulnerabilities. It also helps in planning and conducting operations during the event, evaluating system performance after the event, and supporting better planning for future events. An alternative to the current practices of managing the grid for outages is an innovative TES, which has the potential to provide a platform for including distributed energy resources for managing CLs. This report also describes how TES qualities can help (1) to maintain power supply to critical customers for uninterrupted operations and (2) to restore lost power supply to the critical customers rapidly.

24 POWER TRANSMISSION AND DISTRIBUTION↗
DOE OSTI2020

Multi-omics Characterization of the Host Response to COVID-19

This project is a multi-disciplinary collaboration between investigators at PNNL with expertise in mass spectrometry (MS)-based omics technology development, omics measurement methods development and application, statistics, machine learning and integration of disparate datasets for a systems-level understanding, and expertise in pathogenic coronaviruses, and investigators at the University of Wisconsin-Madison (UW-Madison) with expertise in pathogenic respiratory viruses (e.g. influenza). The goal of this project is to obtain a comprehensive picture of the human host factors critical for the outcome of SARS-CoV-2 infection. We will generate broad untargeted multi-omics profiles using both state-of-the-art and novel instrumentation and approaches to enable the identification of the molecular mechanisms and host response pathways that impact human COVID-19 outcomes. We anticipate these results will lead to the generation of biomarker panels that are predictive of disease outcomes and mechanistic hypotheses that can be further interrogated in future studies and will provide the basis for vaccine or therapeutic development. To do so, we are obtaining and analyzing blood samples from COVID-19 patients with a range of disease outcomes that were treated at the Center Hospital of the National Center for Global Health and Medicine in Tokyo, Japan and other collaborating hospitals in our network. Specifically, this project will fund proteomics and metabolomics analyses of clinical COVID samples, machine learning-based integration of the data, and pathway-based interpretation of the data. This project was funded in June 2020. In the time span of June to September 2020, the project team developed an analytically and statistically robust analysis plan and made various preparations to facilitate sample receipt from our UW-Madison collaborators. This included blocking and randomization of sample prep orders, ordering of reagents and reference materials, and shipping of materials needed for preparation of the samples under BSL3 conditions to our collaborators at UW-Madison. As of FY21, this project has been picked up via a sponsor, the Naval Medical Research Center, which will cover the remainder of the proposed scope of work.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

Prefeasibility Assessment for Solar PV and Storage for Critical Community Facilities in Chernihiv, Ukraine [Slides]

A prefeasibility analysis is performed for integrating solar photovoltaics and battery energy storage at four critical facilities in Chernihiv, Ukraine. The facilities were identified by Chernihiv city officials and include Hospital No. 2, the Maternity Hospital, Secondary School No. 11, and Preschool No. 4. The analyses were performed using NREL's REopt decision-support software tool. The analysis identifies potential capacities for PV and battery energy storage to provide both economic and resilience benefits. The conceptual architecture and estimates of key summary financial and performance metrics are presented.

14 SOLAR ENERGY↗
DOE OSTI2022

Precursor Analysis Report: Conti Ransomware Attack on the Health Service Executive of Ireland 2021

The Conti Ransomware Attack on the Health Service Executive (HSE) of Ireland 2021 Precursor Analysis Report leverages publicly available information about the attack and catalogs anomalous observables for each technique employed by the adversary. This analysis is based upon the methodology of the Cybersecurity for the Operational Technology Environment (CyOTE) program. The HSE provides public healthcare corporate services and operational services throughout Ireland, with critical functions including the acute national ambulance service, acute hospital service, and community healthcare service. On 14 May 2021, Conti ransomware encrypted 80 percent of the HSE’s Information Technology (IT) infrastructure across corporate, hospital, community, and electronic health record services. Conti is a ransomware-as-a-service operation that encrypts local files, uses double extortion against victims, and is facilitated by many intrusion tools. The attack forced the HSE to shut down its entire IT infrastructure to contain the ransomware, forcing employees to revert to pen and paper recordkeeping and leading to the cancellation of many appointments and procedures. The adversary also exfiltrated 700 GB of data, compromising the confidentiality of patients’ protected health information. Had the adversary targeted the COVID-19 cloud systems or operational technology assets, such as Internet of Medical Things medical devices or smart building management systems, the impact of the attack would almost certainly have been far more severe. Researchers and analysts identified 21 unique techniques (used in a sequence of 23 steps) likely utilized during the attack with a total of 1,185 observables using MITRE ATT&CK® for Industrial Control Systems. The CyOTE program assesses observables accompanying techniques used prior to the triggering event to identify opportunities to detect malicious activity. If observables accompanying the attack techniques are perceived and investigated prior to the triggering event, earlier comprehension of malicious activity can take place. Twenty-one of the identified techniques used during the attack on the HSE were precursors to the triggering event. Analysis identified 1,086 observables associated with these precursor techniques, 850 of which were assessed to have an increased likelihood of being perceived in the 57 days preceding the triggering event. The response and comprehension time could have been reduced if the observables had been identified earlier. The information gathered in this report contributes to a library of observables tied to a repository of artifacts, data sources, and technique detection references for practitioners and developers to support the comprehension of indicators of attack. Asset owners and operators can use these products if they experience similar observables or to prepare for comparable scenarios.

45 MILITARY TECHNOLOGY, WEAPONRY, AND NATIONAL DEF↗
DOE OSTI2024

In vivo evaluation of an adaptive resuscitation controller using whole blood and crystalloid infusates for hemorrhagic shock

Introduction Hemorrhage remains the leading cause of preventable death on the battlefield. The most effective means to increase survivability is early hemorrhage control and fluid resuscitation. Unfortunately, fluid resuscitation requires constant adjustments to ensure casualty is properly managed, which is often not feasible in the pre-hospital setting. In this study, we showed how an adaptive closed-loop controller for hemorrhage resuscitation can be used to automate hemodynamic management using a swine hemorrhagic shock injury model. Methods The adaptive resuscitation controller (ARC) was previously developed to track pressure–volume responsiveness in real time and adjust its infusion rate to reach the target mean arterial pressure (MAP). Swine while maintained under a surgical plane of anesthesia and analgesia underwent a splenectomy, followed by two hemorrhage and resuscitation events. For the first resuscitation event, hemorrhage was induced to reduce the MAP to 35 mmHg until arterial lactate reached 4 mmol/L. The ARC system then infused whole blood (WB) to reach the target MAP and maintained the subject using crystalloids for 120 min. For the second resuscitation event, the subjects were hemorrhaged again but resuscitated using only crystalloid infusion to reach the target MAP and 120-min maintenance. Results The ARC was effective at WB resuscitation, reaching the target MAP in 2.0 ± 1.0 min. The median performance error was 1.1% ± 4.6%, and target overshoot was 14.4% ± 7.0% of the target MAP. The ARC maintained all animals throughout the 120 min maintenance period. For the second crystalloid-based resuscitation, ARC required a longer time to reach the target MAP, at an average rise time of 4.3 ± 4.0 min. However, target overshoot was reduced to 8.4% ± 7.3% of the target MAP. Much higher flow rates were required to maintain the target MAP during the second resuscitation event than during the first resuscitation event. Discussion The ARC was able to rapidly reach and maintain the target MAP effectively. However, this sometimes required large volumes of fluid as the ARC’s only goal was to reach the target MAP. Further clinical insight is needed regarding the preferred aggression level to achieve the target MAP. In conclusion, the ARC was successful in its programmed objective of reaching and maintaining the target MAP for extended periods of time in vivo , a critical next step toward improving hemorrhage treatment in the pre-hospital environment.

Snider, Eric J.↗
DOE OSTI2024

Prognostic analysis of high-flow nasal cannula therapy and non-invasive ventilation in mild to moderate hypoxemia patients and construction of a machine learning model for 48-h intubation prediction—a retrospective analysis of the MIMIC database

Background This study aims to investigate the clinical outcome between high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) therapy in mild to moderate hypoxemic patients on the first ICU day and to develop a predictive model of 48-h intubation. Methods The study included adult patients from the MIMIC III and IV databases who first initiated HFNC or NIV therapy due to mild to moderate hypoxemia (100 < PaO2/FiO2 ≤ 300). The 48-h and 30-day intubation rates were compared using cross-sectional and survival analysis. Nine machine learning and six ensemble algorithms were deployed to construct the 48-h intubation predictive models, of which the optimal model was determined by its prediction accuracy. The top 10 risk and protective factors were identified using the Shapley interpretation algorithm. Result A total of 123,042 patients were screened, of which, 673 were from the MIMIC IV database for ventilation therapy comparison (HFNC n = 363, NIV n = 310) and 48-h intubation predictive model construction (training dataset n = 471, internal validation set n = 202) and 408 were from the MIMIC III database for external validation. The NIV group had a lower intubation rate (23.1% vs. 16.1%, p = 0.001), ICU 28-day mortality (18.5% vs. 11.6%, p = 0.014), and in-hospital mortality (19.6% vs. 11.9%, p = 0.007) compared to the HFNC group. Survival analysis showed that the total and 48-h intubation rates were not significantly different. The ensemble AdaBoost decision tree model (internal and external validation set AUROC 0.878, 0.726) had the best predictive accuracy performance. The model Shapley algorithm showed Sequential Organ Failure Assessment (SOFA), acute physiology scores (APSIII), the minimum and maximum lactate value as risk factors for early failure and age, the maximum PaCO 2 and PH value, Glasgow Coma Scale (GCS), the minimum PaO 2 /FiO 2 ratio, and PaO 2 value as protective factors. Conclusion NIV was associated with lower intubation rate and ICU 28-day and in-hospital mortality. Further survival analysis reinforced that the effect of NIV on the intubation rate might partly be attributed to the other impact factors. The ensemble AdaBoost decision tree model may assist clinicians in making clinical decisions, and early organ function support to improve patients’ SOFA, APSIII, GCS, PaCO 2 , PaO 2 , PH, PaO 2 /FiO 2 ratio, and lactate values can reduce the early failure rate and improve patient prognosis.

Fu, Wei↗
DOE OSTI2023

Infant burn injuries related to water heating for powdered infant formula preparation

Guidance for preparing powdered infant formula (PIF) helps to ensure it meets the nutritional needs of infants and is safe to consume. Among safety concerns is Cronobacter sakazakii contamination which can lead to serious infections and death. PIF preparation guidance varies; there is a lack of consensus on whether there is a need to boil water to inactivate potential Cronobacter and for how long to let the water cool before reconstitution. We sought to quantify the burden of burn injuries among infants related to water heating for PIF preparation. Estimating this burden may help inform preparation recommendations. Burn injuries among infants <18 months of age were identified from 2017 to 2019 National Electronic Injury Surveillance System data collected from sampled hospital emergency departments. Injuries were classified as related to PIF water heating, potentially related to PIF water heating but with undetermined causation, related to other infant feeding aspects, or unrelated to infant formula or breast milk feeding. Unweighted case counts for each injury classification were determined. Across sampled emergency departments, 7 PIF water heating injuries were seen among the 44,395 injuries reported for infants <18 months. No reported PIF water heating injuries were fatal, but 3 required hospitalization. Another 238 injuries potentially related to PIF water heating but with undetermined causation were also seen. Preparation guidance should consider both the potential risk for Cronobacter infection and the potential risk for burns.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

Evaluation of Deep Learning Model Architectures for Point-of-Care Ultrasound Diagnostics

Point-of-care ultrasound imaging is a critical tool for patient triage during trauma for diagnosing injuries and prioritizing limited medical evacuation resources. Specifically, an eFAST exam evaluates if there are free fluids in the chest or abdomen but this is only possible if ultrasound scans can be accurately interpreted, a challenge in the pre-hospital setting. In this effort, we evaluated the use of artificial intelligent eFAST image interpretation models. Widely used deep learning model architectures were evaluated as well as Bayesian models optimized for six different diagnostic models: pneumothorax (i) B- or (ii) M-mode, hemothorax (iii) B- or (iv) M-mode, (v) pelvic or bladder abdominal hemorrhage and (vi) right upper quadrant abdominal hemorrhage. Models were trained using images captured in 27 swine. Using a leave-one-subject-out training approach, the MobileNetV2 and DarkNet53 models surpassed 85% accuracy for each M-mode scan site. The different B-mode models performed worse with accuracies between 68% and 74% except for the pelvic hemorrhage model, which only reached 62% accuracy for all model architectures. These results highlight which eFAST scan sites can be easily automated with image interpretation models, while other scan sites, such as the bladder hemorrhage model, will require more robust model development or data augmentation to improve performance. With these additional improvements, the skill threshold for ultrasound-based triage can be reduced, thus expanding its utility in the pre-hospital setting.

47 OTHER INSTRUMENTATION↗
NASA NTRS1974

Development and fabrication of heat-sterilizable inhalation therapy equipment

The development of a completely heat sterilizable intermittent positive pressure breathing (IPPB) ventilator in an effort to reduce the number of hospital acquired infections is reported. After appropriate changes in materials and design were made, six prototype units were fabricated and were successfully field tested in local hospitals. Most components of the modified ventilators are compatible with existing machines. In all but a few instances, such as installation of bacteria-retentive filters and a modified venturi, the change over from non-heat-sterilizable to sterilizable units was accomplished by replacement of heat labile materials with heat stable materials.

Irons, A. S.↗
NASA NTRS1974

Current therapeutic techniques and rehabilitation from neurological disorders

Rancho Los Amigos Hospital is a 1100-bed teaching hospital that is primarily oriented toward rehabilitation. The individual services that deal with neuromuscular disorders are categorically disease entity oriented: They are directed toward the major problems, such as spinal cord injuries, amputations, stroke, cerebral palsy, and rheumatoid arthritis. The services at Rancho cross many traditional medical specialty barriers.

Nickel, V. L.↗
NASA NTRS1980

An assessment of alternative fuel cell designs for residential and commercial cogeneration

A comparative assessment of three fuel cell systems for application in different buildings and geographic locations is presented. The study was performed at the NASA Lewis Center and comprised the fuel cell design, performance in different conditions, and the economic parameters. Applications in multifamily housing, stores and hospitals were considered, with a load of 10kW-1 MW. Designs were traced through system sizing, simulation/evaluation, and reliability analysis, and a computer simulation based on a fourth-order representation of a generalized system was performed. The cells were all phosphoric acid type cells, and were found to be incompatible with gas/electric systems and more favorable economically than the gas/electric systems in hospital uses. The methodology used provided an optimized energy-use pattern and minimized back-up system turn-on.

Wakefield, R. A.↗
NASA NTRS1992

Combining constraint satisfaction and local improvement algorithms to construct anaesthetists' rotas

A system is described which was built to compile weekly rotas for the anaesthetists in a large hospital. The rota compilation problem is an optimization problem (the number of tasks which cannot be assigned to an anaesthetist must be minimized) and was formulated as a constraint satisfaction problem (CSP). The forward checking algorithm is used to find a feasible rota, but because of the size of the problem, it cannot find an optimal (or even a good enough) solution in an acceptable time. Instead, an algorithm was devised which makes local improvements to a feasible solution. The algorithm makes use of the constraints as expressed in the CSP to ensure that feasibility is maintained, and produces very good rotas which are being used by the hospital involved in the project. It is argued that formulation as a constraint satisfaction problem may be a good approach to solving discrete optimization problems, even if the resulting CSP is too large to be solved exactly in an acceptable time. A CSP algorithm may be able to produce a feasible solution which can then be improved, giving a good, if not provably optimal, solution.

Smith, Barbara M.↗