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Fluid-loading solutions and plasma volume: Astro-ade and salt tablets with water

Fluid loading with salt and water is a countermeasure used after space flight to restore body fluids. However, gastrointestinal side effects have been frequently reported in persons taking similar quantities of salt and water in ground-based studies. The effectiveness of the Shuttle fluid-loading countermeasure (8 gms salt, 0.97 liters of water) was compared to Astro-ade (an isotonic electrolyte solution), to maintain plasma volume (PV) during 4.5 hrs of resting fluid restriction. Three groups of healthy men (n=6) were studied: a Control Group (no drinking), an Astro-ade Group, and a Salt Tablet Group. Changes in PV after drinking were calculated from hematocrit and hemoglobin values. Both the Salt Tablet and Astro-ade Groups maintained PV at 2-3 hours after ingestion compared to the Control Group, which had a 6 percent decline. Side effects (thirst, stomach cramping, and diarrhea) were noted in at least one subject in both the Astro-ade and Salt Tablet Groups. Nausea and vomiting were reported in one subject in the Salt Tablet Group. It was concluded that Astro-ade may be offered as an alternate fluid-loading countermeasure but further work is needed to develop a solution that is more palatable and has fewer side effects.

Fortney, Suzanne M.↗

Stratospheric Ozone Response in Experiments G3 and G4 of the Geoengineering Model Intercomparison Project (GeoMIP)

Geoengineering with stratospheric sulfate aerosols has been proposed as a means of temporarily cooling the planet, alleviating some of the side effects of anthropogenic CO2 emissions. However, one of the known side effects of stratospheric injections of sulfate aerosols is a decrease in stratospheric ozone. Here we show results from two general circulation models and two coupled chemistry climate models that have simulated stratospheric sulfate aerosol geoengineering as part of the Geoengineering Model Intercomparison Project (GeoMIP). Changes in photolysis rates and upwelling of ozone-poor air in the tropics reduce stratospheric ozone, suppression of the NOx cycle increases stratospheric ozone, and an increase in available surfaces for heterogeneous chemistry modulates reductions in ozone. On average, the models show a factor 20-40 increase of the sulfate aerosol surface area density (SAD) at 50 hPa in the tropics with respect to unperturbed background conditions and a factor 3-10 increase at mid-high latitudes. The net effect for a tropical injection rate of 5 Tg SO2 per year is a decrease in globally averaged ozone by 1.1-2.1 DU in the years 2040-2050 for three models which include heterogeneous chemistry on the sulfate aerosol surfaces. GISS-E2-R, a fully coupled general circulation model, performed simulations with no heterogeneous chemistry and a smaller aerosol size; it showed a decrease in ozone by 9.7 DU. After the year 2050, suppression of the NOx cycle becomes more important than destruction of ozone by ClOx, causing an increase in total stratospheric ozone. Contribution of ozone changes in this experiment to radiative forcing is 0.23 W m-2 in GISS-E2-R and less than 0.1 W m-2 in the other three models. Polar ozone depletion, due to enhanced formation of both sulfate aerosol SAD and polar stratospheric clouds, results in an average 5 percent increase in calculated surface UV-B.

aerosol↗

DF-1, A Nontoxic Carbon Fullerene Based Antioxidant, is Effective as a Biomedical Countermeasure Against Radiation

A long-term goal of radiation research is the mitigation of inherent risks of radiation exposure. Thus the study and development of safe agents, whether biomedical or dietary, that act as effective radioprotectors is an important step in accomplishing this long-term goal. Some of the most effective agents to date have been aminothiols and their derivatives. Unfortunately, most of these agents have side effects such as nausea, vomiting, hypotension, weakness, and fatigability. For example, nausea and emesis occur in most patients treated with WR-2721 (Amifostine), requiring the use of effective antiemetics, with hypotension being the dose-limiting side effect in patients treated. Clearly, the need for a radioprotector that is both effective and safe still exists. Development of biocompatible nano-materials for radioprotection is a promising emerging technology that could be exploited to address the need to minimize biological effects when exposure is unavoidable. Testing free radical scavenging nanoparticles for potential use in radioprotection is exciting and highly relevant. Initial investigations presented here demonstrate the ability of a particular functionalized carbon fullerene nanoparticle, (DF-1), to act as an effective radioprotector. DF-1 was first identified as the most promising candidate in a screen of several functionalized carbon fullerenes based on lack of toxicity and antioxidant therapeutic potential against oxidative injuries (i.e. organ reperfusion and ionizing radiation). Subsequently, DF-1 has been shown to reduce chromosome aberration yield and cell death, as well as overall ROS levels in human lymphocytes and fibroblasts after exposure to gamma radiation and energetic protons while demonstrating no associated toxicity. The dose-reducing factor of DF-1 at LD50 is nearly 2.0 for gamma radiation. In addition, DF-1 treatment also significantly prevented cell cycle arrest after exposure. Finally, DF-1 markedly attenuated COX2 upregulation in cell culture after irradiation thus preventing an inflammatory response to irradiation. Taken together, these results suggest that DF-1 provides potent protection against several deleterious cellular consequences of irradiation in mammalian systems including oxidative stress, DNA damage, inflammation and cell death.

Theriot, Corey A.↗

Effect of neurovestibular stimulation on autonomic regulation

Conditions associated with nausea and vomiting, such as motion sickness or side effects of medications, are commonly associated with a clinical picture consistent with parasympathetic activation and sympathetic withdrawal. It can be postulated, therefore, that vestibular stimulation contributes to sympathetic withdrawal. To test this hypothesis five normal volunteers, 24-33 years old, were studied during caloric vestibular stimulation while monitoring muscle sympathetic nerve activity directly through a needle electrode placed in a peroneal nerve. The ear was irrigated with water at a flow rate of 450 ml/min and 37 degrees C. The water temperature was sequentially lowered by 7 degree C intervals until intolerable side effects developed or a temperature of 16 degrees C was reached. Nystagmus was induced in all subjects, but heart rate, blood pressure, muscle sympathetic nerve activity and plasma norepinephrine levels did not change significantly during or after caloric stimulation, even when the subjects felt dizzy and nauseated. No evidence of sympathetic withdrawal was observed in any subject either by muscle sympathetic nerve activity or plasma norepinephrine measurements. In conclusion, we have found that selective vestibular stimulation is not accompanied by significant changes in the sympathetic nervous system function. In particular, no sympathetic withdrawal was observed. It could be argued that lack of sympathetic stimulation is an inadequate response to the symptoms associated with caloric stimulation.

Clinical Trial↗

The Evolution of the Impact Evidence Library Methods – What We Learned

During fiscal years 2020-2022 NASA’s Human Research Program, Exploration Medical Capability Element has worked to source this evidence for the model. During the process several lessons learned have been identified and drive recommendations for future efforts. The ICL 1.0: Spaceflight Medical Operational expertise should be consulted regarding the addition of future conditions. A clinician experienced with the nuances of spaceflight is recommended to have a minimum of 20 hours per condition to adequately source the evidence. Condition definitions should be carefully crafted to maintain mutual exclusivity. Common side effects from medications, common and consequential incidental findings in laboratory studies, and consequential side effects of diagnostic and procedural capabilities should be considered for inclusion as unique conditions in future iterations of the ICL 1.0. Incidence: Spaceflight incidence, although based on small population sizes, is the gold standard. Terrestrial incidence should be applied cautiously. Probability of minor vs. severe cases of the condition: Data informing severity probability of the medical condition are nearly always terrestrial. Special attention should be paid to this metric as it drives outcomes in the model and terrestrial data often overestimate severity of expected cases in spaceflight. Condition duration: Three clinical phases currently exist in the model. They represent the time necessary for diagnosis, treatment/convalescence/recurrence, and the remaining duration of the mission after maximal recovery, respectively. Further subdivision of acute and convalescent treatment/recurrence is recommended. Probability of need for evacuation: Surrogates for “Return to Definitive Care” were chosen prior to data collection. In most cases these surrogates were “need for hospitalization” or “need for surgery.” For many conditions these may not be realistic drivers of “Return to Definitive Care” and should be re-examined. Probability of Crew Mortality: Terrestrial mortality data is difficult to apply to astronauts who, invariably, have less comorbidities than terrestrial subjects. It must be applied judiciously. The proportion of mission tasks impaired by the condition: “Task Impairment” was assigned to each condition prior to the condition duration data becoming available. Future efforts should assign Task Impairment as the final step in sourcing the evidence.

A.J. Kreykes↗

Vestibular mechanisms underlying certain problems in a rotating spacecraft

Vestibular side effects are discussed with the aid of a conceptual framework based on an analysis of vestibular input-output relations. These side effects tend to fall into two main categories: (1) Reflex phenomena, and (2) motion sickness, a delayed epiphenomenon. Although the symptomatology of motion sickness is similar wherever experienced, both the eliciting stimuli and the opportunity to adapt may differ in different motion environments. These differences not only are exemplified when motion sickness is compared in a weightless and in a rotating environment, but they also point to important differences in the problem of preventing (or treating) motion sickness in these two very different environments.

Graybiel, A.↗

Quasi-linear toroidal simulations of resonant magnetic perturbations in eight ITER H-mode scenarios

Abstract Both linear and quasi-linear aspects of the plasma response to the resonant magnetic perturbation (RMP) field are numerically investigated for various H-mode scenarios in ITER, covering the pre-fusion power operation and the fusion power operation phases. Linear response computations for eight ITER scenarios, with varying plasma current and toroidal magnetic field, reveal that the best coil current phasing for controlling the type-I edge localized modes (ELMs) scales roughly linearly with the edge safety factor. The coil phasing is defined as the relative toroidal phase of the coil currents between different rows, for a given toroidal harmonic. Quasi-linear initial value simulation, which is the focus of the present study, shows that application of the n = 3 ( n is the toroidal mode number) RMP field has a minimum side effect on the plasma core momentum confinement but potentially a large effect on the global particle transport. Generally, the RMP field with the best (worst) coil phasing for ELM control produces the strongest (weakest) effect on the plasma edge flow and the overall density. This robustly holds for all eight ITER scenarios. Consequently, in order to minimize the RMP induced side effects while achieving ELM control (suppression) in ITER, a compromise is necessary in choosing the coil current configuration.

Physics↗

Bioavailability of Promethazine during Spaceflight

Promethazine (PMZ) is the choice anti-motion sickness medication for treating space motion sickness (SMS) during flight. The side effects associated with PMZ include dizziness, drowsiness, sedation, and impaired psychomotor performance which could impact crew performance and mission operations. Early anecdotal reports from crewmembers indicate that these central nervous system side effects of PMZ are absent or greatly attenuated in microgravity, potentially due to changes in pharmacokinetics (PK) and pharmacodynamics in microgravity. These changes could also affect the therapeutic effectiveness of drugs in general and PMZ, in particular. In this investigation, we examined bioavailability and associated pharmacokinetics of PMZ in astronauts during and after space flight. Methods. Nine astronauts received, per their preference, PMZ (25 or 50 mg as intramuscular injection, oral tablet, or rectal suppository) on flight day one for the treatment of SMS and subsequently collected saliva samples and completed sleepiness scores for 72 h post dose. Thirty days after the astronauts returned to Earth, they repeated the protocol. Bioavailability and PK parameters were calculated and compared between flight and ground. Results. Maximum concentration (Cmax) was lower and time to reach Cmax (tmax) was longer in flight than on the ground. Area under the curve (AUC), a measure of bioavailability, was lower and biological half-life (t1/2) was longer in flight than on the ground. Conclusion. Results indicate that bioavailability of PMZ is reduced during spaceflight. Number of samples, sampling method, and sampling schedule significantly affected PK parameter estimates.

Boyd, Jason L.↗

Evaluation of Intranasal Scopolamine for the Prevention of Wave Motion Induced Motion Sickness While Maintaining Performance on Operationally Relevant Tasks

Motion sickness represents one of the greatest clinical challenges impacting crew activities during and following g-transitions. Our overall goal is to characterize the effectiveness of motion sickness countermeasures during controlled laboratory experiments using capsule wave motion simulation and during field testing in operational environments. This laboratory study focused on prevention of motion sickness using intranasal scopolamine using a double-blinded repeated measures design in 30 subjects (19M, 11F). Intranasal scopolamine was provided by Defender Pharmaceuticals, Inc. (DPI-386 Nasal Gel, referred to as Inscop) self-administered by a nasal pump (Aptar Pharma) that delivers 0.4 mg dose (0.2 mg / nostril). During each session, subjects were exposed to complex wave motion on a six degree-of-freedom platform that included pitch, roll and heave at provocative stimulus frequencies (0.1-0.25 Hz) while seated in an illuminated cabin deprived of external visual cues. Motion sickness symptoms were compared across treatment and placebo control sessions counterbalanced across subjects and separated by at least one week. The time-to-motion sickness endpoint was based on severe malaise, defined as symptom score of ≥8 points using the Pensacola Diagnostic Index [1]. The bioavailability of scopolamine for each session was estimated from plasma concentrations obtained every 15 min[2]. Side effects during the treatment session were minimal, and performance was not impaired on a test battery including motion perception tracking, tablet-based eye-hand coordination and psychomotor vigilance testing. The plasma concentration remained near-peak levels throughout the 45 min motion sickness testing for most subjects. The percentile ranking on the Motion Sickness Susceptibility Questionnaire [MSSQ, 3]was moderately correlated with the motion sickness time-to-endpoint during the placebo control session (rho = –0.3, p=0.056). Seventeen subjects did not reach an endpoint during their placebo session and were eliminated from subsequent analysis. Another subject was excluded due to insufficient plasma concentration during the treatment session. For the remaining 12 subjects, the change in time-to-motion sickness endpoint between placebo and treatment sessions was moderately correlated with plasma concentration (rho =0.48, p = 0.056), improving on average 4.4 ± 18.4 min, mean ± std with Inscop versus placebo. Our results are consistent with previous findings that intranasal delivery of scopolamine can be effective at reducing motion sickness symptoms with minimal cognitive or sedative side effects. Future work is needed to optimize the delivery of Inscop for rescue (treatment) of symptoms following g-transitions as one of the key advantages of this formulation is self-administration in a suited environment. We will also explore how the combination of Inscop with non-pharmaceutical sensory aids, e.g., vibrotactile feedback of Earth vertical, may further mitigate motion sickness and improve task performance.

S J Wood↗

Revisiting the Effects of Xenon on Urate Oxidase and Tissue Plasminogen Activator: No Evidence for Inhibition by Noble Gases

Although chemically inert, Xe and other noble gases have been shown to have functional effects on biological systems. For example, Xe is a powerful anesthetic with neuroprotective properties. Recent reports have claimed that Xe inhibits the activity of tissue plasminogen activator (tPA) and urate oxidase (UOX), indicating that the use of Xe as an anesthetic may have undesirable side effects. Here, we revisited the methods used to demonstrate Xe inhibition of UOX and tPA, testing both indirect and direct gas delivery methods with variable bubble sizes and gas flowrates. Our results indicate that Xe or Kr do not affect the activity of UOX or tPA and that the previously reported inhibition is due to protein damage attendant to directly bubbling gases into protein solutions. The lack of evidence to support Xe inhibition of UOX or tPA alleviates concerns regarding possible side effects for the clinical application of Xe as an anesthetic. Furthermore, this study illustrates the importance of using indirect methods of gas dissolution for studying gas-protein interactions in aqueous solution.

59 BASIC BIOLOGICAL SCIENCES↗

Sensorimotor aspects of high-speed artificial gravity: III. Sensorimotor adaptation

As a countermeasure to the debilitating physiological effects of weightlessness, astronauts could live continuously in an artificial gravity environment created by slow rotation of an entire spacecraft or be exposed to brief daily "doses" in a short radius centrifuge housed within a non-rotating spacecraft. A potential drawback to both approaches is that head movements made during rotation may be disorienting and nauseogenic. These side effects are more severe at higher rotation rates, especially upon first exposure. Head movements during rotation generate aberrant vestibular stimulation and Coriolis force perturbations of the head-neck motor system. This article reviews our progress toward distinguishing vestibular and motor factors in side effects of rotation, and presents new data concerning the rates of rotation up to which adaptation is possible. We have studied subjects pointing to targets during constant velocity rotation, because these movements generate Coriolis motor perturbations of the arm but do not involve unusual vestibular stimulation. Initially, reaching paths and endpoints are deviated in the direction of the transient lateral Coriolis forces generated. With practice, subjects soon move in straighter paths and land on target once more. If sight of the arm is permitted, adaptation is more rapid than in darkness. Initial arm movement trajectory and endpoint deviations are proportional to Coriolis force magnitude over a range of rotation speeds from 5 to 20 rpm, and there is rapid, complete motor adaptation at all speeds. These new results indicate that motor adaptation to high rotation rates is possible. Coriolis force perturbations of head movements also occur in a rotating environment but adaptation gradually develops over the course of many head movements.

Non-NASA Center↗

Vivid Motor Imagery as an Adaptation Method for Head Turns on a Short-Arm Centrifuge

Artificial gravity (AG) has been proposed as a potential countermeasure to the debilitating physiological effects of long duration space flight. The most economical means of implementing AG may be through the use of a short-radius (2m or less) centrifuge. For such a device to produce gravitational forces comparable to those on earth requires rotation rates in excess of 20 revolutions per minute (rpm). Head turns made out of the plane of rotation at these rates, as may be necessary if exercise is combined with AG, result in cross-coupled stimuli (CCS) that cause adverse side effects including motion sickness, illusory sensations of motion, and inappropriate eye movements. Recent studies indicate that people can adapt to CCS and reduce these side effects by making multiple head turns during centrifuge sessions conducted over consecutive days. However, about 25% of the volunteers for these studies have difficulty tolerating the CCS adaptation paradigm and often drop out due to motion sickness symptoms. The goal of this investigation was to determine whether vivid motor imagery could be used as a pseudostimulus for adapting subjects to this unique environment. Twenty four healthy human subjects (14 males, 10 females), ranging in age from 21 to 48 years (mean 33, sd 7 years) took part in this study. The experimental stimuli were produced using the NASA JSC short-arm centrifuge (SAC). Subjects were oriented supinely on this device with the nose pointed toward the ceiling and head centered on the axis of rotation. Thus, centrifuge rotation was in the body roll plane. After ramp-up the SAC rotated clockwise at a constant rate of 23 rpm, producing a centrifugal force of approximately 1 g at the feet. Semicircular canal CCS were produced by having subjects make yaw head turns from the nose up (NU) position to the right ear down (RED) position and from RED to NU. Each head turn was completed in about one second, and a 30 second recovery period separated consecutive head movements. Participants were randomly assigned to one of three groups (n=8 per group): physical adapters (PA), mental adapters (MA), or a control group (CG). Each subject participated in a one hour test session on each of three consecutive days. Each test session consisted of an initial (preadaptation) period during which the subject performed six CCS maneuvers in the dark, followed by an adaptation period with internal lighting on the centrifuge, and a final (postadaptation) period during which six more CCS maneuvers were performed in the dark. For the PA group, the adaptation period consisted of performing 30 additional CCS maneuvers in the light. For the MA and CG group the centrifuge was ramped down to 0 rpm after the pre-adaptation period and ramped back up to 23 rpm before the post-adaptation period. For the both of these groups, the adaptation period consisted of making 30 CCS maneuvers in the light with the centrifuge stationary (so no cross-coupling occurred). MA group subjects were instructed to vividly imagine the provocative sensations produced by the preadaptation CCS maneuvers in terms of magnitude, duration, and direction of illusory body tilt, as well as any accompanying levels of motion sickness. CG group subjects were asked to answer low imagery content questions (trivial pursuit) during each adaptation period head turn. During the 30 second recovery following each head turn, psychophysical data were collected including self reports of motion sickness, magnitude and direction estimates of illusory body tilt, and the overall duration of these sensations. A multilevel mixed effects linear regression analysis performed on all response variables indicated that all three groups experienced some psychophysical adaptation across the three test sessions. For illusory tilt magnitude, the PA group exhibited the most overall adaptation, followed by the MA group, and the CG group. The slopes of these adaptation trajectories by group over day were significantly diffent from one another. For the perceived duration of sensations, the CG group again exhibited the least amount of adaptation. However, the rates of adaptation of the PA and the MA groups were indistinguishable, suggesting that the imagined pseudostimulus appeared to be just as effective a means of adaptation as the actual stimulus. The MA group's rate of adaptation to motion sickness symptoms was also comparable to the PA group. The use of vivid motor imagery may be an effective method for adapting to the illusory sensations and motion sickness symptoms produced by cross-coupled stimuli. For space-based AG applications, this technique may prove quite useful in retaining astronauts considered highly susceptible to motion sickness as it reduces the number of actual CCS required to attain adaptation.

Newby, N. J.↗

Are Medications Involved in Vision and Intracranial Pressure Changes Seen in Spaceflight?

Some crewmembers have experienced changes in their vision after long-duration spaceflight on the ISS. These impairments include visual performance decrements, development of cotton-wool spots or choroidal folds, optic-disc edema, optic nerve sheath distention, and/or posterior globe flattening with varying degrees of severity and permanence. These changes are now used to define the visual impairment/intracranial pressure (VIIP) syndrome. It is known that many medications can have side effects that are similar to VIIP symptoms. Some medications raise blood pressure, which can affect intracranial pressure. Many medications that act in the central nervous system can affect intracranial pressures and/or vision. About 40% of the medications in the ISS kit are known to cause side effects involving changes in blood pressure, intracranial pressure and/or vision. For this reason, we have begun an investigation of the potential relationship between ISS medications and their risk of causing or exacerbating VIIP-like symptoms.

Wotring, V. E.↗

Are Medications Involved in Vision and intracranial Pressure Changes Seen in Spaceflight?

Some crewmembers have experienced changes in their vision after long-duration spaceflight on the ISS. These impairments include visual performance decrements, development of cotton-wool spots or choroidal folds, optic-disc edema, optic nerve sheath distention, and/or posterior globe flattening with varying degrees of severity and permanence. These changes are now used to define the visual impairment/intracranial pressure (VIIP) syndrome. The reasons for these potentially debilitating medical issues are currently unknown. The potential role of administered medications has not yet been examined, but it is known that many medications can have side effects that are similar to VIIP symptoms. Some medications raise blood pressure, which can affect intracranial pressure. Many medications that act in the central nervous system can affect intracranial pressures and/or vision. About 40% of the medications in the ISS kit are known to cause side effects involving changes in blood pressure, intracranial pressure and/or vision. For this reason, we proposed an investigation of the potential relationship between ISS medications and their risk of causing or exacerbating VIIP-like symptoms. The purpose of this study was to use medication usage records for affected and unaffected crew to determine if use of particular medications seemed to correlate with VIIP occurrence or severity.

Wotring, V. E.↗

A Review of the Safety of Selective Serotonin Reuptake Inhibitors for Long Duration Spaceflight

Introduction: As humankind ventures further into the depths of space, planning is already underway for long-duration exploration missions that will test the bounds of human performance. Deep space travel will include added risk related to stressors from the isolated, confined, and extreme (ICE) environment that lies outside the boundaries of low-earth orbit. Currently, selective serotonin reuptake inhibitors (SSRIs) are considered the gold standard treatment for many mental health diagnoses including anxiety and depression; however, SSRIs are also associated with several undesired side effects. The utility of non-pharmacologic therapies for the management of behavioral health conditions has not yet been fully explored. Methods: A comprehensive literature search was performed using PubMed and relevant articles pertaining to the psychological impacts of ICE environments, use of SSRIs in spaceflight, side effects associated with SSRIs, and non-pharmacologic treatments for anxiety and depression were reviewed. Over 100 studies were reviewed in total. Results: Reduced bone mineral density, impaired hemostatic function, significant individual variability resulting from gene polymorphisms, and drug-drug interactions are well described adverse effects of SSRIs that may complicate their operational use in the deep space environment. Many non-pharmacologic therapies have been utilized with success for the management of behavioral health conditions in the terrestrial environment that may show promise for long duration missions. Discussion: Although SSRIs have long been considered standard of care treatment for many behavioral health conditions, we cannot trivialize the risk that prolonged pharmacologic therapy may pose. The need to mitigate these risks by exploring alternative non-pharmacologic therapies has never been more relevant.

Charles H Dukes↗

Using Demanded Power and RDE Aggressiveness Metrics to Analyze the Impact of CACC Aggressiveness on Heavy Duty Platooning Power Consumption

Presently, a main mobility sector objective is to reduce its impact on the global greenhouse gas emissions. While there are many techniques being explored, a promising approach to improve fuel economy is to reduce the required energy by using slipstream effects. This study analyzes the demanded engine power and mechanical energy used by heavy-duty trucks during platooning and non-platooning operation to determine the aerodynamic benefits of the slipstream. A series of platooning tests utilizing class 8 semi-trucks platooning via Cooperative Adaptive Cruise Control (CACC) are performed. Comparing the demanded engine power and mechanical energy used reveals the benefits of platooning on the aerodynamic drag while disregarding any potential negative side effects on the engine. However, energy savings were lower than expected in some cases. It was hypothesized that the CACC may have amplified transient platooning events relative to the individual truck baseline results, hampering the potential energy savings. Therefore, the impact of the controller on the observed driving style was analyzed in detail. In order to quantify the transient operational characteristics of the experimental trials, metrics from the European Real Driving Emissions (RDE) legislation were modified to serve as metrics of aggressiveness during platooning. The metrics (v · apos)95 and Relative Positive Acceleration (RPA) were calculated for platooning and non-platooning runs. These results indicate that the CACC induces small acceleration events during platooning to retain the commanded longitudinal separation between vehicles. These small acceleration events increase following vehicle aggressiveness during platooning and prevent the following vehicles from obtaining maximum energy savings. Moreover, a correlation between the RDE metric (v · apos)95 and energy savings is developed. Hence, this work establishes the ability of RDE metrics to assess CACC impacts on platoon energy savings.

European Real Driving Emissions, RDE, greenhouse g↗

2014 Space Radiation Standing Review Panel

The 2014 Space Radiation Standing Review Panel (from here on referred to as the SRP) participated in a WebEx/teleconference with members of the Space Radiation Program Element, representatives from the Human Research Program (HRP), the National Space Biomedical Research Institute (NSBRI), and NASA Headquarters on November 21, 2014 (list of participants is in Section XI of this report). The SRP reviewed the updated Research Plan for the Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure (Degen Risk). The SRP also received a status update on the Risk of Acute and Late Central Nervous System Effects from Radiation Exposure (CNS Risk), the Risk of Acute Radiation Syndromes Due to Solar Particle Events (ARS Risk), and the Risk of Radiation Carcinogenesis (Cancer Risk). The SRP thought the teleconference was very informative and that the Space Radiation Program Element did a great job of outlining where the Element is with respect to our state of knowledge on the risks of carcinogenesis, central nervous system effects, and the risk of cardiovascular disease and other degenerative tissue effects from exposure to space radiation. The SRP was impressed with the quality of research that is being conducted and the progress the Space Radiation Program Element has made in the past year. While much work has been done, the SRP had a few remaining questions regarding the broad applicability of these findings to a manned deep space mission (in terms of cognitive function, the paradigms were still hippocampal based and also using Alzheimer disease models). The SRP believes that NASA should consider developing an approach to follow astronauts long-term (beyond retirement) for potential side-effects/risks of space exposure that may be unknown. Radiation toxicities often occur decades after exposure, and potential consequences would be missed if intensified exams stop after retirement of the astronauts. In addition, while cancer is one consequence of radiation exposure that is monitored, potential other side effects (CNS, Alzheimer Disease, loss of cognitive function, etc.) are not included in long-term studies and would be missed. Inclusion of long-term data would be of benefit to the astronauts themselves who have given their service to the corps but also to future astronauts and the future of space exploration.

Steinberg, Susan↗

ARCH: Large-scale knowledge graph via aggregated narrative codified health records analysis

Objective: Electronic health record (EHR) systems contain a wealth of clinical data stored as both codified data and free-text narrative notes (NLP). The complexity of EHR presents challenges in feature representation, information extraction, and uncertainty quantification. Here, to address these challenges, we proposed an efficient Aggregated naRrative Codified Health (ARCH) records analysis to generate a large-scale knowledge graph (KG) for a comprehensive set of EHR codified and narrative features. Methods: Using data from 12.5 million Veterans Affairs patients, ARCH first derives embedding vectors and generates similarities along with associated p-values to measure the strength of relatedness between clinical features with statistical certainty quantification. Next, ARCH performs a sparse embedding regression to remove indirect linkage between features to build a sparse KG. Finally, ARCH was validated on various clinical tasks, including detecting known relationships between entity pairs, predicting drug side effects, disease phenotyping, as well as sub-typing Alzheimer’s disease patients. Results: ARCH produces high-quality clinical embeddings and KG for over 60,000 codified and narrative EHR concepts. The KG and embeddings are visualized in the R-shiny powered web-API.3 ARCH achieved high accuracy in detecting EHR concept relationships, with AUCs of 0.926 (codified) and 0.861 (NLP) for similar EHR concepts, and 0.810 (codified) and 0.843 (NLP) for related pairs. It detected drug side effects with a 0.723 AUC, which improved to 0.826 after fine-tuning. Using both codified and NLP features, the detection power increased significantly. Compared to other methods, ARCH has superior accuracy and enhances weakly supervised phenotyping algorithms’ performance. Notably, it successfully categorized Alzheimer’s patients into two subgroups with varying mortality rates. Conclusion: The proposed ARCH algorithm generates large-scale high-quality semantic representations and knowledge graph for both codified and NLP EHR features, useful for a wide range of predictive modeling tasks.

Electronic health records↗