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At least 55 records · Page 3

A Population-Level Summary of Health Care Utilization for the Management of Patellar Tendinopathy in the Military Health System

Abstract Patellar tendinopathy (PT) is a common nontraumatic orthopaedic disorder of the knee suffered by many service members. Understanding the make-up of usual care for PT at the system level can better frame current clinical gaps and areas that need improvement. Exercise therapy is recommended as a core treatment for PT, but it is unclear how often it is used as a part of usual care for PT within the Military Health System (MHS). The purpose of the study was to identify interventions used in the management of PT and the timing of these interventions. A secondary purpose was to determine if exercise therapy use was associated with reduced recurrence of knee pain. In total, 4,719 individuals aged 17 to 50 years in the MHS diagnosed with PT between 2010 and 2011 were included. Pharmacological and nonpharmacological interventions, visits to specialty providers, and imaging services were captured. Descriptive statistics were used to report the findings. Interventions were further categorized as being part of initial care (within the first 7 days), the initial episode of care (within the first 60 days), or the 2-year time period after diagnosis. Linear regression assessed the relationship between the number of exercise therapy visits in the initial episode of care and recurrences of knee pain. In total, 50.6% of this cohort had no more than one medical visit total for PT. Exercise therapy (18.2%) and nonsteroidal anti-inflammatory drugs (4.3%) were the two most used interventions in the initial episode of care. Radiographs were ordered for 23.1% of the cohort in the initial episode of care. The number of exercise therapy visits a patient received during the initial episode of care was not associated with recurrences of knee pain. Half of the individuals received no further care beyond an initial visit for the diagnosis of PT. Exercise therapy was the most common intervention used during the initial episode of care, but exercise therapy did not influence the recurrence of knee pain.

Orthopedics↗

Machine Learning Analysis of Temperature-Strain Relationships for Structural Health Monitoring of Pipes: Self-powered wireless sensor system for health monitoring of liquid-sodium cooled fast reactors

This report presents machine learning (ML) analysis of temperature-strain relationships for structural health monitoring of nuclear reactor stainless steel (SS) pipes with the strain gauge sensor directly printed on the pipe with a 3D conformal aerosol jet printer. We investigate correlations for two sensor pairs installed on the same SS304 pipe: commercial K-type thermocouple with a printed gold strain gauge (TC3-SG3), and commercial K-type thermocouple with commercial Kyowa strain gauge (TC0-SG0). The temperature ranges for the sensor pairs TC0-SG0 and TC3-SG3 are 20.00°C to 266.37°C and 39.95°C to 219.28°C respectively. ML algorithms in this study include Linear Regression (baseline method), Ridge Regression, Lasso Regression, and Gradient Boosting. Performance evaluation metrics include Root Mean Square Error (RMSE), Mean Square Error (MSE), Mean Absolute Error (MAE), R 2 Score, and Explained Variance. Using advanced feature engineering techniques, we extracted 27 temperature-based features and 30 strategic inclusion features. The best performance was obtained with the Gradient Boosting method, which achieves prediction accuracy of R 2 = 0.9999 and RMSE = 7.69 μStrain for TC0-SG0, and R 2 = 0.9998 and RMSE = 18.03 μStrain for TC3-SG3. While the temperature-strain correlations are weaker for the gauge directly printed on the pipe than for the commercial strain gauge, deployment-ready performance exceeding industry standards is achieved for both sensor pairs.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

Prospective Observational Study of Ocular Health in ISS Crews - The Ocular Health Study

The Visual Impairment Intracranial Pressure (VIIP) syndrome is currently NASA's number one human space flight risk. The syndrome, which is related to microgravity exposure, manifests with changes in visual acuity (hyperopic shifts, scotomas), changes in eye structure (optic disc edema, choroidal folds, cotton wool spots, globe flattening, and dilated optic nerve sheaths), and in some cases with documented increased intracranial pressure (ICP) postflight. While the eye appears to be the main affected end organ of this syndrome, the ocular effects are thought to be related to underlying changes in the vascular system and the central nervous system. The leading hypotheses for the development of VIIP involve microgravity-induced head-ward fluid shifts along with a loss of gravity-assisted drainage of venous blood from the brain, leading to cephalic congestion, decreased CSF resorption and increased ICP. Since 70% of ISS crewmembers have manifested clinical signs or symptoms of the VIIP syndrome, it is assumed that the majority have some degree of ICP elevation in-flight compared to the ground. Prolonged elevations of ICP can cause long-term reduced visual acuity and loss of peripheral visual fields, and have been reported to cause mild cognitive impairment in the analog terrestrial population of Idiopathic Intracranial Hypertension (IIH). These potentially irreversible health consequences underscore the importance of identifying the factors that lead to this syndrome and mitigating them.

Otto, C.↗

Assessment of Individualizing lactobacillus plantarum Supplementation with Precision Health to Preserve Muscle Health in Astronauts During Long Duration Spaceflight

Muscle atrophy is an unfortunate reality seen after spending time in microgravity. Decreases in muscle strength, size, and endurance can negatively impact mission productivity and increase the risk of injury in astronauts. In preparing for long-duration spaceflight aboard future orbiting stations and interplanetary vessels, supplementation with lactobacillus plantarum has been suggested as a possible countermeasure for crew members. Early clinical trials have shown the probiotic to improve muscle strength, endurance, and associated biomarkers, even without significant physical exercise by influencing the gut-muscle-axis. While current onboard exercise protocols have significantly helped limit degradation (as seen below), individualized implementation of this supplement could not only add another layer of protection but also protect against inadequate exercise equipment on future missions due to payload constraints

Precision Health↗

The National Aeronautics and Space Administration-U.S. Public Health Service Health Evaluation and Enhancement Program - Summary of results.

An exercise program was initiated in a federal agency to assess the feasibility of such a program, and to identify the factors that influenced joining, adherence to, and effectiveness of the program. The program was utilized by 237 of the 998 eligible federal employees; mean attendance rate was 1.3 days/week. Those who volunteered perceived a need for increased physical activity, believed they had sufficient time to participate and derived subjective as well as objective benefits. Significant improvements were found in heart rate response to the standard exercise test, body weight, skinfold measurements and triglyceride levels.

Durbeck, D. C.↗

Inflatable Habitat Health Monitoring: Implementation, Lessons Learned, and Application to Lunar or Martian Habitat Health Monitoring

NASA's exploration mission is to send humans to the Moon and Mars, in which the purpose is to learn how to live and work safely in those harsh environments. A critical aspect of living in an extreme environment is habitation, and within that habitation element there are key systems which monitor the habitation environment to provide a safe and comfortable living and working space for humans. Expandable habitats are one of the options currently being considered due to their potential mass and volume efficiencies. This paper discusses a joint project between the National Science Foundation (NSF), ILC Dover, and NASA in which an expandable habitat was deployed in the extreme environment of Antarctica to better understand the performance and operations over a one-year period. This project was conducted through the Innovative Partnership Program (IPP) where the NSF provided the location at McMurdo Station in Antarctica and support at the location, ILC Dover provided the inflatable habitat, and NASA provided the instrumentation and data system for monitoring the habitat. The outcome of this project provided lessons learned in the implementation of an inflatable habitat and the systems that support that habitat. These lessons learned will be used to improve current habitation capabilities and systems to meet the objectives of exploration missions to the moon and Mars.

Rojdev, Kristina↗

Cherokee Water Resources Project Summary - Mapping Forest Composition and Health in the Southern Appalachians Using NASA Earth Observations to Enhance Drought and Watershed Health-Related Forest Management for the Eastern Band of the Cherokee Indians

The Eastern Band of Cherokee Indians (EBCI) owns and manages more than 55,000 acres of land in the Southern Appalachian Mountains of western North Carolina. Most of these lands reside within the Oconaluftee River watershed. In this region and watershed, hemlock trees are a culturally significant foundation species that contribute to habitat biodiversity, regulate temperature and evapotranspiration of riparian environments, and provide economic value for tourism and recreation. The hemlock woolly adelgid (HWA), an invasive insect, has caused widespread hemlock mortality in recent decades, raising concerns about hemlock decline. Hemlock mortality leads to standing dead trees and increased evapotranspiration which can abet the spread of wildfires, especially during periods of drought. The DEVELOP team used satellite imagery from Landsat 5 Thematic Mapper (TM) to quantify and map possible hemlock decline by comparing changes in the normalized difference vegetation index (NDVI) values of winter season between 2003 and 2010. The project utilized the Shuttle Radar Topography Mission (SRTM) along with imagery from Landsat 8 Operational Land Imager (OLI) to create a weighted suitability analysis that maps topographic and environmental conditions favorable for hemlock habitat. This study found that 67%of evergreen and mixed forest cover in the Oconaluftee River valley exhibited a decrease in winter NDVI from 2003 to 2010. Additionally, the two-example weighted suitability analyses showed 4.5-9.5% of hemlock suitable land in 2018 in the Oconaluftee. The partners of this project can use the outputs to identify the extent of potential hemlock decline in the Oconaluftee and establish benchmark metrics for assessing changes in hemlock suitable areas over time.

DEVELOP Project Summary↗

Cherokee Water Resources - Mapping Hemlock Tree Composition and Health in the Southern Appalachians Using NASA Earth Observations to Enhance Drought and Watershed Health-Related Forest Management for the Eastern Band of the Cherokee Indians

The Eastern Band of Cherokee Indians (EBCI) owns and manages more than 55,000 acres of land in the Southern Appalachian Mountains of western North Carolina. Most of these lands reside within the Oconaluftee River watershed. In this region and watershed, hemlock trees are a culturally significant foundation species that contribute to habitat biodiversity, regulate temperature and evapotranspiration of riparian environments, and provide economic value for tourism and recreation. The hemlock woolly adelgid (HWA), an invasive insect, has caused widespread hemlock mortality in recent decades, raising concerns about hemlock decline. Hemlock mortality leads to standing dead trees and increased evapotranspiration which can abet the spread of wildfires, especially during periods of drought. The DEVELOP team used satellite imagery from Landsat 5 Thematic Mapper (TM) to quantify and map possible hemlock decline by comparing changes in the normalized difference vegetation index (NDVI) values of winter season between 2003 and 2010. The project utilized the Shuttle Radar Topography Mission (SRTM) along with imagery from Landsat 8 Operational Land Imager (OLI) to create a weighted suitability analysis that maps topographic and environmental conditions favorable for hemlock habitat. This study found that 67% of evergreen and mixed forest cover in the Oconaluftee River valley exhibited a decrease in winter NDVI from 2003 to 2010. Additionally, the two-example weighted suitability analyses showed 4.5-9.5% of hemlock suitable land in 2018 in the Oconaluftee. The partners of this project can use the outputs to identify the extent of potential hemlock decline in the Oconaluftee and establish benchmark metrics for assessing changes in hemlock suitable areas over time.

Richard Murray↗