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At least 145 records · Page 8
All sourcesNASA NTRSDOE OSTI
NASA NTRS2009

NASA Space Life Sciences

This slide presentation reviews the requirements that NASA has for the medical service of a crew returning to earth after long duration space flight. The scenarios predicate a water landing. Two scenarios are reviewed that outline the ship-board medical operations team and the ship board science reseach team. A schedule for the each crew upon landing is posited for each of scenarios. The requirement for a heliport on board the ship is reviewed and is on the requirement for a helicopter to return the Astronauts to the Baseline Data Collection Facility (BDCF). The ideal is to integrate the medical and science requirements, to minimize the risks and Inconveniences to the returning astronauts. The medical support that is required for all astronauts returning from long duration space flight (30 days or more) is reviewed. The personnel required to support the team is outlined. The recommendations for medical operations and science research for crew support are stated.

Hayes, Judith↗
NASA NTRS2016

Access to Archived Astronaut Data for Human Research Program Researchers: Update on Progress and Process Improvements

Since the 2010 NASA directive to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for astronaut medical data has increased greatly. LSAH and LSDA personnel are working with Human Research Program on many fronts to improve data access and decrease lead time for release of data. Some examples include the following: Feasibility reviews for NASA Research Announcement (NRA) data mining proposals; Improved communication, support for researchers, and process improvements for retrospective Institutional Review Board (IRB) protocols; Supplemental data sharing for flight investigators versus purely retrospective studies; Work with the Multilateral Human Research Panel for Exploration (MHRPE) to develop acceptable data sharing and crew consent processes and to organize inter-agency data coordinators to facilitate requests for international crewmember data. Current metrics on data requests crew consenting will be presented, along with limitations on contacting crew to obtain consent. Categories of medical monitoring data available for request will be presented as well as flow diagrams detailing data request processing and approval steps.

Lee, L. R.↗
NASA NTRS1990

Medical impact analysis for the Space Station

In this study, Space Station medical care priorities were determined by a medical impact analysis of two analog populations, U.S. Army and U.S. Navy personnel. Diseases and injuries in the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) were ranked, using a Medical Impact Score (MIS) combining modified incidence rate and a function of disease outcome. The validity of the analysis method was tested by measuring rank order correlation between the two analog populations. Despite virtually identical age and sex distributions, Army and Navy incidence rates differed significantly for half of the ICD-9-CM categories, p less than 0.05. Disability rates differed for 76 percent, p less than 0.05. Nevertheless, Army and Navy MIS rank orders for categories and sections were not significantly different, p less than 0.001. In critical ways, the Space Station will be a safer environment than earth. Cardiac events, musculoskeletal injuries, affective psychoses, and renal calculi were among the highest scoring categories.

Nelson, Brent D.↗
NASA NTRS1969

Air crash rescue in the army

Air crash rescue operations by helicopter ambulances of U.S. Army Medical Department, discussing postcrash fire suppresion and injured personnel removal, emergency treatment and evacuation

Briot, W. R.↗
NASA NTRS2021

Exploration Medical Capability Clinical Decision Support System Concept of Operations

The Clinical Decision Support (CDS) project supports the Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP). Specifically, the CDS project addresses the ExMC gap, Medical-701: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant as we enter a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant change in in-flight medical care due to constraints on mass, volume, power, crew time, skills reduction over time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. Unlike the current paradigm for crew health in low-Earth orbit missions that rely on constant communication with Mission Control, the deep space missions will experience communication delays and possibly, no communications for finite periods of time. Hence, crew health management will benefit from analytics’ capabilities to augment decision support. A comprehensive, multi-functional on-board clinical decision support system (CDSS) will help crews assess and diagnose conditions, decide appropriate responses, and guide the provision of tailored and evidence-based treatments, while reflecting contextual factors and constraints. The context may include present and historical data, viable diagnostic equipment, available supplies and medications, and vehicle and environmental health. Communication time with ground-based personnel is delayed or non-existent during significant portions of the mission so the crew will need to autonomously respond to health, performance and medical situations, particularly those that are unplanned. The CDSS must also provide additional capabilities as complex as training for an emergency situation while augmenting non-expert practitioner skillsets if the Crew Medical Officer (CMO) is incapacitated, and as routine as facilitating delayed communication with flight surgeons on the ground. The CDSS must connect complex issues involving health, wellness, task performance and environmental domains. Furthermore, CDSS functionality will focus on semi-autonomous and autonomous decision-making by the crew that is necessary to address challenges in executing a self-contained medical system that enables health care without assistance from ground clinical experts. The document, ExMC CDSS Architecture Recommendation, (HRP- 48032) establishes a description of the envisioned CDSS architecture. The analytics, descriptive or advanced, contained in a CDSS will interface with the integrated crew health and performance architecture that provides the appropriate data sets. The aim of the CDS project is to develop requirements for a CDSS through a series of test-bed prototype developments and demonstrations.

HRP↗
NASA NTRS1964

Biomedical and Human Factors Requirements for a Manned Earth Orbiting Station

This report is the result of a study conducted by Republic Aviation Corporation in conjunction with Spacelabs, Inc.,in a team effort in which Republic Aviation Corporation was prime contractor. In order to determine the realistic engineering design requirements associated with the medical and human factors problems of a manned space station, an interdisciplinary team of personnel from the Research and Space Divisions was organized. This team included engineers, physicians, physiologists, psychologists, and physicists. Recognizing that the value of the study is dependent upon medical judgments as well as more quantifiable factors (such as design parameters) a group of highly qualified medical consultants participated in working sessions to determine which medical measurements are required to meet the objectives of the study. In addition, various Life Sciences personnel from NASA (Headquarters, Langley, MSC) participated in monthly review sessions. The organization, team members, consultants, and some of the part-time contributors are shown in Figure 1. This final report embodies contributions from all of these participants.

EARTH ORBIT↗
NASA NTRS2012

Exploration Medical System Demonstration (EMSD) Project

The Exploration Medical System Demonstration (EMSD) is a project under the Exploration Medical Capability (ExMC) element managed by the Human Research Program (HRP). The vision for the EMSD is to utilize ISS as a test bed to show that several medical technologies needed for an exploration mission and medical informatics tools for managing evidence and decision making can be integrated into a single system and used by the on-orbit crew in an efficient and meaningful manner. Objectives: a) Reduce and even possibly eliminate the time required for on-orbit crew and ground personnel (which include Surgeon, Biomedical Engineer (BME) Flight Controller, and Medical Operations Data Specialist) to access and move medical data from one application to another. b) Demonstrate that the on-orbit crew has the ability to access medical data/information using an intuitive and crew-friendly software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management framework and architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities.

Chin, Duane↗
NASA NTRS2010

Visual Impairment and Intracranial Hypertension: An Emerging Spaceflight Risk

During recent long duration missions to the International Space Station (ISS) crewmembers have reported changes in visual acuity or visual field defects. Exams in the postflight period revealed changes to the visual system and elevated intracranial pressures. As a result, NASA Space Medicine has added a number of tests to be performed in the preflight, inflight and postflight periods for ISS and shuttle missions with the goal of determining the processes at work and any potential mitigation strategies. This discussion will acquaint you with the changes that NASA has made to its medical requirements in order to address the microgravity induced intracranial hypertension and associated visual changes. Key personnel have been assembled to provide you information on this topic. Educational Objectives: Provide an overview of the current Medical Operations requirements and the mitigation steps taken to operationally address the issue.

Taddeo, Terrance A.↗
NASA NTRS1977

Utilization of NASA Lewis mobile terminals for the Hermes satellite

The paper describes the portable earth terminal (PET) and the transportable earth terminal (TET) which enable two-way television and voice communication. Both terminals were developed by NASA and utilize the high power of the Hermes satellite. PET is a bus-type vehicle which has receiving equipment for full duplex color television and which can transmit programs originating in either the on-board PET studio or in nearby buildings. PET has a collapsible 2.4-m diameter parabolic antenna interfacing with a 500-watt 14-GHz wideband TV transmitter and a 12-GHz wideband TV receiver system. TET uses two parabolic reflector antennas, 3 m and 1.2 m in diameter, mounted on a flat trailer towed by a truck. TET can receive and relay color TV signals, and its narrowband transmitter can serve as a return audio link permitting a question-and-answer format. Also described are uplink and downlink performance characteristics, operation procedures, and field demonstrations which enabled personnel at several hospitals to participate in a distant medical conference.

Edelman, E. A.↗
NASA NTRS2004

Communicating Medical Needs to Non-Medical Managers

Differences in communication styles and languages between groups often lead to miscommunication, confusion, and/or frustration. Engineers, computer specialists, clinicians, and managers often utilize the English language in very different ways, with different groups using the same words to represent different concepts ("complaint" is a typical example). In addition, medical issues are often perceived as "off-nominal" and not "primary mission tasks" by managers, which can cause them to assign lower priorities to medical training time and resources. Knowledge bases differ due to variations in training and skill sets, and the goals (both immediate and long-term) of the communicators may also vary, with managers being primarily concerned with overall mission objectives, while clinicians focus on individual or group health issues. Furthermore, true communication is only possible when clinicians possess a deep understanding of mission requirements as well as the ability to communicate medical requirements on a priority basis using risk assessment, added value, and cost benefit analysis. These understandable differences may contribute to difficulties in expressing concerns and ideas in an efficient manner, particularly in projects, such as the space program or many military operations, where these varied groups must collaborate, and where the final decisions must be made by fully informed mission commanders. Methods: Three scenario-based approaches were developed utilizing decision trees and problem based learning, to help define and integrate these concepts. Results: Use of these techniques by NASA and military personnel will be presented. Discussion: To enhance communication, particularly of medical needs, one must identify the concerns and motivating factors for the other groups; for example, members of management may focus on financial concerns, a desire for risk mitigation, public perceptions, mission objectives, etc. Training clinicians to frame issues in these terms may lead to better understanding of the medical concerns by other groups.

Bacal, Kira↗
NASA NTRS2009

The Skylab Medical Operations Project: Recommendations to Improve Crew Health and Performance for Future Exploration Missions

From May 1973 to February 1974, NASA conducted a series of three human missions to the Skylab space station, which was a voluminous vehicle largely descendant of Apollo hardware and the first U.S. space station. Crew members of these missions spent record-breaking durations of time in microgravity (28, 59, and 84 days, respectively) and gave the U.S. space program its first experiences with long-duration space flight. The program overcame a number of obstacles to conduct a lauded scientific program that encompassed life sciences, astronomy, solar physics, materials sciences, and Earth observation. Yet Skylab has more to offer than the results of these scientific efforts. The operations that were conducted by the crews and ground personnel represent a rich legacy of operational experience. As we plan a return to the moon and subsequent human exploration of Mars, it is essential to use the experiences and insights of those who were involved in previous programs. Skylab and Skylab Medical Experiments Altitude Test personnel possess unique insight into operations that are being planned for the Constellation Program, such as umbilical extravehicular activity and water landing/recovery of long-duration crew members. The Skylab Program was also well known for its habitability and extensive medical suite.

Scheuring, Richard A.↗
NASA NTRS2004

Code Blue on Orbit: Treating Cardiac Arrest on the ISS

As a result of the Columbia tragedy on February 1,2003, the International Space Station (ISS) crew size has been temporarily reduced from three to two. This change forces adaptations in many operational procedures used by the crew, including medical protocols which were designed for scenarios involving one casualty and two caregivers. The Office of Space Medicine directed that the procedure for the resuscitation of a crewmember in cardiac arrest be rewritten for use by a single care provider. Methods: Adaptation of this procedure made use of current American Heart Association Advanced Cardiac Life Support (ACLS) procedures and reflects necessary compromises between the realities of the operational environment and prompt provision of medical care. Results: Numerous changes were incorporated due to the diminution in available personnel, including substitution of endotracheal rather than intravenous delivery of drugs, more rapid defibrillation, addition of a precordial thump, removal of transcutaneous pacing, streamlining of procedural steps, and clarification of termination criteria. Discussion: The on-orbit care available to the ISS crewmembers is constrained by numerous factors, including crew medical training, minimal medical assets, limited air/ground communication , and a single caregiver for the foreseeable future. All of these combine to make a successful resuscitation unlikely, however, this procedure must ultimately deal with not only the patient's welfare, but also that of the caregiver, the mission, and the program.

Bacal, Kira↗
DOE OSTI2020

Uncertainty analysis of Resource Demand Model for Covid-19

As part of the Department of Energy response to the novel coronavirus pandemic of 2020, a modeling effort was sponsored by the DOE Office of Science. One task of this modeling effort at Sandia was to develop a model to predict medical resource needs given various patient arrival scenarios. Resources needed include personnel resources (nurses, ICU nurses, physicians, respiratory therapists), fixed resources (regular or ICU beds and ventilators), and consumable resources (masks, gowns, gloves, face shields, sedatives). This report documents the uncertainty analysis that was performed on the resource model. The uncertainty analysis involved sampling 26 input parameters to the model. The sampling was performed conditional on the patient arrival streams that also were inputs to the model. These patient arrival streams were derived from various epidemiology models and had a significant effect on the projected resource needs. In this report, we document the sampling approach, the parameter ranges used, and the computational workflow necessary to perform large-scale uncertainty studies for every county and state in the United States.

59 BASIC BIOLOGICAL SCIENCES↗
NASA NTRSDate not supplied

Earth Independent Medical Operations (EIMO) Datascope: Challenges and Potential Solutions

Data flows and storage/retrieval capacity are severely constrained during missions in space and challenges will become even greater during exploration class missions. There is a need for an artificial intelligence (AI)-based clinical decision support system (CDSS) to monitor and analyze data to provide real-time consultative support for crew medical officer (CMO) decision-making. EIMO is defined as the gradual transition of medical care and decision making from terrestrial to space-based assets, enabling support of astronaut health and performance and reducing overall mission risk. While a hallmark of this paradigm shift from low-earth orbit is that on-board care will increasingly become the responsibility of the astronauts for primary management and decision making, terrestrial assets will continue to be paramount in pre-mission screening and planning, as well as prevention, health maintenance and long-term care contingencies. New capabilities and systems that enable progressively more robust and resilient systems and crews will be necessary to reduce risk and increase probability of deep space exploration mission success. An aspiration for EIMO is to develop AI-enhanced solutions for analysis of crew health & performance data and to facilitate clinical decision support for autonomous medical operations. A “system of systems” approach is envisioned whereby EIMO will deploy AI-supported natural language processing and machine learning (ML) techniques to utilize embedded reference databases and real-time data streams [input vectors] from multiple data sources. Constituent input vectors may include environmental controls, countermeasures data, behavioral data, physiologic wearables, point-of-care laboratory tests, personalized medical records, inventory trade space risk assessments, COTS medical databases, and ground support inputs. An ideal AI capability would possess trained fusion algorithms to cross reference input vectors with medical ‘knowledge’ [cultivated database] to stratify relevant data streams for predictive and actionable capabilities. In addition, EIMO will feature mobility, in that it can be accessed and can push/pull data within and between multiple vehicles/habitats. Large amounts and variable sources of data can be leveraged to diagnose, inform treatment strategies, and potentially predict medical events and performance decrements. Inclusion of advanced training tools using extended reality will enable increasingly autonomous medical care to aid a CMO when ground support is unavailable or time-delayed beyond required action window, e.g., emergent medical situations. EIMO CDSS would require very large datasets to train pre-flight and significant amounts of data are needed to support ML via in-flight CDSS operations. An additional challenge will be to find sufficient data to train a model relevant to astronaut demographics. The rapid, accelerating evolution of this field creates a propitious solution space to leverage multi-modal AI through public-private partnership(s). The status of multi-modal AI systems today would preclude their use for long duration missions as they remain unreliable and are subject to “digital hallucinations” and other errors that could pose operational risk. A federated labs structure is being considered to test and optimize data flow from the multiple input vectors leading to field testing in suitable ground/flight analogs. Critical to the success of an EIMO CDSS will be integration and interoperability and success will be defined by a system that can serve as an in-flight medical consult for the CMO providing critical support during medical contingencies. Benefits to terrestrial medicine may be significant as an outflow of the EIMO medical system, particularly for remote areas and communities lacking significant infrastructure, personnel and resources.

J Lemery↗
NASA NTRSDate not supplied

Evaluation of Markerless Motion Capture for Monitoring Sensorimotor Performance

BACKGROUND Astronauts returning from long-duration exposure to microgravity frequently exhibit alterations in sensorimotor function leading to postural imbalance, impaired locomotion, and operational challenges to manual control. Mission duration and individual responses often influence both the severity of performance decrements and the variability in adaptation timelines. Postflight disruptions during functional tasks are often detected through body-worn inertial measurement unit (IMU) devices. While IMU sensors are relatively compact, the long-term wear may lead to discomfort, displacement of the sensors on the body, and restrictions in movement or crew behavior. Although IMU data offers valuable insights from a research standpoint, interpreting changes in pre- and post-flight measures can be difficult for crew support personnel beyond the research domain, which can hinder the application for medical assessments and rehabilitation. Finally, the availability of inertial sensors in-flight is limited. There is a need for unobtrusive monitoring tools to improve our ability to monitor adaptation following gravitational transitions in various postflight evaluations and rehabilitation settings. Markerless motion capture (MMC) is an evolving unobtrusive technology that builds upon decades of research with marker-based motion capture systems to provide 3D human pose estimation from multiple synchronized 2D camera views using deep learning algorithms. Markerless technology can revolutionize how data is captured pre- and post-flight and potentially in-flight during intravehicular activity by enabling pose estimation of multiple crew members from onboard camera hardware. METHODS The following presents the initial evaluation of a state-of-the-art commercial-off-the-shelf MMC system, Theia Markerless, compared to IMU devices during various ground-based functional tasks and environmental conditions. The featured functional tasks include assessments from Human Research Program (HRP) funded studies such as Sensorimotor Standard Measures and Sensorimotor Assessments. Synchronous data collected using both motion capture and IMUs are analyzed for six male and female subjects of varying anthropometry. The analysis includes limited assessments of clothing, capture volume configurations, and the tool's sensitivity to detecting performance changes after a spaceflight analog centrifuge exposure. The development of visualization tools to enhance the application of the pose estimation output is also presented. RESULTS Initial results demonstrate comparable root mean square error (RMSE) to existing literature evaluating markerless and marker-based motion capture systems. Considering the relative functional range of motion of the cervical spine, normalized error values for the markerless system’s accuracy of the head was 0.032 in pitch, 0.025 in roll, and 0.018 in yaw plane of motion across a subset of functional tasks. The raw RMSE values were 3.49, 2.25, and 2.81 degrees respectively. For the torso, results suggest normalized errors of 0.469 in pitch, 0.191 in roll, and 0.307 in yaw planes of motion and raw RMSE values of 3.52, 1.53, and 3.07 degrees respectively. The data suggests the functional demands of a particular task influences the estimation accuracy of the MMC system where more dynamic motion and cases where subjects are not upright may introduce diminished tracking accuracy. DISCUSSION The following work lays the foundation for future implementations leveraging markerless motion capture to assess the time course of recovery and provide insight for rehabilitation protocols to enhance crew readiness for the resumption of daily activities. These tools offer effective methods for anonymizing sensitive crew data, facilitating numerous applications across research, medical, and rehabilitation groups. Collaborations with the Anthropometry and Biomechanics Facility will provide further comparisons of the Markerless system to a marker-based system. ACKNOWLEDGEMENT</ This work is supported by NASA’s Exploration Systems Development Mission Directorate Mars Campaign Office Crew Health Countermeasures.

Hannah M. Weiss↗
NASA NTRS2006

Human Factors Engineering as a System in the Vision for Exploration

In order to accomplish NASA's Vision for Exploration, while assuring crew safety and productivity, human performance issues must be well integrated into system design from mission conception. To that end, a two-year Technology Development Project (TDP) was funded by NASA Headquarters to develop a systematic method for including the human as a system in NASA's Vision for Exploration. The specific goals of this project are to review current Human Systems Integration (HSI) standards (i.e., industry, military, NASA) and tailor them to selected NASA Exploration activities. Once the methods are proven in the selected domains, a plan will be developed to expand the effort to a wider scope of Exploration activities. The methods will be documented for inclusion in NASA-specific documents (such as the Human Systems Integration Standards, NASA-STD-3000) to be used in future space systems. The current project builds on a previous TDP dealing with Human Factors Engineering processes. That project identified the key phases of the current NASA design lifecycle, and outlined the recommended HFE activities that should be incorporated at each phase. The project also resulted in a prototype of a webbased HFE process tool that could be used to support an ideal HFE development process at NASA. This will help to augment the limited human factors resources available by providing a web-based tool that explains the importance of human factors, teaches a recommended process, and then provides the instructions, templates and examples to carry out the process steps. The HFE activities identified by the previous TDP are being tested in situ for the current effort through support to a specific NASA Exploration activity. Currently, HFE personnel are working with systems engineering personnel to identify HSI impacts for lunar exploration by facilitating the generation of system-level Concepts of Operations (ConOps). For example, medical operations scenarios have been generated for lunar habitation in order to identify HSI requirements for the lunar communications architecture. Throughout these ConOps exercises, HFE personnel are testing various tools and methodologies that have been identified in the literature. A key part of the effort is the identification of optimal processes, methods, and tools for these early development phase activities, such as ConOps, requirements development, and early conceptual design. An overview of the activities completed thus far, as well as the tools and methods investigated will be presented.

Mihriban Whitmore↗
DOE OSTI2022

Iraq/Afghanistan war lung injury reflects burn pits exposure

This descriptive case series retrospectively reviewed medical records from thirty-one previously healthy, war-fighting veterans who self-reported exposure to airborne hazards while serving in Iraq and Afghanistan between 2003 and the present. They all noted new-onset dyspnea, which began during deployment or as a military contractor. Twenty-one subjects underwent non-invasive pulmonary diagnostic testing, including maximum expiratory pressure (MEP) and impulse oscillometry (IOS). In addition, five soldiers received a lung biopsy; tissue results were compared to a previously published sample from a soldier in our Iraq Afghanistan War Lung Injury database and others in our database with similar exposures, including burn pits. We also reviewed civilian control samples (5) from the Stony Brook University database. Military personnel were referred to our International Center of Excellence in Deployment Health and Medical Geosciences, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell under the auspices of Northwell IRB: 17-0140-FIMR Feinstein Institution for Medical Research “Clinicopathologic characteristics of Iraq Afghanistan War Lung Injury.” We retrospectively examined medical records, including exposure data, radiologic imaging, and non-invasive pulmonary function testing (MGC Diagnostic Platinum Elite Plethysmograph) using the American Thoracic Society (ATS) standard interpretation based on Morgan et al., and for a limited cohort, biopsy data. Lung tissue, when available, was examined for carbonaceous particles, polycyclic aromatic hydrocarbons (Raman spectroscopy), metals, titanium connected to iron (Brookhaven National Laboratory, National Synchrotron Light Source II, Beamline 5-ID), oxidized metals, combustion temperature, inflammatory cell accumulation and fibrosis, neutrophil extracellular traps, Sirius red, Prussian Blue, as well as polarizable crystals/particulate matter/dust. Among twenty-one previously healthy, deployable soldiers with non-invasive pulmonary diagnostic tests, post-deployment, all had severely decreased MEP values, averaging 42% predicted. These same patients concurrently demonstrated abnormal airways reactance (X5Hz) and peripheral/distal airways resistance (D5–D20%) via IOS, averaging – 1369% and 23% predicted, respectively. These tests support the concept of airways hyperresponsiveness and distal airways narrowing, respectively. Among the five soldiers biopsied, all had constrictive bronchiolitis. We detected the presence of polycyclic aromatic hydrocarbons (PAH)—which are products of incomplete combustion—in the lung tissue of all five warfighters. All also had detectable titanium and iron in the lungs. Metals were all oxidized, supporting the concept of inhaling burned metals. Combustion temperature was consistent with that of burned petrol rather than higher temperatures noted with cigarettes. All were nonsmokers. Neutrophil extracellular traps were reported in two biopsies. Compared to our prior biopsies in our Middle East deployment database, these histopathologic results are similar, since all database biopsies have constrictive bronchiolitis, one has lung fibrosis with titanium bound to iron in fixed mathematical ratios of 1:7 and demonstrated polarizable crystals. These results, particularly constrictive bronchiolitis and polarizable crystals, support the prior data of King et al. (N. Engl. J. Med. 365:222–230, 2011) Soldiers in this cohort deployed to Iraq and Afghanistan since 2003, with exposure to airborne hazards, including sandstorms, burn pits, and improvised explosive devices, are at high risk for developing chronic clinical respiratory problems, including: (1) reduction in respiratory muscle strength; (2) airways hyperresponsiveness; and (3) distal airway narrowing, which may be associated with histopathologic evidence of lung damage, reflecting inhalation of burned particles from burn pits along with particulate matter/dust. Non-invasive pulmonary diagnostic tests are a predictor of burn pit-induced lung injury

36 MATERIALS SCIENCE↗