Engineering PapersSearch

SEARCH · Engineering Papers

Results for “Prospective Studies”

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

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

At least 19 records

Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients

BACKGROUND: Cardiac papillary fibroelastoma (CPF) is a primary cardiac neoplasm that is increasingly detected by echocardiography. The clinical manifestations of this entity are not well described. METHODS AND RESULTS: In a 16-year period, we identified patients with CPF from our pathology and echocardiography databases. A total of 162 patients had pathologically confirmed CPF. Echocardiography was performed in 141 patients with 158 CPFs, and 48 patients had CPFs that were not visible by echocardiography (<0.2 cm), leaving an echocardiographic subgroup of 93 patients with 110 CPFs. An additional 45 patients with a presumed diagnosis of CPF were identified. The mean age of the patients was 60+/-16 years of age, and 46.1% were male. Echocardiographically, the mean size of the CPFs was 9+/-4.6 mm; 82.7% occurred on valves (aortic more than mitral), 43.6% were mobile, and 91.4% were single. During a follow-up period of 11+/-22 months, 23 of 26 patients with a prospective diagnosis of CPF that was confirmed by pathological examination had symptoms that could be attributable to embolization. In the group of 45 patients with a presumed diagnosis of CPF, 3 patients had symptoms that were likely due to embolization (incidence, 6.6%) during a follow-up period of 552+/-706 days. CONCLUSIONS: CPFs are generally small and single, occur most often on valvular surfaces, and may be mobile, resulting in embolization. Because of the potential for embolic events, symptomatic patients, patients undergoing cardiac surgery for other lesions, and those with highly mobile and large CPFs should be considered for surgical excision.

NASA Discipline Cardiopulmonary

Outcome analysis of individualized vestibular rehabilitation protocols

OBJECTIVE: To determine the outcome of vestibular rehabilitation protocols in subjects with peripheral vestibular disorders compared with normal and abnormal control subjects. STUDY DESIGN: Prospective study using repeated measure, matched control design. Subjects were solicited consecutively according to these criteria: vestibular disorder subjects who had abnormal results of computerized dynamic posturography (CDP) sensory organization tests (SOTs) 5 and 6 and underwent rehabilitation; vestibular disorder subjects who had abnormal results of SOTs 5 and 6 and did not undergo rehabilitation; and normal subjects (normal SOTs). SETTING: Tertiary neurotology clinic. SUBJECTS: Men and women over age 18 with chronic vestibular disorders and chief complaints of unsteadiness, imbalance, and/or motion intolerance, and normal subjects. INTERVENTIONS: Pre- and post-rehabilitation assessment included CDP, vestibular disability, and activities of daily living questionnaires. Individualized rehabilitation plans were designed and implemented to address the subject's specific complaints and functional deficits. Supervised sessions were held at weekly intervals, and self-administered programs were devised for daily home use. MAIN OUTCOME MEASURES: CDP composite and SOT scores, number of falls on CDP, and self-assessment questionnaire results. RESULTS: Subjects who underwent rehabilitation (Group A) showed statistically significant improvements in SOTs, overall composite score, and reduction in falls compared with abnormal (Group B) control groups. Group A's performances after rehabilitation were not significantly different from those of normal subjects (Group C) in SOTs 3 through 6, and close to normal on SOTs 1 and 2. Subjects in Group A also reported statistically significant symptomatic improvement. CONCLUSIONS: Outcome measures of vestibular protocol physical therapy confirmed objective and subjective improvement in subjects with chronic peripheral vestibular disorders. These findings support results reported by other investigators.

NASA Discipline Neuroscience

Electric propulsion - Past history and future prospects

Studies of feasibility and flight mechanics of electric propulsion systems began around 1946. Conceptual systems design started in 1954, experimental development in 1958; flight tests in 1964 and 1970 proved the functioning of electric thrusters in space. Further development of ion thruster systems has concentrated on bombardment ionization in the U.S., and on radiofrequency, bombardment, and surface-contact ionization in West Germany, Great Britain, France, and the USSR. Electrothermal, plasma, and colloid thruster development has been pursued in many countries. Electric thrusters were used successfully during past years for satellite attitude control, and for prime propulsion of the Soviet spacecraft Yantar. Further applications for attitude and position control of satellites are planned.

Stuhlinger, E.

Electric propulsion - Past history and future prospects

Studies of feasibility and flight mechanics of electric propulsion systems began around 1946. Conceptual systems design started in 1954, experimental developments in 1958; flight tests in 1964 and 1970 proved the functioning of electric thrusters in space. Further development of ion thruster systems has concentrated on bombardment ionization in the U.S., and on radiofrequency, bombardment, and surface contact ionization in West Germany, Great Britain, France and Russia. Electrothermal, plasma, and colloid thruster development has been pursued in many contries. Electric thrusters were used successfully during past years for satellite attitude control, and for prime propulsion of the Russian spacecraft Yantar. Further applications for attitude and position control of satellites are planned. Studies are presently underway for solar electric missions to planets, planetary moons, comets, asteroids, and toward the sun, and also for missions in near-earth space involving transfer, servicing, and repair of orbiting spacecraft.

Stuhlinger, E.

Usefulness of microvolt T-wave alternans for prediction of ventricular tachyarrhythmic events in patients with dilated cardiomyopathy: results from a prospective observational study

OBJECTIVES: This study was designed to evaluate the ability of microvolt-level T-wave alternans (MTWA) to identify prospectively patients with idiopathic dilated cardiomyopathy (DCM) at risk of ventricular tachyarrhythmic events and to compare its predictive accuracy with that of conventional risk stratifiers. BACKGROUND: Patients with DCM are at increased risk of sudden death from ventricular tachyarrhythmias. At present, there are no established methods of assessing this risk. METHODS: A total of 137 patients with DCM underwent risk stratification through assessment of MTWA, left ventricular ejection fraction, baroreflex sensitivity (BRS), heart rate variability, presence of nonsustained ventricular tachycardia (VT), signal-averaged electrocardiogram, and presence of intraventricular conduction defect. The study end point was either sudden death, resuscitated ventricular fibrillation, or documented hemodynamically unstable VT. RESULTS: During an average follow-up of 14 +/- 6 months, MTWA and BRS were significant univariate predictors of ventricular tachyarrhythmic events (p < 0.035 and p < 0.015, respectively). Multivariate Cox regression analysis revealed that only MTWA was a significant predictor. CONCLUSIONS: Microvolt-level T-wave alternans is a powerful independent predictor of ventricular tachyarrhythmic events in patients with DCM.

Evaluation Studies

Parametric study of prospective early commercial OCMHD power plants /PSPEC/

The paper presents a parametric study conducted to obtain the performance, economics, natural resource requirements, and environmental impact of moderate technology MHD/steam power plants that do not require development of direct-fired high-temperature air heaters. The study was divided into three base cases, each with a reference case and parametric variations. The case using recuperative air preheat in the range of 1000 F to 1300 F, combined with O2 enrichment to 42% by volume has been selected for conceptual design.

Marston, C. H.

Parametric study of prospective early commercial MHD power plants (PSPEC). General Electric Company, task 1: Parametric analysis

The performance and cost of moderate technology coal-fired open cycle MHD/steam power plant designs which can be expected to require a shorter development time and have a lower development cost than previously considered mature OCMHD/steam plants were determined. Three base cases were considered: an indirectly-fired high temperature air heater (HTAH) subsystem delivering air at 2700 F, fired by a state of the art atmospheric pressure gasifier, and the HTAH subsystem was deleted and oxygen enrichment was used to obtain requisite MHD combustion temperature. Coal pile to bus bar efficiencies in ease case 1 ranged from 41.4% to 42.9%, and cost of electricity (COE) was highest of the three base cases. For base case 2 the efficiency range was 42.0% to 45.6%, and COE was lowest. For base case 3 the efficiency range was 42.9% to 44.4%, and COE was intermediate. The best parametric cases in bases cases 2 and 3 are recommended for conceptual design. Eventual choice between these approaches is dependent on further evaluation of the tradeoffs among HTAH development risk, O2 plant integration, and further refinements of comparative costs.

Marston, C. H.

Ecological study of dietary and smoking links to lymphoma

The ecological approach is used to investigate dietary and smoking links to lymphoma. International mortality rate data for 1986 and 1994 by gender and age group are compared with national dietary supply values of various food components for up to 10 years prior to the mortality data as well as per capita cigarette consumption rates 5 and 15 years earlier. The non-fat portion of milk, 3-9 years prior to the 1986 mortality data and 4 years prior to the 1994 data, was found to have the highest association with lymphoma, with r as high as 0.89. The results imply that 70 percent of lymphoma mortality may be related to this dietary component. Cigarette smoking in 1980 was found to have a weaker association with 1994 lymphoma mortality rates, being most important for younger men and statistically insignificant for younger women. The non-fat milk result is consistent with both case-control studies and a Norwegian prospective study, and with the often-observed finding that abnormal calcium metabolism, hypercalciuria, and dysregulated calcitriol production are common in normocalcemic patients with non-Hodgkin's lymphoma (NHL). It is hypothesized that excess dietary calcium from milk is a significant risk factor for lymphoma.

Calcium/adverse effects

Prospects for Studying Interstellar Magnetic Fields with a Far-Infrared Polarimeter for SAFIR

Polarimetry at mid-infrared through millimeter wavelengths using airborne and ground-based telescopes has revealed magnetic structures in dense molecular clouds in the interstellar medium, primarily in regions of star formation. Furthermore, spectropolarimetry has offered clues about the composition of the dust grains and the mechanism by which they are aligned with respect to the local magnetic field. The sensitivity of the observations to date has been limited by the emission from the atmosphere and warm telescopes. A factor of 1000 in sensitivity can be gained by using instead a cold space telescope. With 5 arcminute resolution, Planck will make the first submillimeter polarization survey of the full Galaxy early in the next decade. We discuss the science case for and basic design of a far-infrared polarimeter on the SAFIR space telescope, which offers resolution in the few arcsecond range and wavelength selection of cold and warm dust components. Key science themes include the formation and evolution of molecular clouds in nearby spiral galaxies, the magnetic structure of the Galactic center, and interstellar turbulence.

Dowell, C. Darren

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.

Association Between Vascular Density and Loss of Protective RAS During Early NPDR by Fractal Dimension

Purpose: Our hypothesis predicts that blood vessels within the retina increase in density during early-stage nonproliferative diabetic retinopathy (NPDR), based on previous results of a small retrospective study. For the current prospective study, the remodeling of arteries and veins during progression of early NPDR is assessed by a repertoire of parameters that includes the fractal dimension (D(sub f) ). In complex structures such as branching vascular trees, D(sub f) is a sensitive measure of space-filing capacity. The renin-angiotensin system (RAS) is implicated in DR pathogenesis and the function of circulating angiogenic cells (CACs), a critical bone marrow-derived population instrumental in vascular repair. Methods: Arterial and venous branching patterns were extracted from images of 6 normal controls and 3 early NPDR subjects (2 moderate, 1 mild) acquired by Heidelberg Spectralis (Registered Trademark) OCT following fluorescein angiography (FA). The vascular branching patterns were analyzed by NASAs VESsel GENeration Analysis (VESGEN) software, in which skeletonized representations were generated automatically to yield D(sub f) by the box-counting method. For binary 2D images, D(sub f) varies between limiting Euclidean dimensions of 1 and 2. Peripheral blood of diabetics and controls was collected for CD34+ CAC isolation. The gene expression of RAS in CACs was assessed by qPCR for Mas receptor to Ang-(1-7). The vasoreparative function of the CACs was measured by migration ability toward CXCL12 (SDF-1). Results: By D(sub f), venous and arterial densities were 1.370 +/- 0.006 and 1.329 +/- 0.016 for early NPDR, compared to 1.318 +/- 0.012 and 1.320 +/- 0.036 for control. The space filling capacity in early NPDR measured by D(sub f), a sensitive parameter, therefore demonstrated a pronounced increase for veins, but not for arteries. Mas receptor mRNA in CACs was increased in diabetics without DR but reduced with onset of NPDR, indicating possible loss of compensation of protective RAS during early DR. Migratory dysfunction of CD34+ cells was further associated with DR. Conclusions: As assessed by the fractal dimension in our preliminary study, the space-filling capacity of veins, but not arteries, was greater in early NPDR than in control. Larger patient populations will be examined as we complete our ongoing longitudinal study. Results further suggest the protective RAS axis within diabetic CACs is lost early in DR and is associated with increased vascular remodeling as evidenced by VESGEN analysis.

vascular

Patients' choice of portable folding chairs to reduce symptoms of orthostatic hypotension

Patients with neurogenic orthostatic hypotension may use portable folding chairs to prevent or reduce symptoms of low blood pressure. However, a concomitant movement disorder may limit the use of these chairs in daily living. In this prospective study, 13 patients with orthostatic hypotension, balance disturbance associated with motor disability, or both examined three commercially available portable folding chairs. A questionnaire was used to document the characteristics in chair design that were relevant for satisfactory use to these patients. Armrests, seat width, and an adjustable sitting height were found to be important features of a portable folding chair. One chair was selected by 11 of 13 patients to fit most needs.

NASA Discipline Cardiopulmonary

An Update on Mortality in the U.S. Astronaut Corps: 1959-2009

Although it has now been over 50 years since mankind first ventured into space, the long-term health impacts of human space flight remain largely unknown. Identifying factors that affect survival and prognosis among those who participate in space flight is vitally important, as the era of commercial space flight approaches and NASA prepares for missions to Mars. The Longitudinal Study of Astronaut Health is a prospective study designed to examine trends in astronaut morbidity and mortality. The purpose of this analysis was to describe and explore predictors of overall and cause-specific mortality among individuals selected for the U.S. astronaut corps. All U.S. astronauts (n=321), regardless of flight status, were included in this analysis. Death certificate searches were conducted to ascertain vital status and cause of death through April 2009. Data were collected from medical records and lifestyle questionnaires. Multivariable Cox regression modeling was used to calculate the mortality hazard associated with embarking on space flight, adjusted for sex, race, and age at selection. Between 1959 and 2009, there were 39 (12.1%) deaths. Of these deaths, 18 (42.2%) were due to occupational accidents; 7 (17.9%) were due to other accidents; 6 (15.4%) were attributable to cancer; 6 (15.4%) resulted from cardiovascular/circulatory diseases; and 2 (5.1%) were from other causes. Participation in space flight did not significantly increase mortality hazard over time (adjusted hazard ratio=0.57; 95% confidence interval=0.26-1.26. Because our results are based on a small sample size, future research that includes payload specialists, other space flight participants, and international crew members is warranted to maximize statistical power.

Amirian, E.

Axial and appendicular bone density predict fractures in older women

To determine whether measurement of hip and spine bone mass by dual-energy x-ray absorptiometry (DEXA) predicts fractures in women and to compare the predictive value of DEXA with that of single-photon absorptiometry (SPA) of appendicular sites, we prospectively studied 8134 nonblack women age 65 years and older who had both DEXA and SPA measurements of bone mass. A total of 208 nonspine fractures, including 37 wrist fractures, occurred during the follow-up period, which averaged 0.7 years. The risk of fracture was inversely related to bone density at all measurement sites. After adjusting for age, the relative risks per decrease of 1 standard deviation in bone density for the occurrence of any fracture was 1.40 for measurement at the proximal femur (95% confidence interval 1.20-1.63) and 1.35 (1.15-1.58) for measurement at the spine. Results were similar for all regions of the proximal femur as well as SPA measurements at the calcaneus, distal radius, and proximal radius. None of these measurements was a significantly better predictor of fractures than the others. Furthermore, measurement of the distal radius was not a better predictor of wrist fracture (relative risk 1.64: 95% CI 1.13-2.37) than other sites, such as the lumbar spine (RR 1.56; CI 1.07-2.26), the femoral neck (RR 1.65; CI 1.12-2.41), or the calcaneus (RR 1.83; CI 1.26-2.64). We conclude that the inverse relationship between bone mass and risk of fracture in older women is similar for absorptiometric measurements made at the hip, spine, and appendicular sites.

Multicenter Study