ALBERT

Description: INTRODUCTION: Sustained microvolt-level T wave alternans (TWA) is a marker of increased risk for malignant ventricular arrhythmia. There is a significant risk of arrhythmia and sudden death after repair of congenital heart disease. The aim of this study was to determine the prevalence and characteristics of TWA after repair of tetralogy of Fallot (TOF). METHODS AND RESULTS: TWA was evaluated during bicycle exercise in 49 subjects who had consecutively undergone transatrial-transpulmonary repair. Median values for age, age at repair, and follow-up duration were 14.9 years (11.5-20.8), 1.6 years (0.2-4.9), and 11.6 years (9.4-17.2), respectively. All patients were in New York Heart Association functional class I and were asymptomatic. Median QRS duration was 120 msec (80-150). Sustained TWA was detected in 7 (23%) of 31 subjects with adequate tests. In these 7 subjects, median onset heart rate (HR) was 120 (98-155). Median HR threshold as a percentage of predicted maximum HR (220 - age) was 58% (48-77). Sustained TWA prevalence was not significantly different compared with normal subjects (7/31 vs 9/83; P = 0.1). Onset HR in the TOF group was significantly lower [mean (SD) of 122 (20) vs 139 (12), P 〈 0.05]. In the TOF group with sustained TWA, the TWA occurred in 4 of 7 at 〈60% predicted maximum HR versus 1 of 9 normal subjects (P 〈 0.05); 3 of 7 had onset HR 〈120 versus 0 of 9 normal subjects (P 〈 0.03). There was no significant difference in age, gender, transannular patch use, restrictive right ventricular physiology, QRS duration, QTc, QT/QRS dispersion, or nonsustained ventricular tachycardia in subjects with or those without sustained TWA. CONCLUSION: The onset HR for sustained TWA is significantly lower after repair of TOF. Further study is required to determine whether this represents an increased risk for arrhythmia in this patient group.

Description: Because of the variability of collagen crosslinks, their use as markers for bone resorption is often criticized. We hypothesized that the variability could be reduced by collecting urine for 24 hours (or longer) instead of using single voids, and by not normalizing to creatinine. Urine samples were collected from 22 healthy subjects during two or more 24-hour periods. Each 24-hour pool and each 2nd void of the day were analyzed for N-telopeptide (NTX), pyridinium (PYD), and deoxypyridinoline (DPD) crosslinks. Data were analyzed by using linear regression. For NTX, R2 for the two, 2nd-void samples (n = 38) was 0.55, whereas R2 for the two 24-hour pools was 0.51 or 0.52, expressed per day or per creatinine. For PYD and DPD, R2 for the 2nd-void samples was 0.26 and 0.18, R2 for the 24-hour pools expressed per day was 0.58 and 0.74, and R2 for the 24-hour pools expressed per creatinine was 0.65 and 0.76, respectively. Regression of the 2nd void and the corresponding 24-hour pool, expressed per day, yielded R2 = 0.19, 0.19, and 0.08, for NTX, PYD, and DPD, respectively (n = 76 each). For the 2nd-void sample and its corresponding 24-hour pool, expressed per creatinine, R2 = 0.24, 0.33, and 0.08, respectively. In a separate study, the coefficient of variation for NTX was reduced (P 〈 0.05) when data from more than one 24-hour collection were combined. Thus, the variability inherent in crosslink determinations can be reduced by collecting urine for longer periods. In research studies, the high variability of single-void collections, compounded by creatinine normalization, may alter or obscure findings.

Description: Adequate nutrition is critical during long-term spaceflight, as is the ability to easily monitor dietary intake. A comprehensive nutritional status assessment profile was designed for use before, during and after flight. It included assessment of both dietary intake and biochemical markers of nutritional status. A spaceflight food-frequency questionnaire (FFQ) was developed to evaluate intake of key nutrients during spaceflight. The nutritional status assessment protocol was evaluated during two ground-based closed-chamber studies (60 and 91 d; n = 4/study), and was implemented for two astronauts during 4-mo stays on the Mir space station. Ground-based studies indicated that the FFQ, administered daily or weekly, adequately estimated intake of key nutrients. Chamber subjects maintained prechamber energy intake and body weight. Astronauts tended to eat 40--50% of WHO-predicted energy requirements, and lost 〉10% of preflight body mass. Serum ferritin levels were lower after the chamber stays, despite adequate iron intake. Red blood cell folate concentrations were increased after the chamber studies. Vitamin D stores were decreased by 〉 40% on chamber egress and after spaceflight. Mir crew members had decreased levels of most nutritional indices, but these are difficult to interpret given the insufficient energy intake and loss of body mass. Spaceflight food systems can provide adequate intake of macronutrients, although, as expected, micronutrient intake is a concern for any closed or semiclosed food system. These data demonstrate the utility and importance of nutritional status assessment during spaceflight and of the FFQ during extended-duration spaceflight.

Description: Ground-based analogs of spaceflight are an important means of studying physiologic and nutritional changes associated with space travel, and the NASA Extreme Environment Mission Operations V (NEEMO) is such an analog. To determine whether saturation diving has nutrition-related effects similar to those of spaceflight, we conducted a clinical nutritional assessment of the NEEMO crew (4 men, 2 women) before, during, and after their 14-d saturation dive. Blood and urine samples were collected before, during, and after the dive. The foods consumed by the crew were typical of the spaceflight food system. A number of physiologic changes were observed, during and after the dive, that are also commonly observed during spaceflight. Hemoglobin and hematocrit were lower (P 〈 0.05) after the dive. Transferrin receptors were significantly lower immediately after the dive. Serum ferritin increased significantly during the dive. There was also evidence indicating that oxidative damage and stress increased during the dive. Glutathione peroxidase and superoxide dismutase decreased during and after the dive (P 〈 0.05). Decreased leptin during the dive (P 〈 0.05) may have been related to the increased stress. Subjects had decreased energy intake and weight loss during the dive, similar to what is observed during spaceflight. Together, these similarities to spaceflight provide a model to use in further defining the physiologic effects of spaceflight and investigating potential countermeasures.

Description: An axial extensometer able to measure global bone strain magnitudes and rates encountered during physiological activity, and suitable for use in vivo in human subjects, is described. The extensometer uses paired capacitive sensors mounted to intraosseus pins and allows measurement of strain due to bending in the plane of the extensometer as well as uniaxial compression or tension. Data are presented for validation of the device against a surface-mounted strain gage in an acrylic specimen under dynamic four-point bending, with square wave and sinusoidal loading inputs up to 1500 mu epsilon and 20 Hz, representative of physiological strain magnitudes and frequencies. Pearson's correlation coefficient (r) between extensometer and strain gage ranged from 0.960 to 0.999. Mean differences between extensometer and strain gage ranged up to 15.3 mu epsilon. Errors in the extensometer output were directly proportional to the degree of bending that occurs in the specimen, however, these errors were predictable and less than 1 mu epsilon for the loading regime studied. The device is capable of tracking strain rates in excess of 90,000 mu epsilon/s.

Description: A method to study the stress distribution inside the forefoot during walking was developed at the Cleveland Clinic Foundation by a researcher from the NASA Glenn Research Center. In this method, a semiautomated process was outlined to create a three-dimensional, patient-specific, finite element model (FEM) of the forefoot using magnetic resonance images (MRI). The images were processed in Matlab using the k-nearest neighbor (k-NN) classification algorithm and Sobel edge detection to separate the different tissue types: bone, skin, fat, and muscle. This information was used to create curves and surfaces that were exported to an FEM preprocessor known as Truegrid. In Truegrid, eight-noded or brick elements were created by using surface mapping. The FEM was processed and postprocessed in Abaqus. Material properties of the models were obtained from past experiments such as fat pad confined compression, skin axial and biaxial tests, muscle in vivo compressive tests, and reference literature (bone properties). Nonlinear (hyperelastic) material models were used for the skin (epidermis and dermis), fat, and muscles; and a linear elastic model was used for the bones. Muscle activation during walking yielded uncertainties in the muscle material model since contracted muscles are stiffer than relaxed muscles. These uncertainties were resolved by performing a sensitivity analysis of the muscle material properties. The original properties were multiplied by arbitrary factors of 2, 3, 0.5, and 0.33. The strain and stress distributions, as well as the locations of peak values, were similar in all cases. The peak contact pressure P obtained for each case varied with respect to the applied factor f as follows:

Description: This paper will describe the scientific objectives of the MSFC SUMI project and the optical components that have been developed to meet those objectives. In order to test the scientific feasibility of measuring magnetic fields in the UV, a sounding rocket payload is being developed, This paper will describe the optical measurements that have been made on the SUMI telescope mirrors and polarization optics.

Description: This paper will describe the polarizing optics that are being developed for an ultraviolet magnetograph (SUMI) which will be flown on a sounding rocket payload. With a limited observing program, the polarizing optics were optimized to make simultaneous observation at two magnetic lines CIV (155nm) and MgII (280). This paper will give a brief overview of the SUMI instrument, will describe the polarimeter that will be used in the sounding rocket program and will present some of the measurements that have been made on the (SUMI) polarization optics.

Description: There are several microwave instruments in low Earth orbit (LEO) that are used for atmospheric temperature and humidity sounding in conjunction with companion IR sounders as well as by themselves. These instruments have achieved a certain degree of maturity and undergoing a redesign to minimize their size, mass, and power from the previous generation instruments. An example of these instruments is the AMSU-A series, now flying on POES and AQUA spacecraft with the IR sounders HIRS and AIRS. These older microwave instruments are going to be replaced by the ATMS instruments that will fly on NPP and NPOESS satellites with the CrIS sounder. A number of techniques learned from the ATMS project in instrument hardware design and data processing are directly applicable to a similar microwave sounder on a geosynchronous platform. These techniques can significantly simplify the design of a Geostationary orbit (GEO) microwave instrument, avoiding costly development and minimizing the risk of not being able to meet the scientific requirements. In fact, some of the 'enabling' technology, such as the use of MMIC microwave components (which is the basis for the ATMS' much reduced volume) can be directly applied to a GEO sounder. The benefits of microwave sounders are well known; for example, they penetrate non-precipitating cloud cover and allow for use of colocated IR observations in up to 80% cloud cover. The key advantages of a microwave instrument in GEO will be the ability to provide high temporal resolution as well as uniform spatial resolution and extend the utility of a colocated advanced IR sounder to cases in which partial cloud cover exists. A footprint of the order of 100 km by 100 km resolution with hemispherical coverage within one hour can be easily achieved for sounding channels in the 50 to 59 GHz range. A GEO microwave sounder will also allow mesoscale sampling of select regions.

Description: This paper will describe the objectives of the Marshall Space Flight Center (MSFC) Solar Ultraviolet Magnetograph Investigation (SUMI) and the optical components that have been developed to meet those objectives. In order to test the scientific feasibility of measuring magnetic fields in the W, a sounding rocket payload is being developed. This paper will discuss: (1) the scientific measurements that will be made by the SUMI sounding rocket program, (2) how the optics have been optimized for simultaneous measurements of two magnetic lines CIV (1550 Angstroms) and MgII (2800 Angstroms), and (3) the optical, reflectance, transmission and polarization measurements that have been made on the SUMI telescope mirrors and polarimeter.