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At least 253 records · Page 14

Risk Factors and Trends for HPV-Associated Subsequent Malignant Neoplasms among Adolescent and Young Adult Cancer Survivors

Subsequent malignant neoplasms (SMN; new cancers that arise after an original diagnosis) contribute to premature mortality among adolescent and young adult (AYA) cancer survivors. Because of the high population prevalence of human papillomavirus (HPV) infection, we identify demographic and clinical risk factors for HPV-associated SMNs (HPV-SMN) among AYA cancer survivors in the SEER-9 registries diagnosed from 1976 to 2015. Outcomes included any HPV-SMN, oropharyngeal-SMN, and cervical-SMN. Follow-up started 2 months after their original diagnosis. Standardized incidence ratios (SIR) compared risk between AYA survivors and general population. Age-period-cohort (APC) models examined trends over time. Fine and Gray's models identified therapy effects controlling for cancer and demographic confounders. Of 374,408 survivors, 1,369 had an HPV-SMN, occurring on average 5 years after first cancer. Compared with the general population, AYA survivors had 70% increased risk for any HPV-SMN [95% confidence interval (CI), 1.61–1.79] and 117% for oropharyngeal-SMN (95% CI, 2.00–2.35); cervical-SMN risk was generally lower in survivors (SIR, 0.85; 95% CI, 0.76–0.95), but Hispanic AYA survivors had a 8.4 significant increase in cervical-SMN (SIR, 1.46; 95% CI, 1.01–2.06). AYAs first diagnosed with Kaposi sarcoma, leukemia, Hodgkin, and non-Hodgkin lymphoma had increased HPV-SMN risks compared with the general population. Oropharyngeal-SMN incidence declined over time in APC models. Chemotherapy and radiation were associated with any HPV-SMN among survivors with first HPV-related cancers, but not associated among survivors whose first cancers were not HPV-related. HPV-SMN in AYA survivors are driven by oropharyngeal cancers despite temporal declines in oropharyngeal-SMN. Hispanic survivors are at risk for cervical-SMN relative to the general population. Encouraging HPV vaccination and cervical and oral cancer screenings may reduce HPV-SMN burden among AYA survivors.

60 APPLIED LIFE SCIENCES↗

Low-Level Mesoscale and Cloud-Scale Interactions Promoting Deep Convection Initiation

Data from scanning radars, radiosondes, and vertical profilers deployed during three field campaigns are analyzed to study interactions between cloud-scale updrafts associated with initiating deep moist convection and the surrounding environment. Three cases are analyzed in which the radar networks permitted dual-Doppler wind retrievals in clear air preceding and during the onset of surface precipitation. These observations capture the evolution of (i) the mesoscale and boundary layer flow, and (ii) low-level updrafts associated with deep moist convection initiation (CI) events yielding sustained or short-lived precipitating storms. The elimination of convective inhibition did not distinguish between sustained and unsustained CI events, though the vertical distribution of convective available potential energy may have played a role. The clearest signal differentiating the initiation of sustained versus unsustained precipitating deep convection was the depth of the low-level horizontal wind convergence associated with the mesoscale flow feature triggering CI, a sharp surface wind shift boundary, or orographic upslope flow. The depth of the boundary layer relative to the height of the LFC failed to be a consistent indicator of CI potential. Widths of the earliest detectable low-level updrafts associated with sustained precipitating deep convection were ~3–5 km, larger than updrafts associated with surrounding boundary layer turbulence (~1–3 km wide). It is hypothesized that updrafts of this larger size are important for initiating cells to survive the destructive effects of buoyancy dilution via entrainment.

54 ENVIRONMENTAL SCIENCES↗

Vegetable intake and the risk of bladder cancer in the BLadder Cancer Epidemiology and Nutritional Determinants (BLEND) international study

Although a potential inverse association between vegetable intake and bladder cancer risk has been reported, epidemiological evidence is inconsistent. This research aimed to elucidate the association between vegetable intake and bladder cancer risk by conducting a pooled analysis of data from prospective cohort studies. Vegetable intake in relation to bladder cancer risk was examined by pooling individual-level data from 13 cohort studies, comprising 3203 cases among a total of 555,685 participants. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were estimated using Cox proportional hazards regression models stratified by cohort for intakes of total vegetable, vegetable subtypes (i.e. non-starchy, starchy, green leafy and cruciferous vegetables) and individual vegetable types. In addition, a diet diversity score was used to assess the association of the varied types of vegetable intake on bladder cancer risk. The association between vegetable intake and bladder cancer risk differed by sex ( P -interaction = 0.011) and smoking status ( P -interaction = 0.038); therefore, analyses were stratified by sex and smoking status. With adjustment of age, sex, smoking, energy intake, ethnicity and other potential dietary factors, we found that higher intake of total and non-starchy vegetables were inversely associated with the risk of bladder cancer among women (comparing the highest with lowest intake tertile: HR = 0.79, 95% CI = 0.64–0.98, P = 0.037 for trend, HR per 1 SD increment = 0.89, 95% CI = 0.81–0.99; HR = 0.78, 95% CI = 0.63–0.97, P = 0.034 for trend, HR per 1 SD increment = 0.88, 95% CI = 0.79–0.98, respectively). However, no evidence of association was observed among men, and the intake of vegetable was not found to be associated with bladder cancer when stratified by smoking status. Moreover, we found no evidence of association for diet diversity with bladder cancer risk. Higher intakes of total and non-starchy vegetable are associated with reduced risk of bladder cancer for women. Further studies are needed to clarify whether these results reflect causal processes and potential underlying mechanisms.

59 BASIC BIOLOGICAL SCIENCES↗

Prescribed fires, smoke exposure, and hospital utilization among heart failure patients

Abstract Background Prescribed fires often have ecological benefits, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire, wildfire smoke exposure, and heart failure (HF) patients’ hospital utilization. Methods We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated the prescribed fire occurrences within 1, 2, and 5 km of the patients’ primary residence with the number of hospital visits and 7- and 30-day readmissions. To compare prescribed fire associations with those observed for wildfire smoke, we also associated zip code-level smoke density data designed to capture wildfire smoke emissions with hospital utilization amongst HF patients. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regression models were used for readmissions. All models were adjusted for age, sex, race, and neighborhood socioeconomic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI). Results Associations between prescribed fire occurrences and hospital visits were generally null, with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence in the negative direction but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke (primarily from wildfires) at the zip code level was associated with both 7-day (8.5% increase; 95% CI = 1.5%, 16.0%) and 30-day readmissions (5.4%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.5%; 95% CI: 0.0%, 3.0%) matching previous studies. Conclusions Area-level smoke exposure driven by wildfires is positively associated with hospital utilization but not proximity to prescribed fires.

Raab, Henry↗

Estimating the Effects of Soil Remediation on Children’s Blood Lead near a Former Lead Smelter in Omaha, Nebraska, USA

Lead exposures from legacy sources threaten children’s health. Soil in Omaha, Nebraska, was contaminated by emissions from a lead smelter and refinery. The U.S. Environmental Protection Agency excavated and replaced contaminated soil at the Omaha Lead Superfund Site between 1999 and 2016. The goal of this study was to assess the association of soil lead level (SLL) and soil remediation status with blood lead levels (BLLs) in children living near or on the site. We linked information on SLL at residential properties with children’s BLLs and assigned remediation status to children’s BLL measurements based on whether their measurements occurred during residence at remediated or unremediated properties. We examined the association of SLL and remediation status with elevated BLL (EBLL). We distinguished the roles of temporal trend and the intervention with time-by-intervention-status interaction contrasts. All analyses estimated odds ratios (ORs) with a generalized estimating equations approach to ensure robustness under the complex correlations among BLL measurements. All analyses controlled for relevant covariates including children’s characteristics. EBLL (> 5 μg/dL ) was associated with both residential SLL [e.g., OR=2.00; 95% confidence interval (CI): 1.83, 2.19; > 400–800 vs. ≤ 200 ppm] and neighborhood SLL [e.g., OR=1.85 (95% CI: 1.62, 2.11; > 400–800 vs. ≤ 200 ppm)] before remediation but only with neighborhood SLL after remediation. The odds of EBLL were higher before remediation [OR 1.52 (95% CI: 1.34, 1.72)]. Similarly, EBLL was positively associated with preremediation status in our interaction analysis [interaction OR=1.18 (95%CI: 1.02, 1.37)]. Residential and neighborhood SLLs were important predictors of EBLLs in children residing near or on this Superfund site. Neighborhood SLL remained a strong predictor following remediation. Our data analyses showed the benefit of soil remediation. Results from the interaction analyses should be interpreted cautiously due to imperfect correspondence of remediation times between remediation and comparison groups. https://doi.org/10.1289/EHP8657

54 ENVIRONMENTAL SCIENCES↗

FY20 Proxy App Suite Release: Report for ECP Proxy App Project Milestone ADCD-504-10

Version 4.0 of the ECP Proxy App Suite is practically unchanged from the previous release. The current set of proxies has proven useful for many aspects of benchmarking and co-design and we see little reason to alter the suite. Although there have been few changes to the ECP suite, the team has been hard at work in other areas. In the area of Machine Learning (ML) we have now created a separate proxy suite dedicated to this scientific applications of ML. The suite includes: miniGAN (Generative Adversarial Networks), miniRL (Reinforcement Learning), CRADL (inline inference), Cosmoflow-Benchmark (Convolutional Neural Network), and MLPerf-DeepCam (Climate Segmentation Benchmark). Section 3 contains more information about these proxies as well as the principles that are guiding the development of the suite. We have surveyed available proxies for several application domains including Computational Fluid Dynamics, Quantum Chemistry, Quantum Computing Simulation, Molecular Dynamics, Monte Carlo Transport, and Density Functional Theory to identify gaps in proxy coverage. Several new proxy apps are either already available or will be released soon to fill these gaps. Section 4 provides full details. Finally, section 5 reports on our continued collaboration with the ECP Continuous Integration (CI) effort to use proxy apps to help identify problems and roadblocks to cross-lab CI. We have also assisted the El Capitan Center of Excellence (COE) to stand up a CI system that will be used to test releases of HPE and AMD software stacks. We hope that the COE effort can serve as a model for ECP by showing how the Proxy App Team can work with AD and ST teams identify critical features, kernels, patterns, etc. and incorporate them into a CI system that will help ensure that Frontier and Aurora will provide those needed capabilities.

97 MATHEMATICS AND COMPUTING↗

TRACER-Coastal Urban Boundary-Layer Interactions with Convection (TRACER-CUBIC) Field Campaign Report

To better understand the complicated web of processes governing convective cloud life cycle and aerosol-convection interactions, the U.S. Department of Energy (DOE)’s Atmospheric Radiation Measurement (ARM) user facility supported deployment of a variety of advanced atmospheric measurement systems to the greater Houston, Texas, area from 1 October 2021 to 30 September 2022 as part of the Tracking Aerosol Convection Interactions Experiment (TRACER). Houston was selected as a study area because isolated convection and a variety of aerosol conditions are common in this region. This one-year ARM Mobile Facility (AMF) deployment featured a four-month intensive operational period (IOP) during summer 2022 (1 June–30 September). The ARM instrumentation was deployed at three sites along an east-west transect from La Porte, Texas to an ancillary site in a less-polluted rural region southwest of downtown Houston (Figure 1). At the La Porte Site, which is located near the Houston ship channel in an area that experiences significant pollution, the first ARM Mobile Facility (AMF1) was deployed. During the IOP, the ARM tethered balloon system (TBS) operated at the ancillary site. The second-generation C-Band Scanning ARM Precipitation Radar (CSAPR) operated near Pearland, Texas, roughly halfway between the Laporte and ancillary sites. As part of the TRACER- Coastal Urban Boundary-Layer Interactions with Convection (CUBIC) project, three boundary-layer profiling systems) were deployed along a north-south transect spanning from the University of Houston Coastal Center to the Aldine site north of downtown Houston (also blue dot in Figure 1) during the TRACER IOP. These systems included the National Oceanic and Atmospheric Administration (NOAA) National Severe Storms Laboratory CLAMPS2 (C2), which was deployed at the UHCC, the University of Wisconsin SPARC, which was deployed at the ARM CSAPR site near Pearland (orange diamond in middle of map in Figure 1), and the University of Oklahoma CLAMPS1 (C1), which was deployed at Aldine. These three systems have been successfully operated in various field campaigns, providing data sets that collectively offer new insights into atmospheric-boundary-layer (ABL) processes, sea-breeze (SB) circulations, and convection initiation (CI). For the TRACER IOP window, these systems ran continuously between 1 June and 26 September, 2022. Due to commitments to NOAA projects, the Doppler lidar at the UHCC site was not available until 24 June 2022. The CLAMPS and SPARC profiling systems are self-contained platforms that have benefited from several years of development and deployment. Instruments and data processing were maintained remotely, which made the 4-month deployment for the TRACER-CUBIC IOP period possible. The same basic instrument configuration comprises each system: a scanning Doppler wind lidar for flow characterization and passive profiler(s) for characterizing planetary-boundary-layer (PBL) thermodynamic properties. Each platform includes a Halo Streamline Doppler wind lidar, an Atmospheric Emitted Radiance Interferometer (AERI), and a surface meteorology station. CLAMPS1 and CLAMPS2 each also include a microwave radiometer (MWR, Figure 1d). The TRACER-CUBIC hypotheses included (i) Interactions of SB and urban circulations and how they affect the PBL structure in the Houston environment, causing spatially (horizontally and vertically) and temporally highly variable flow patterns, (ii) heat, moisture, and aerosol transport and mixing depend on these flow dynamics, and (iii) an improved understanding of the flow patterns and PBL structure are critical for investigating the processes leading to CI. To test these hypotheses, the project aimed at (i) characterizing SB circulations and their impacts on the diurnal evolution of the structure of the ABL, (ii) studying the evolution of Houston’s complex urban boundary layer, and (iii) identifying effects of urban-induced circulations on pre-convective environments. TRACER-CUBIC observations generally provide good coverage during the summer IOP. Initial screening of the data indicates a good number of cases with bay-breeze (BB) and/or SB signatures, local CI, and interesting boundary-layer features such as strong nocturnal low-level jets (LLJs, Table 1). The numbers listed in rows 3-5 in this table will be further updated as part of ongoing in-depth analyses and systematic identification of local circulations and CI events. More detailed information about the data availability and quality for each instrument is provided in the “readme” files that were submitted to the ARM Data Center along with each archived data sets. These “readme” files also provide instrument descriptions, information about the data collection and processing procedures, data formats, and any additional information relevant for further data analysis.

54 ENVIRONMENTAL SCIENCES↗

Nonsynonymous amino acid changes in the α-chain of complement component 5 influence longitudinal susceptibility to Plasmodium falciparum infections and severe malarial anemia in kenyan children

Background: Severe malarial anemia (SMA; Hb < 5.0 g/dl) is a leading cause of childhood morbidity and mortality in holoendemic Plasmodium falciparum transmission regions such as western Kenya. Methods: We investigated the relationship between two novel complement component 5 (C5) missense mutations [rs17216529:C>T, p(Val145Ile) and rs17610:C>T, p(Ser1310Asn)] and longitudinal outcomes of malaria in a cohort of Kenyan children (under 60 mos, n = 1,546). Molecular modeling was used to investigate the impact of the amino acid transitions on the C5 protein structure. Results: Prediction of the wild-type and mutant C5 protein structures did not reveal major changes to the overall structure. However, based on the position of the variants, subtle differences could impact on the stability of C5b. The influence of the C5 genotypes/haplotypes on the number of malaria and SMA episodes over 36 months was determined by Poisson regression modeling. Genotypic analyses revealed that inheritance of the homozygous mutant (TT) for rs17216529:C>T enhanced the risk for both malaria (incidence rate ratio, IRR = 1.144, 95%CI: 1.059–1.236, p = 0.001) and SMA (IRR = 1.627, 95%CI: 1.201–2.204, p = 0.002). In the haplotypic model, carriers of TC had increased risk of malaria (IRR = 1.068, 95%CI: 1.017–1.122, p = 0.009), while carriers of both wild-type alleles (CC) were protected against SMA (IRR = 0.679, 95%CI: 0.542–0.850, p = 0.001). Conclusion: Collectively, these findings show that the selected C5 missense mutations influence the longitudinal risk of malaria and SMA in immune-naïve children exposed to holoendemic P. falciparum transmission through a mechanism that remains to be defined.

60 APPLIED LIFE SCIENCES↗

How long were older people expected to live with or without sarcopenia? Multistate modeling of a national cohort study

Objectives Sarcopenia is well known to be associated with mortality, but there is a lack of evidence on the estimates of life expectancy (LE) for sarcopenia in China. This study aims to estimate total life expectancy (TLE) and sarcopenia-specific LE in community-dwelling older Chinese adults with and without sarcopenia. Methods This study included participants aged 60 years and older who enrolled in the cohort in 2011 and 2013 and at least completed one follow-up until 2015 as part of the China Health and Retirement Longitudinal Study (CHARLS). The criteria for defining sarcopenia were based on the guidelines established by the Asian Working Group on Sarcopenia in 2019. TLE and sarcopenia-specific LE were estimated for the total population and subgroups using continuous-time multistate modeling. Results A total of 6,029 participants (49.2% women) with an average age of 68.4 (SD: 6.56) years were included in the study. The baseline prevalence of sarcopenia and possible sarcopenia was 19.5 and 44.9%, respectively. We observed that sarcopenia stages naturally deteriorated to worse stages (including death, by 24.4%) and returned to better stages (17.1%) during a median follow-up of 3.92 years (IQR: 2.00 ~ 4.00). The average TLE at the age of 60 was 20.9 [95% CI: 20.2–21.5] years (22.1 [95% CI: 19.6–24.6] for non-sarcopenic older adults, 20.9 [95% CI: 19.5–22.3] for possible sarcopenic, and 18.7 [95% CI: 16.4–21.1] for sarcopenic). Men, former and current smokers, and those living in northwest China had less TLE. Sarcopenic older adults, those with lower education, those who are unmarried, those with agriculture hukou, and those living in rural and northwest China were expected to live fewer years with non-sarcopenia. Sarcopenic older people, men, those with agriculture hukou, and those living in rural and southwest China were expected to live more years with sarcopenia. Discussion The results improved our understanding of the relationship between sarcopenia and life expectancy. We suggested that targeted strategies should be considered in high-risk populations and underdeveloped regions to prevent sarcopenia and improve non-sarcopenic life years for the older population.

Ye, Bo↗

An evaluation of prognostic factors, oncologic outcomes, and management for primary and recurrent squamous cell carcinoma of the vulva

Objective: To evaluate prognostic factors, outcomes, and management patterns of patients treated for squamous cell carcinoma of the vulva. Methods: One hundred sixty-four women were retrospectively identified with primary squamous cell carcinoma of the vulva treated at our institution between 1/1996–12/2018. Descriptive statistics were performed on patient, tumor, and treatment characteristics. The χ 2 tests and t-tests were used to compare categorical variables and continuous variables, respectively. Recurrence free survival (RFS), overall survival (OS), and disease-specific survival (DSS) were analyzed with Kaplan-Meier estimates, the log-rank test, and Cox proportional hazards. Results: Median follow-up was 52.5 months. Five-year RFS was 67.9%, 60.0%, 42.1%, and 20.0% for stage I–IV, respectively. Five-year DSS was 86.2%, 81.6%, 65.0%, and 42.9% for stage I–IV, respectively. On multivariate analysis, positive margins predicted overall RFS (hazard ratio [HR]=3.55; 95% confidence interval [CI]=1.18–10.73; p=0.025), while presence of lichen sclerosus on pathology (HR=2.78; 95% CI=1.30–5.91; p=0.008) predicted local RFS. OS was predicted by nodal involvement (HR=2.51; 95% CI=1.02–6.13; p=0.043) and positive margins (HR=5.19; 95% CI=2.03–13.26; p=0.001). Adjuvant radiotherapy significantly improved RFS (p=0.016) and DSS (p=0.012) in node-positive patients. Median survival after treatment of local, groin, and pelvic/distant recurrence was 52, 8, and 5 months, respectively. Conclusion: For primary treatment, more conservative surgical approaches can be considered with escalation of treatment in patients with concurrent precursor lesions, positive margins, and/or nodal involvement. Further studies are warranted to improve risk stratification in order to optimize treatment paradigms for vulvar cancer patients.

60 APPLIED LIFE SCIENCES↗

An upper limit to the atomic carbon abundance in the Orion plateau

Observations made of the atomic carbon line at 492 GHz toward OMC-1 show no evidence for the high velocity dispersion wings observed for many molecular rotational lines. The 3sigma upper limit to the CI column density, NCI, is 6.9 x 10 to the 17th per sq cm for velocities greater than or equal to 4 km per sec from the line center. This upper limit corresponds to a ratio of CI to CO abundances as low as less than 0.13, depending on the assumed CO column density. Atomic carbon is apparently depleted by a factor as large as five in the hot plateau gas, relative to its abundance in other molecular clouds. The lack of CI in the plateau source may mean that the shocks thought to be present in the region are not dissociative in nature and thus do not produce the UV radiation required to convert CO into CI.

Beichman, C. A.↗

Mineralogy versus bulk composition of the carbonaceous chondrite clast Kaidun 2

Kaidun is an unusual chondritic meteorite. Its main mass is of CR-type (Kaidun I) and contains CI-like (Kaidun II), EL, and EH clasts. The classification of Kaidun II based on mineralogy and bulk chemical criteria does not allow an unambigious assignment to CI. Here we report on the bulk chemical composition and the mineralogy of the Kaidun II clasts. The results of our investigation show that Kaidun II has some characteristics of both CI and CM chondrites. A possible relationship to the texture and composition of micrometeorites is indicated. The Kaidun II clast shows some conflicting mineralogical and chemical characteristics that do not allow an unambigious assignment to the well established carbonaceous chondrite classes. The overall texture of the matrix-rich clast and morphology of opaques are typical for CI's. Bulk matrix and bulk sample compositions reveal similarities with CM's. In addition, the presence of low-Fe Mn-enriched olivines and the relatively high abundance of enstatite resembles some micrometeorites.

Brandstaetter, F.↗

C/O atomic ratios in micrometer-size crushed grains from Antarctic micrometeorites and two carbonaceous meteorites

Antarctic micrometeorites (AMM's) have similarities (but also differences) with primitive meteorites, such as unequilibrated mineral assemblages. To further assess such similarities, we have measured the carbon content of micrometeorites and meteorites (Orgueil and Murchison), as determined in a random selection of micrometer-size crushed grain, with an analytical transmission electron microscope. Such analyses yield the C/O atomic ratio, the major and minor elements contents, and the textural features of the grains on a scale of approx. equal to 100 nanometers. An important proportion of micrometeorites from both the 100-400 micron and the 50-100 micron size fractions contains much more carbon than CI chondrite Orgueil. The average C-content of all micrometeorites in these two size fractions amount to approximately 1.8 x CI, and approximately 0.8 x CI, respectively (CI refers to the bulk C-content of Orgueil, of about 3.5 percent by weight). Carbon is usually not homogeneously distributed in the micrometeorite but is concentrated in C-rich grains. So far, most of these grains are amorphous, and seem to be associated with an oxidized Fe-rich phase (possibly a variety of 'dirty' magnetite). About 5 percent of them have the composition of 'COPS', a phase additionally enriched in O, P, and S.

Perreau, M.↗

Multielement analysis of interplanetary dust particles using TOF-SIMS

Sections of three stratospheric particles (U2015G1, W7029*A27, and L2005P9) were analyzed with TOF-SIMS (Time Of Flight-Secondary Ion Mass Spectrometry) continuing our efforts to investigate the element distribution in interplanetary dust particles (IDP's) with high lateral resolution (approximately 0.2 micron), to examine possible atmospheric contamination effects, and to further explore the abilities of this technique for element analysis of small samples. The samples, previously investigated with SXRF (synchrotron X-ray fluorescence analysis), are highly enriched in Br (Br/Fe: 59 x CI, 9.2 x CI, and 116 x CI, respectively). U2015G1 is the IDP with the by far highest Zn/Fe-ratio (81 x CI) ever reported in chondritic particles.

Stephan, T.↗

Continual improvement plan

NASA's approach to continual improvement (CI) is a systems-oriented, agency-wide approach that builds on the past accomplishments of NASA Headquarters and its field installations and helps achieve NASA's vision, mission, and values. The NASA of the future will fully use the principles of continual improvement in every aspect of its operations. This NASA CI plan defines a systematic approach and a model for continual improvement throughout NASA, stressing systems integration and optimization. It demonstrates NASA's constancy of purpose for improvement - a consistent vision of NASA as a worldwide leader in top-quality science, technology, and management practices. The CI plan provides the rationale, structures, methods, and steps, and it defines NASA's short term (1-year) objectives for improvement. The CI plan presents the deployment strategies necessary for cascading the goals and objectives throughout the agency. It also provides guidance on implementing continual improvement with participation from top leadership and all levels of employees.

Source record↗

The Circumstellar Imager: Direct detection of extra-solar planetary systems

The Astrometric Imaging Telescope (AIT) is designed to probe the circumstellar environment by both direct imaging and indirect astrometric measurements. The Circumstellar Imager (CI) is a coronagraphic camera and is the direct imaging component of the AIT. The CI is designed to obtain high-sensitivity images of the circumstellar region. It provides crucial non-inferential information relating to the frequency, origin, and evolution of planetary systems and all forms of circumstellar matter. Such imaging is usually limited by the scattered and diffracted light halos of the star itself, which are greatly suppressed in the CI by mating a novel high-efficiency coronagraph with a phase-compensated optical system. For faint point sources in the circumstellar region, the CI will have a sensitivity in excess of 5 magnitudes fainter than the as-designed Hubble Space Telescope (HST). Laboratory data are shown for the coronagraph, which, in a diffraction-limited environment, is capable of suppressing the stellar diffraction sidelobes by several orders of magnitude without significant sacrifice of field of view. In order to realize the high rejection levels inherent in the coronagraph design, it is necessary to limit scatter in the optical systems, imposing a mid-spatial frequency figure error requirement an order of magnitude smaller than that of the HST. Experimental data directed toward meeting this requirement are also shown.

Ftaclas, Christ↗

Continual Improvement in Shuttle Logistics

It has been said that Continual Improvement (CI) is difficult to apply to service oriented functions, especially in a government agency such as NASA. However, a constrained budget and increasing requirements are a way of life at NASA Kennedy Space Center (KSC), making it a natural environment for the application of CI tools and techniques. This paper describes how KSC, and specifically the Space Shuttle Logistics Project, a key contributor to KSC's mission, has embraced the CI management approach as a means of achieving its strategic goals and objectives. An overview of how the KSC Space Shuttle Logistics Project has structured its CI effort and examples of some of the initiatives are provided.

Flowers, Jean↗

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↗