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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.

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At least 343 records · Page 19
All sourcesNASA NTRSDOE OSTI
NASA NTRS2002

Understanding How Astronauts Adapt to Space and to Earth: Anatomical Studies of Central Vestibular Adaptation

Significant changes take place in the nervous systems of astronauts during and following exposure to microgravity. These changes, particularly in the part of the brain that controls balance, the vestibular system, can cause sensations of rotation, dizziness, and vertigo, as well as space adaptation syndrome. Adaptation to the microgravity environment usually occurs within one week, and a subsequent re-adaptation period of several days is often required upon return to Earth. In order to realize long-term spaceflight, effective countermeasures for these symptoms must be developed. The structural changes that take place in one of the vestibular regions of the brain (the cerebellar cortex) during the process of adaptation to Earth's gravity remain unclear and are the subject of an experiment being conducted on STS-107 by Dr. Gay Holstein of the Mount Sinai School of Medicine in New York. Using the rat as a model, Dr. Holstein and her team will seek to identify the cellular changes underlying the vestibular changes experienced by astronauts.

Holstein, Gay↗
NASA NTRS1993

Learning fuzzy information in a hybrid connectionist, symbolic model

An instance-based learning system is presented. SC-net is a fuzzy hybrid connectionist, symbolic learning system. It remembers some examples and makes groups of examples into exemplars. All real-valued attributes are represented as fuzzy sets. The network representation and learning method is described. To illustrate this approach to learning in fuzzy domains, an example of segmenting magnetic resonance images of the brain is discussed. Clearly, the boundaries between human tissues are ill-defined or fuzzy. Example fuzzy rules for recognition are generated. Segmentations are presented that provide results that radiologists find useful.

Romaniuk, Steve G.↗
DOE OSTI2026

Impact of Selenium and Vitamin E Deficiency on Zika Virus Pathogenesis and Immune Response in Mice

Micronutrient status is recognized to influence host susceptibility to viral infections, yet its impact on Zika virus (ZIKV) pathogenesis remains incompletely understood. We investigated the effects of dietary selenium and combined selenium plus vitamin E deficiency on ZIKV infection outcomes in a type I interferon α/β receptor knockout (Ifnar1 −/− ) murine model. Mice maintained on deficient diets exhibited significantly lower neutralizing antibody titers and reduced levels of key antiviral cytokines (IFN-γ, TNF-α, IFN-α, IFN-β, IL-12p70, CCL5) compared to controls. Correspondingly, higher viral RNA loads were detected in the brains of double-deficient mice, which also experienced greater weight loss and increased mortality. Deep sequencing revealed no major differences in overall viral genome diversity across diet groups; however, specific mutations, including V330L and D67E in the E gene, and V360I in the NS3 gene, were enriched or detected in nutritionally deficient animals. These findings suggest that antioxidant micronutrient deficiency impairs both humoral and cellular immune responses to ZIKV, potentially facilitating enhanced neuroinvasion. While the functional consequences of the identified mutations warrant further investigation, our results underscore the importance of adequate micronutrient intake for optimal antiviral defense. Further studies are needed to clarify the epidemiological significance of these observations.

Biological and medical sciences↗
NASA NTRS2000

Development of a Reference Dose for Perchlorate: Current Issues and Status

The perchlorate anion (ClO4) is typically manufactured as the ammonium salt. The most common use of ammonium perchlorate is in the aerospace program as a component of solid rocket fuel. The perchlorate anion is exceedingly stable under environmental conditions and has been found in ground and surface waters in CA, NV, UT, AZ, TX, AK, NY, MD, WV and FL. The National Center for Environmental Assessment (NCEA) of the U.S. Environmental Protection Agency (US EPA) is in the process of developing an oral reference dose (RfD) for perchlorate. An oral RfD is a body-weight-adjusted dose that can be consumed daily over an entire lifetime with the expectation of no adverse health effects. Once developed, the new RfD will be used by US EPA as the basis of a safe-drinking-water level (SDWL) guideline. US EPA and regional regulatory agencies will then jointly or separately propose clean-up action levels for ground and surface waters at contaminated sites. The toxicological database on CIO4- as of March 1997 was determined by an expert peer-review panel to be inadequate for the purpose of deriving an oral RfD. For example, little or no experimental data existed on the subchronic, reproductive, or developmental toxicity of perchlorate. To fill gaps in the toxicological database, eight animal studies were designed by a government-industry consortium that included US EPA and AFRL. These studies were performed in 1997-1998. It has been known for many years that in the thyroid, high doses of perchlorate block the function of iodide by competing for iodide binding sites. Perchlorate was used in the 1950s-60s as a treatment for Graves' disease (a hyperthyroid condition). Because of what was already known about the pharmacological mode of action of perchlorate, specific concerns addressed in the design of the recent animal studies included the potential for developmental toxicity, notably neurological development. Upon review of complete study reports from four of the studies and incomplete data from the other two, US EPA/NCEA issued a document in December 1998 stating that the critical effects were hormone and histology data from the neurodevelopmental/behavioral toxicity study that had been performed in rats; an RfD was proposed based upon the observation of thyroid-follicular-cell hypertrophy in the 5-day-old pups (PND) of dams given perchlorate in drinking water at 0.1 mg/kg-day (the lowest dose tested) in this study. US EPA/NCEA also focused attention on a nonsignificant increase in motor activity observed in 14-day-old male pups in the same study at the same dose. In February 1999, a public workshop was convened at which an external peer-review panel determined that there was still insufficient data to support the development of a RfD. Additional studies were recommended. Since that time a clinical study revealed significant depression of thyroidal uptake of iodide in volunteers receiving potassium perchlorate at 10 mg/day for 14 days. Follow-up studies currently underway include a pathology working-group review of histology slides from the all of the previous studies, a motor activity study similar to the first behavioral study, an additional immunotoxicity study, male and female rat kinetic studies, a hormone interlaboratory study, and an effects study for thyroid and brain in developing rats. These studies are expected to be complete by mid-2000. A clinical study is planned to determine inhibition of iodide uptake and kinetic parameters in humans following 14-day perchlorate ingestion. The kinetics studies will provide data for developing physiologically based pharmacokinetic (PBPK) models for rats and humans needed to establish the RfD.

Pleus, R. C.↗
NASA NTRS1998

Evaluation of pGL1-TNF-alpha therapy in combination with radiation

Long-term control of high-grade brain tumors is rarely achieved with current therapeutic regimens. In this study a new plasmid-based human tumor necrosis factor-alpha (TNF-alpha) expression vector was synthesized (pGL1-TNF-alpha) and evaluated together with radiation in the aggressive, rapidly growing C6 rat glioma model. pGL1-TNF-alpha was successfully transfected into C6 cells in vitro using a cationic polyamine method. Expression was detected up to 7 days and averaged 0.4 ng of TNF-alpha in the culture medium from 1x10(5) cells. The expressed protein was biologically functional, as evidenced by growth inhibition of L929, a TNF-alpha-susceptible cell line. Using fluorescence-labeled monoclonal antibodies and laser scanning cytometry, we confirmed that both the P55 and P75 receptors for TNF-alpha were present on the C6 cell membrane. However, the receptors were present at low density and P55 was expressed more than the P75 receptor. These findings were in contrast to results obtained with TNF-alpha-susceptible L929 cells. Tests in athymic mice showed that pGL1-TNF-alpha administered intratumorally 16-18 h before radiation (each modality given three times) significantly inhibited C6 tumor progression (P<0.05). This effect was more than additive, because pGL1-TNF-alpha alone did not slow tumor growth and radiation alone had little effect on tumor growth. These results indicate that pGL1-TNF-alpha has potential to augment the antitumor effects of radiation against a tumor type that is virtually incurable.

Non-NASA Center↗
DOE OSTI2021

In-depth quantitative proteomic characterization of organotypic hippocampal slice culture reveals sex-specific differences in biochemical pathways

Sex differences in the brain of mammals range from neuroarchitecture through cognition to cellular metabolism. The hippocampus, a structure mostly associated with learning and memory, presents high vulnerability to neurodegeneration and aging. Therefore, we explored basal sex-related differences in the proteome of organotypic hippocampal slice culture, a major in vitro model for studying the cellular and molecular mechanisms related to neurodegenerative disorders. Results suggest a greater prevalence of astrocytic metabolism in females and significant neuronal metabolism in males. The preference for glucose use in glycolysis, pentose phosphate pathway and glycogen metabolism in females and high abundance of mitochondrial respiration subunits in males support this idea. An overall upregulation of lipid metabolism was observed in females. Upregulation of proteins responsible for neuronal glutamate and GABA synthesis, along with synaptic associated proteins, were observed in males. In general, the significant spectrum of pathways known to predominate in neurons or astrocytes, together with the well-known neuronal and glial markers observed, revealed sex-specific metabolic differences in the hippocampus. TEM qualitative analysis might indicate a greater presence of mitochondria at CA1 synapses in females. These findings are crucial to a better understanding of how sex chromosomes can influence the physiology of cultured hippocampal slices and allow us to gain insights into distinct responses of males and females on neurological diseases that present a sex-biased incidence.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗
NASA NTRS2008

Developing Humanoid Robots for Real-World Environments

Humanoids are steadily improving in appearance and functionality demonstrated in controlled environments. To address the challenges of operation in the real-world, researchers have proposed the use of brain-inspired architectures for robot control, and the use of robot learning techniques that enable the robot to acquire and tune skills and behaviours. In the first part of the paper we introduce new concepts and results in these two areas. First, we present a cerebellum-inspired model that demonstrated efficiency in the sensory-motor control of anthropomorphic arms, and in gait control of dynamic walkers. Then, we present a set of new ideas related to robot learning, emphasizing the importance of developing teaching techniques that support learning. In the second part of the paper we propose the use in robotics of the iterative and incremental development methodologies, in the context of practical task-oriented applications. These methodologies promise to rapidly reach system-level integration, and to early identify system-level weaknesses to focus on. We apply this methodology in a task targeting the automated assembly of a modular structure using HOAP-2. We confirm this approach led to rapid development of a end-to-end capability, and offered guidance on which technologies to focus on for gradual improvement of a complete functional system. It is believed that providing Grand Challenge type milestones in practical task-oriented applications accelerates development. As a meaningful target in short-mid term we propose the 'IKEA Challenge', aimed at the demonstration of autonomous assembly of various pieces of furniture, from the box, following included written/drawn instructions.

Stoica, Adrian↗
DOE OSTI2021

Budget Constrained Machine Learning for Early Prediction of Adverse Outcomes for COVID-19 Patients

Background: Machine learning (ML) based risk stratification models of Electronic Health records (EHR) data may help to optimize treatment of COVID-19 patients, but are often limited by their lack of clinical interpretability and cost of laboratory tests. We develop a ML based tool for predicting adverse outcomes based on EHR data to optimize clinical utility under a given cost structure. This cohort study was performed using deidentified EHR data from COVID-19 patients from ProMedica Healthcare in northwest Ohio and southeastern Michigan. Methods: We tested performance of various ML approaches for predicting either increasing ventilatory support or mortality and the set of model features under a budget constraint was optimized via exhaustive search across all combinations of features. Results: The optimal sets of features for predicting ventilation under any budget constraint included demographics and comorbidities (DCM), basic metabolic panel (BMP), D-dimer, lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), CRP, brain natriuretic peptide (BNP), and procalcitonin and for mortality included DCM, BMP, complete blood count, D-dimer, LDH, CRP, BNP, procalcitonin and ferritin. Conclusions: This study presents a quick, accurate and cost-effective method to evaluate risk of deterioration for patients with SARS-CoV-2 infection at the time of clinical evaluation.

Cadena Pico, JoseE.↗
NASA NTRS2003

Differences in the hemodynamic response to event-related motor and visual paradigms as measured by near-infrared spectroscopy

Several current brain imaging techniques rest on the assumption of a tight coupling between neural activity and hemodynamic response. The nature of this neurovascular coupling, however, is not completely understood. There is some evidence for a decoupling of these processes at the onset of neural activity, which manifests itself as a momentary increase in the relative concentration of deoxyhemoglobin (HbR). The existence of this early component of the hemodynamic response function, however, is controversial, as it is inconsistently found. Near infrared spectroscopy (NIRS) allows quantification of levels of oxyhemoglobin (HbO(2)) and HbR during task performance in humans. We acquired NIRS data during performance of simple motor and visual tasks, using rapid-presentation event-related paradigms. Our results demonstrate that rapid, event-related NIRS can provide robust estimates of the hemodynamic response without artifacts due to low-frequency signal components, unlike data from blocked designs. In both the motor and visual data the onset of the increase in HbO(2) occurs before HbR decreases, and there is a poststimulus undershoot. Our results also show that total blood volume (HbT) drops before HbO(2) and undershoots baseline, raising a new issue for neurovascular models. We did not find early deoxygenation in the motor data using physiologically plausible values for the differential pathlength factor, but did find one in the visual data. We suggest that this difference, which is consistent with functional magnetic resonance imaging (fMRI) data, may be attributable to different capillary transit times in these cortices.

NASA Program Biomedical Research and Countermeasur↗
DOE OSTI2021

Upscaling X-ray nanoimaging to macroscopic specimens

Upscaling X-ray nanoimaging to macroscopic specimens has the potential for providing insights across multiple length scales, but its feasibility has long been an open question. By combining the imaging requirements and existing proof-of-principle examples in large-specimen preparation, data acquisition and reconstruction algorithms, the authors provide imaging time estimates for howX-ray nanoimaging can be scaled to macroscopic specimens. To arrive at this estimate, a phase contrast imaging model that includes plural scattering effects is used to calculate the required exposure and corresponding radiation dose. The coherent X-ray flux anticipated from upcoming diffraction-limited light sources is then considered. This imaging time estimation is in particular applied to the case of the connectomes of whole mouse brains. To image the connectome of the whole mouse brain, electron microscopy connectomics might require years, whereas optimized X-ray microscopy connectomics could reduce this to one week. Furthermore, this analysis points to challenges that need to be overcome (such as increased X-ray detector frame rate) and opportunities that advances in artificial-intelligence-based `smart' scanning might provide. While the technical advances required are daunting, it is shown that X-ray microscopy is indeed potentially applicable to nanoimaging of millimetre- or even centimetre-size specimens.

97 MATHEMATICS AND COMPUTING↗
NASA NTRS1985

Electroencephalogram (EEG) and Magnetoencephalogram (MEG) as Tools for Evaluation of Cognitive Function

We have developed computerized analysis and display techniques to help identify the origins of visually evoked scalped potentials (VESP). The potentials are recorded simultaneously from many electrodes (usually 40 to 48) spaced over the region of the scalp where appreciable evoked potentials are found in response to particular stimulus. Contour mapping algorithms are then used to display the time behavior of equipotential surfaces on the scalp during the VESP. We then use an optimization technique to select the parameters of arrays of current dipole sources within the model until the model equipotential field distribution closely fits the measured data. Computer graphics are then used to display, as a movie, the actual and model scalp potential fields and the parameters of the dipole generators within the model head during the course of VESP activity. We have devised reaction time tests that involve potentially separable stages of cognitive processing and utilize stimuli that produce measurable cognition-related features in the late component of the evoked potential. We have used these techniques to determine the loci in the brain where known cognition-related features in the evoked potential are generated and we have explored the extent to which each of these features can be related to the reaction time tasks. We have also examined the temporal-spatial aspects of their cerebral involvement. Our current work is planned to characterize the age-related changes in the processes performed by such sources. We also use a neuromagnetometer to measure the evoked magnetic fields in similar circumstances; we will discuss the relative merits of the two methodologies.

Fender, Derek H.↗
NASA NTRS2019

Mice Exposed to Combined Chronic Low-Dose Irradiation and Modeled Microgravity Develop Long-Term Neurological Sequelae

A combination of spaceflight-relevant factors (fluid-shift and radiation) created a different gene expression profile than either factor individually. Some gene pathways including reduced transcriptional machinery, increased neurogenesis and neuropeptide production, and dysregulated cell structure and cell signaling. Gene expression differences can persist for at least 4 months after a 21- day exposure to a combination of fluid-shift and radiation in the brain tissue of mice. Brain-related transcriptional changes are dynamic during readaptation phase from exposure to spaceflight-like conditions, which may lead to long-term neurological consequences.

Overbey, Eliah G.↗
DOE OSTI2022

MusMorph, a database of standardized mouse morphology data for morphometric meta-analyses

Complex morphological traits are the product of many genes with transient or lasting developmental effects that interact in anatomical context. Mouse models are a key resource for disentangling such effects, because they offer myriad tools for manipulating the genome in a controlled environment. Unfortunately, phenotypic data are often obtained using laboratory-specific protocols, resulting in self-contained datasets that are difficult to relate to one another for larger scale analyses. To enable meta-analyses of morphological variation, particularly in the craniofacial complex and brain, we created MusMorph, a database of standardized mouse morphology data spanning numerous genotypes and developmental stages, including E10.5, E11.5, E14.5, E15.5, E18.5, and adulthood. To standardize data collection, we implemented an atlas-based phenotyping pipeline that combines techniques from image registration, deep learning, and morphometrics. Alongside stage-specific atlases, we provide aligned micro-computed tomography images, dense anatomical landmarks, and segmentations (if available) for each specimen (N = 10,056). Our workflow is open-source to encourage transparency and reproducible data collection.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2024

SQMS Quantum R&D in Machine Learning, Optimization and Sensing beyond Fundamental Physics Applications

This newly formed team at SQMS under the Ecosystem Thrust is looking to develop capabilities impacting societal advances outside the core domain of HEP and condensed matter physics. We explicitly leverage the experimental and algorithmic innovations developed across all groups as well as connect to broad-scope external projects of the diverse team of PIs. As the inaugural set of projects, we are studying numerically quantum machine learning models inspired by efficiently trainable echo-state and orthogonal neural networks and developing designs for related experiments to be performed on quantum processors based on SQMS SRF cQED technology and Rigetti s transmon arrays. Investigated models exploit ideas and lessons learned from multiple prior work by SQMS team members in a variety of internal and external activities [R1]. Target initial applications include noisy signal processing, potentially captured by quantum sensors or noisy QPUs, as well as simulation and classification of healthcare data. For instance, image reconstruction of the brain s electrical properties by solving the inverse Maxwell equation problem with uncertainty [R2] through a hybrid quantum-classical physics-informed architecture for time-dependent processes [R3]. The group is also investigating the application and development of novel quantum sensors based on magnetic levitation of a superconducting sphere coupled to a superconducting qubit. This coupling enables high-precision measurements of the position of the sphere, which can be used for sensitive detection of forces, enabling practical applications such as gravimetry for geophysics analysis, or accelerometry for GPS-denied navigation [R4] [R1] Rieffel, Eleanor G., Ata Akbari Asanjan, M. Sohaib Alam, Namit Anand, David E. Bernal Neira, Sophie Block, Lucas T. Brady et al. "Assessing and advancing the potential of quantum computing: A NASA case study." Future Generation Computer Systems (2024). [R2] Yu, X., Serrall s, J.E., Giannakopoulos, I.I., Liu, Z., Daniel, L., Lattanzi, R. and Zhang, Z., 2023. Pifon-ept: Mr-based electrical property tomography using physics-informed fourier networks. IEEE Journal on Multiscale and Multiphysics Computational Techniques. [R3] Wudarski, Filip, Daniel OConnor, Shaun Geaney, Ata Akbari Asanjan, Max Wilson, Elena Strbac, P. Aaron Lott, and Davide Venturelli. "Hybrid quantum-classical reservoir computing for simulating chaotic systems." arXiv preprint arXiv:2311.14105 (2023). [R4] Higgins, Gerard, Saarik Kalia, and Zhen Liu. "Maglev for dark matter: Dark-photon and axion dark matter sensing with levitated superconductors." Physical Review D 109.5 (2024): 055024.

Venturelli, Davide↗
NASA NTRS1991

Simulating motivated cognition

A research effort to develop a sophisticated computer model of human behavior is described. A computer framework of motivated cognition was developed. Motivated cognition focuses on the motivations or affects that provide the context and drive in human cognition and decision making. A conceptual architecture of the human decision-making approach from the perspective of information processing in the human brain is developed in diagrammatic form. A preliminary version of such a diagram is presented. This architecture is then used as a vehicle for successfully constructing a computer program simulation Dweck and Leggett's findings that relate how an individual's implicit theories orient them toward particular goals, with resultant cognitions, affects, and behavior.

Gevarter, William B.↗
NASA NTRS2002

Understanding How Space Travel Affects Blood Vessels: Arterial Remodeling and Functional Adaptations Induced by Microgravity

Ever rise quickly from the couch to get something from the kitchen and suddenly feel dizzy? With a low heart rate and relaxed muscles, the cardiovascular system does not immediately provide the resistance necessary to keep enough blood going to your head. Gravity wins, at least for a short time, before your heart and blood vessels can respond to the sudden change in position and correct the situation. Actually, the human cardiovascular system is quite well adapted to the constant gravitational force of the Earth. When standing, vessels in the legs constrict to prevent blood from collecting in the lower extremities. In the space environment, the usual head-to-foot blood pressure and tissue fluid gradients that exist during the upright posture on Earth are removed. The subsequent shift in fluids from the lower to the upper portions of the body triggers adaptations within the cardiovascular system to accommodate the new pressure and fluid gradients. In animal models that simulate microgravity, the vessels in the head become more robust while those in the lower limbs become thin and lax. Similar changes may also occur in humans during spaceflight and while these adaptations are appropriate for a microgravity environment, they can cause problems when the astronauts return to Earth or perhaps another planet. Astronauts often develop orthostatic intolerance which means they become dizzy or faint when standing upright. This dizziness can persist for a number of days making routine activities difficult. In an effort to understand the physiological details of these cardiovascular adaptations, Dr. Michael Delp at Texas A&M University, uses the rat as a model for his studies. For the experiment flown on STS-107, he will test the hypothesis that blood vessels in the rats' hindlimbs become thinner, weaker, and constrict less in response to pressure changes and to chemical signals when exposed to microgravity. In addition, he will test the hypothesis that arteries in the brain become thicker as a result of microgravity-induced fluid shifts toward the head.

Delp, Michael↗
NASA NTRS1999

Deblurring

In most instances, traditional EEG methodology provides insufficient spatial detail to identify relationships between brain electrical events and structures and functions visualized by magnetic resonance imaging or positron emission tomography. This article describes a method called Deblurring for increasing the spatial detail of the EEG and for fusing neurophysiologic and neuroanatomic data. Deblurring estimates potentials near the outer convexity of the cortex using a realistic finite element model of the structure of a subject's head determined from their magnetic resonance images. Deblurring is not a source localization technique and thus makes no assumptions about the number or type of generator sources. The validity of Deblurring has been initially tested by comparing deblurred data with potentials measured with subdural grid recordings. Results suggest that deblurred topographic maps, registered with a subject's magnetic resonance imaging and rendered in three dimensions, provide better spatial detail than has heretofore been obtained with scalp EEG recordings. Example results are presented from research studies of somatosensory stimulation, movement, language, attention and working memory. Deblurred ictal EEG data are also presented, indicating that this technique may have future clinical application as an aid to seizure localization and surgical planning.

Non-NASA Center↗
DOE OSTI2024

A multilayer network analysis of Alzheimer's disease pathogenesis: Roles for p‐tau, synaptic peptides, and physical activity

INTRODUCTION: In the aging brain, cognitive abilities emerge from the coordination of complex pathways arising from a balance between protective lifestyle and environmental factors and accumulation of neuropathologies. METHODS: As part of the Rush Memory and Aging Project (n = 440), we measured accelerometer-based actigraphy, cognitive performance, and after brain autopsy, selected reaction monitoring mass spectrometry. Multilevel network analysis was used to examine the relationships among the molecular machinery of vesicular neurotransmission, Alzheimer's disease (AD) neuropathology, cognition, and late-life physical activity. RESULTS: Synaptic peptides involved in neuronal secretory function were the most influential contributors to the multilayer network, reflecting the complex interdependencies among AD pathology, synaptic processes, and late-life cognition. Older adults with lower physical activity evidenced stronger adverse relationships among phosphorylated tau peptides, markers of synaptic integrity, and tangle pathology. DISCUSSION: Network-based approaches simultaneously model interdependent biological processes and advance understanding of the role of physical activity in age-associated cognitive impairment. Highlights: Network-based approaches simultaneously model interdependent biological processes. Secretory synaptic peptides were influential contributors to the multilayer network. Older adults with lower physical activity had adverse relationships among pathology. There was interdependence among phosphorylated tau, synaptic integrity, and tangles. Network methods elucidate the role of physical activity in cognitive impairment.

60 APPLIED LIFE SCIENCES↗