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At least 487 records · Page 27

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DOE OSTI2022

Habitat use by female desert tortoises suggests tradeoffs between resource use and risk avoidance

Animals may select habitat to maximize the benefits of foraging on growth and reproduction, while balancing competing factors like the risk of predation or mortality from other sources. Variation in the distribution of food resources may lead animals to forage at times or in places that carry greater predation risk, with individuals in poor quality habitats expected to take greater risks while foraging. We studied Mojave desert tortoises ( Gopherus agassizii ) in habitats with variable forage availability to determine if risk aversion in their selection of habitat relative was related to abundance of forage. As a measure of risk, we examined tortoise surface activity and mortality. We also compared tortoise body size and body condition between habitats with ample forage plants and those with less forage plants. Tortoises from low forage habitats selected areas where more annual plants were nutritious herbaceous flowering plants but did not favor areas of greater perennial shrub cover that could shelter them or their burrows. In contrast, tortoises occupying high forage habitats showed no preference for forage characteristics, but used burrows associated with more abundant and larger perennial shrubs. Tortoises in high forage habitats were larger and active above ground more often but did not have better body condition. Mortality was four times higher for females occupying low forage habitat than those in high forage habitat. Our results are consistent with the idea that tortoises may minimize mortality risk where food resources are high, but may accept some tradeoff of greater mortality risk in order to forage optimally when food resources are limiting.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2022

Cumulative effects of piscivorous colonial waterbirds on juvenile salmonids: A multi predator-prey species evaluation

We investigated the cumulative effects of predation by piscivorous colonial waterbirds on the survival of multiple salmonid ( Oncorhynchus spp.) populations listed under the U.S. Endangered Species Act (ESA) and determined what proportion of all sources of fish mortality (1 –survival) were due to birds in the Columbia River basin, USA. Anadromous juvenile salmonids (smolts) were exposed to predation by Caspian terns ( Hydroprogne caspia ), double-crested cormorants ( Nannopterum auritum ), California gulls ( Larus californicus ), and ring-billed gulls ( L . delawarensis ), birds known to consume both live and dead fish. Avian consumption and survival probabilities (proportion of available fish consumed or alive) were estimated for steelhead trout ( O . mykiss ), yearling Chinook salmon ( O . tshawytscha ), sub-yearling Chinook salmon, and sockeye salmon ( O . nerka ) during out-migration from the lower Snake River to the Pacific Ocean during an 11-year study period (2008–2018). Results indicated that probabilities of avian consumption varied greatly across salmonid populations, bird species, colony location, river reach, and year. Cumulative consumption probabilities (consumption by birds from all colonies combined) were consistently the highest for steelhead, with annual estimates ranging from 0.22 (95% credible interval = 0.20–0.26) to 0.51 (0.43–0.60) of available smolts. The cumulative effects of avian consumption were significantly lower for yearling and sub-yearling Chinook salmon, with consumption probabilities ranging annually from 0.04 (0.02–0.07) to 0.10 (0.07–0.15) and from 0.06 (0.3–0.09) to 0.15 (0.10–0.23), respectively. Avian consumption probabilities for sockeye salmon smolts was generally higher than for Chinook salmon smolts, but lower than for steelhead smolts, ranging annually from 0.08 (0.03–0.22) to 0.25 (0.14–0.44). Although annual consumption probabilities for birds from certain colonies were more than 0.20 of available smolts, probabilities from other colonies were less than 0.01 of available smolts, indicating that not all colonies of birds posed a substantial risk to smolt mortality. Consumption probabilities were lowest for small colonies and for colonies located a considerable distance from the Snake and Columbia rivers. Total mortality attributed to avian consumption was relatively small for Chinook salmon (less than 10%) but was the single greatest source of mortality for steelhead (greater than 50%) in all years evaluated. Results suggest that the potential benefits to salmonid populations of managing birds to reduce smolt mortality would vary widely depending on the salmonid population, the species of bird, and the size and location of the breeding colony.

Evans, Allen F.↗

NASA NTRS2000

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↗

NASA NTRSDate not supplied

Venous Gas Embolism: Review to Quantify a Safe Volume of Air in Intravenous Fluids Bags for Spaceflight Applications

INTRODUCTION: The ability to create intravenous fluids (IVF) in-situ from the potable water supply of a spaceflight vehicle or habitat is a desired capability for an exploration medical system. In order to define an acceptable volume of air in IVF bags, an understanding of the volume of venous gas embolism as it relates to negative outcomes is needed. The purpose of this study is to review the literature to determine if there is a known volume of gas that contributes to mortality and/or morbidity that could be used to define requirements for rapid IVF infusion in microgravity. METHODS: A literature review was conducted of the PubMed database using the syntax: (Venous) AND (Gas OR Air) AND (Embolism) AND (Morbidity) AND (Mortality) AND (Volume) as well as manual review of references from relevant articles. 151 articles were screened excluding partial text and pediatric articles. Studies were reviewed for identification of volume of venous gas embolism associated with morbidity and/or mortality, which identified 27 articles. RESULTS: Reviewed literature included animal studies, case reports, and review articles. A high variation of proposed volumes contributing to mortality was reported. The limited human data values ranged from 20 ml to 200 ml of infused air with mortality estimated to be 48 – 80%. No studies evaluated human morbidity in any capacity. DISCUSSION: The lack of consensus on the safe volume of infused air has potential ramifications for IVF use in spaceflight as current technologies to create IVF from potable water may introduce air in IVF bags. While current microgravity infusion protocols call for the use of inline air removal filters, commercially available options have flow rate limitations that preclude rapid infusion in a resuscitation scenario. Such filters may be used in parallel to increase flow rate, but the time required to set up such a system may exclude its use during a medical emergency. Additionally, these consumable filters drive up the overall mass and volume of the medical system. Identification of a safe volume of air in IVF would allow for guidelines for the in-situ production of IVF in future spaceflight vehicles/habitats.

Christopher R Woodard↗

NASA NTRS2022

Asparagine Biosynthesis as a Mechanism of Increased Host Lethality Induced by Serratia Marcescens in Simulated Microgravity Environments

While studies have shown an increase in pathogenicity in several microbes during spaceflight and after exposure to simulated microgravity, the mechanisms underlying these changes in phenotype are not understood across different pathogens, particularly in opportunistic pathogens. This study evaluates the mechanism for increased virulence of the opportunistic gram-negative bacterium, Serratia marcescens, in simulated microgravity. Low-shear modeled microgravity (LSMMG) is used in ground-based studies to simulate the effects of microgravity as experienced in spaceflight. Our previous findings showed that there was a significant increase in mortality rates of the Drosophila melanogaster host when infected with either spaceflight or LSMMG treated S. marcescens. Here, we report that LSMMG increases asparagine uptake and synthesis in S. marcescens and that the increased host lethality induced by LSMMG bacteria grown in rich media can be recapitulated in minimal media by adding only aspartate and glutamine, the substrates of asparagine biosynthesis. Interestingly, increased bacterial growth rate alone is not sufficient to contribute to maximal host lethality, since the addition of aspartate to minimal media caused an LSMMG-specific increase in bacterial growth rate that is comparable to that induced by the combination of aspartate and glutamine, but this increase in growth does not cause an equivalent rate of host mortality. However, the addition of both aspartate and glutamine cause both an increase in host mortality and an overexpression of asparagine pathway genes in a LSMMG-dependent manner. We also report that L-asparaginase-mediated breakdown of asparagine is an effective countermeasure for the increased host mortality caused by LSMMG-treated bacteria. This investigation underscores the importance of the asparagine utilization pathway by helping uncover molecular mechanisms that underlie increased mortality rates of a model host infected with microgravity-treated S.marcescens and provides a potential mitigation strategy.

simulated microgravity↗

DOE OSTI2012

Predation by coyotes on white-tailed deer neonates in South Carolina

Abstract: Coyotes (Canis latrans) are novel predators throughout the southeastern United States and their depredation of white-tailed deer (Odocoileus virginianus) neonates may explain observed declines in some deer populations in the region, but direct evidence for such a relationship is lacking. Our objective was to quantify neonate survival rates and causes of mortality at the United States Department of Energy's Savannah River Site (SRS), South Carolina to directly evaluate degree of predation in this deer population. From 2006 to 2009, we radio-monitored 91 neonates captured with the aid of vaginal implant transmitters in pregnant adult females and opportunistic searches. Overall Kaplan Meier survival rate to 16 weeks of age was 0.230 (95% CI = 0.155-0.328), and it varied little among years. Our best-fitting model estimated survival at 0.220 (95% CI = 0.144-0.320). This model included a quadratic time trend variable (lowest survival rate during the first week of life and increasing to near 1.000 around week 10), and Julian date of birth (survival probability declining as date of birth increased). Predation by coyotes was the most frequent cause of death among the 70 monitored neonates that died, definitively accounting for 37% of all mortalities and potentially accounting for as much as 80% when also including probable coyote predation. Predation by bobcats (Felis rufus) accounted for 7% (definitive) to 9% (including probable bobcat predation) of mortalities. The level of coyote-induced mortality we observed is consistent with the low recruitment rates exhibited in the SRS deer population since establishment of coyotes at the site. If representative of recruitment rates across South Carolina, current harvest levels appear unsustainable. This understanding is consistent with the recent declining trend in the statewide deer population. The effects of coyote predation on recruitment should be considered when setting harvest goals, regardless of whether local deer population size is currently above or below desired levels, because coyotes can substantially reduce fawn recruitment. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

South Carolina↗

DOE OSTI2014

Coyote removal, understory cover, and survival of white-tailed deer neonates: Coyote Control and Fawn Survival

Predation by coyotes (Canis latrans) on white-tailed deer (Odocoileus virginianus) neonates has led to reduced recruitment in many deer populations in southeastern North America. This low recruitment combined with liberal antlerless deer harvest has resulted in declines in some deer populations, and consequently, increased interest in coyote population control. We investigated whether neonate survival increased after coyote removal, whether coyote predation on neonates was additive to other mortality sources, and whether understory vegetation density affected neonate survival. We monitored neonate survival for 4 years prior to (2006–2009) and 3 years during (2010–2012) intensive coyote removal on 3 32-km 2 units on the United States Department of Energy’s Savannah River Site, South Carolina. We removed 474 coyotes (1.63 coyotes/km 2 per unit per year), reducing coyote abundance by 78% from pre-removal levels. The best model (w i = 0.927) describing survival probability among 216 radio-collared neonates included a within-year quadratic time trend variable, date of birth, removal treatment, and a varying removal year effect. Under this model, survival differed between pre-treatment and removal periods and it differed among years during the removal period, being >100% greater than pre-treatment survival (0.228) during the first removal year (0.513), similar to pre-treatment survival during the second removal year (0.202), and intermediate during the third removal year (0.431). Despite an initial increase, the overall effect of coyote removal on neonate survival was modest. Mortality rate attributable to coyote predation was lowest during the first removal year (0.357) when survival was greatest, but the mortality rate from all other causes did not differ between the pretreatment period and any year during removals, indicating that coyote predation acted as an additive source of mortality. Survival probability was not related to vegetation cover, either directly or in interaction with coyote abundance. When the objective is to increase the recruitment of white-tailed deer, we conclude that neither coyote control nor vegetation management appear effective. Reduction of the antlerless harvest may be necessary to meet this objective, but this harvest strategy warrants additional research in Southeastern deer populations.

South Carolina↗

DOE OSTI2019

Local Ultrasound-Facilitated Thrombolysis in High-Risk Pulmonary Embolism: First Dutch Experience

Purpose: To provide insight into the current use and results of ultrasound-facilitated catheter-directed thrombolysis (USAT) in patients with high-risk pulmonary embolism (PE). Introduction: Systemic thrombolysis is an effective treatment for hemodynamically unstable, high-risk PE, but is associated with bleeding complications. USAT is thought to reduce bleeding and is therefore advocated in patients with high-risk PE and contraindications for systemic thrombolysis. Methods: We conducted a retrospective cohort study of all patients who underwent USAT for high-risk PE in the Netherlands from 2010 to 2017. Characteristics and outcomes were analyzed. Primary outcomes were major (including intracranial and fatal) bleeding and all-cause mortality after 1 month. Secondary outcomes were all-cause mortality and recurrent venous thromboembolism within 3 months. Results: 33 patients underwent USAT for high-risk PE. Major bleeding occurred in 12 patients (36%, 95% CI 22–53), including 1 intracranial and 3 fatal bleeding. All-cause mortality after 1 month was 48% (16/33, 95% CI 31–66). All-cause mortality after 3 months was 50% (16/32, 95% CI 34–66), recurrent venous thromboembolism occurred in 1 patient (1/32, 3%, 95% CI 1–16). Conclusions: This study was the first to describe characteristics and outcomes after USAT in a study population of patients with high-risk PE only, an understudied population. Although USAT is considered a relatively safe treatment option, our results illustrate that at least caution is needed in critically ill patients with high-risk PE. Further research in patients with high-risk PE is warranted to guide patient selection.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2019

Outcomes of hypercalcemia of malignancy in patients with solid cancer: a national inpatient analysis

Hypercalcemia of malignancy (HCM) is present in one-third of cancer patients and is associated with a significant mortality risk of 50% within 1 month of diagnosis. We aimed to study the impact and outcomes of HCM in hospitalized patients with solid cancer. We analyzed data captured in the National Inpatient Sample database of the Agency of Healthcare Research and Quality. The study included all hospitalizations in adult solid cancer patients between January 2012 and September 2015 with hypercalcemia. All encounters associated with HCM were identified using the ICD-9 code (275.42) for hypercalcemia. Encounters with other known causes of hypercalcemia were excluded. The co-primary outcomes were incidence of HCM and inpatient mortality. During the study period, 7,501,209 hospitalizations met our inclusion criteria. Approximately 1.7% (n = 126,875) of these hospitalizations were related to HCM. This corresponds to approximately 1 in 59 solid malignancy associated hospitalizations. The mean age of patients with HCM was 65.7 years; 49% were females; 69% were Caucasians; 73% had metastatic disease and 22% received a palliative care consult. When compared to those without HCM, those hospitalized with HCM had a significantly longer mean hospital length of stay (7.3 days vs. 5.6 days, p < 0.001), higher inpatient mortality (12.3% vs. 5.5%, adjusted OR 1.76 (95% CI 1.69–1.84), p < 0·0001), and a greater likelihood of discharge to other facilities (27.4% vs. 16.2%, p < 0.0001). Although HCM accounts for < 2% of all hospitalizations in patients with solid cancer, those with HCM display higher mortality than those without HCM.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2020

Recent land cover changes in the Southwestern US lead to an increase in surface temperature

The increase in large-scale land cover change (LCC) in recent decades, particularly in response to climate-driven disturbances, has potential to impact local and regional changes in climate due to modification of carbon sources and sinks, albedo, surface roughness and energy fluxes. Using observational data, we predict the impact of two of the most extensive LCCs occurring in the Southwestern US: drought-induced tree mortality and shrub encroachment into grasslands, on surface temperature. We developed a new energy balance method that extracts the biophysical responses to environmental conditions, to predict how structural changes in albedo, surface roughness and canopy conductance following LCC will alter surface temperature. This method allows us not only to explain the observed differences in surface temperature between two non-adjacent study sites with different environmental conditions, but also to separate the contribution of biophysical and non-biophysical properties to surface temperature. Our results suggest that changes in biophysical properties due to shrub encroachment and tree mortality in the Southwestern US (independent of changes in other environmental properties) can potentially lead to an increase in midday surface temperature (11AM to 2PM) of 1 to 2 degrees Celsius, comparable to changes in surface temperature following deforestation. Although the average surface temperature increase in response to both shrub encroachment and tree mortality is similar, the biophysical properties driving the temperature change are different in each scenario. Change in aerodynamic conductance following tree mortality is the largest contributor to heating, while reduced albedo and canopy conductance drive the increase in surface temperature following shrub encroachment. Finally, we also show how this increase in daytime surface temperature could be further intensified with future climate, especially with the expected reduction in soil water availability in the Southwest.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2018

Organochlorine concentrations in adipose tissue and survival in postmenopausal, Danish breast cancer patients

Highlights: • Few studies have explored organochlorine concentrations and breast cancer mortality. • We did so in a survivor-cohort of 399 postmenopausal women, of whom 177 died. • PCBs and several organochlorine pesticides may be inversely associated with breast cancer mortality. • This association was confined to women with adverse prognostic factors. • Dieldrin was associated with a higher mortality, regardless of prognostic factors. Several studies have investigated an association between organochlorine-concentrations and breast cancer incidence, whereas few have investigated an association with breast cancer mortality.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2018

Assessing the recent estimates of the global burden of disease for ambient air pollution: Methodological changes and implications for low- and middle-income countries

Highlights: • From 2013 to 2015, the Global Burden of Disease estimates for ambient air pollution increased by over one million deaths. • We reconstructed the global estimates to quantify the impact of changes in model inputs. • Much of the change was due to new studies and improved methods in calculating dose response functions. • For certain low-income countries the improved air pollution exposure assessment had a significant impact. • Complete documentation and implications of future input changes are essential. The Global Burden of Disease (GBD) is a comparative assessment of the health impact of the major and well-established risk factors, including ambient air pollution (AAP) assessed by concentrations of PM2.5 (particles less than 2.5 µm) and ozone. Over the last two decades, major improvements have emerged for two important inputs in the methodology for estimating the impacts of PM2.5: the assessment of global exposure to PM2.5 and the development of integrated exposure risk models (IERs) that relate the entire range of global exposures of PM2.5 to cause-specific mortality. As a result, the estimated annual mortality attributed to AAP increased from less than 1 million in 2000 to roughly 3 million for GBD in years 2010 and 2013, to 4.2 million for GBD 2015. However, the magnitude of the recent change and uncertainty regarding its rationale have resulted, in some cases, in skepticism and reduced confidence in the overall estimates. To understand the underlying reasons for the change in mortality, we examined the estimates for the years 2013 and 2015 to determine the quantitative implications of alternative model input assumptions. We calculated that the year 2013 estimates increased by 8% after applying the updated exposure data used in GBD 2015, and increased by 23% with the application of the updated IERs from GBD 2015. The application of both upgraded methodologies together increased the GBD 2013 estimates by 35%, or about one million deaths. We also quantified the impact of the changes in demographics and the assumed threshold level. Since the global estimates of air pollution-related deaths will continue to change over time, a clear documentation of the modifications in the methodology and their impacts is necessary. In addition, there is need for additional monitoring and epidemiological studies to reduce uncertainties in the estimates for low- and medium-income countries, which contribute to about one-half of the mortality.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2012

Incidence of Secondary Cancer Development After High-Dose Intensity-Modulated Radiotherapy and Image-Guided Brachytherapy for the Treatment of Localized Prostate Cancer

Purpose: To report the incidence and excess risk of second malignancy (SM) development compared with the general population after external beam radiotherapy (EBRT) and brachytherapy to treat prostate cancer. Methods and Materials: Between 1998 and 2001, 1,310 patients with localized prostate cancer were treated with EBRT (n = 897) or brachytherapy (n = 413). We compared the incidence of SMs in our patients with that of the general population extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results data set combined with the 2000 census data. Results: The 10-year likelihood of SM development was 25% after EBRT and 15% after brachytherapy (p = .02). The corresponding 10-year likelihood for in-field SM development in these groups was 4.9% and 1.6% (p = .24). Multivariate analysis showed that EBRT vs. brachytherapy and older age were the only significant predictors for the development of all SMs (p = .037 and p = .030), with a trend for older patients to develop a SM. The increased incidence of SM for EBRT patients was explained by the greater incidence of skin cancer outside the radiation field compared with that after brachytherapy (10.6% and 3.3%, respectively, p = .004). For the EBRT group, the 5- and 10-year mortality rate was 1.96% and 5.1% from out-of field cancer, respectively; for in-field SM, the corresponding mortality rates were 0.1% and 0.7%. Among the brachytherapy group, the 5- and 10-year mortality rate related to out-of field SM was 0.8% and 2.7%, respectively. Our observed SM rates after prostate RT were not significantly different from the cancer incidence rates in the general population. Conclusions: Using modern sophisticated treatment techniques, we report low rates of in-field bladder and rectal SM risks after prostate cancer RT. Furthermore, the likelihood of mortality secondary to a SM was unusual. The greater rate of SM observed with EBRT vs. brachytherapy was related to a small, but significantly increased, number of skin cancers in the EBRT patients compared with that of the general population.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2021

Hydraulically‐vulnerable trees survive on deep‐water access during droughts in a tropical forest

Summary Deep‐water access is arguably the most effective, but under‐studied, mechanism that plants employ to survive during drought. Vulnerability to embolism and hydraulic safety margins can predict mortality risk at given levels of dehydration, but deep‐water access may delay plant dehydration. Here, we tested the role of deep‐water access in enabling survival within a diverse tropical forest community in Panama using a novel data‐model approach. We inversely estimated the effective rooting depth (ERD, as the average depth of water extraction), for 29 canopy species by linking diameter growth dynamics (1990–2015) to vapor pressure deficit, water potentials in the whole‐soil column, and leaf hydraulic vulnerability curves. We validated ERD estimates against existing isotopic data of potential water‐access depths. Across species, deeper ERD was associated with higher maximum stem hydraulic conductivity, greater vulnerability to xylem embolism, narrower safety margins, and lower mortality rates during extreme droughts over 35 years (1981–2015) among evergreen species. Species exposure to water stress declined with deeper ERD indicating that trees compensate for water stress‐related mortality risk through deep‐water access. The role of deep‐water access in mitigating mortality of hydraulically‐vulnerable trees has important implications for our predictive understanding of forest dynamics under current and future climates.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2019

Is Robotic-Assisted Surgery Safe in the Elderly Population? An Analysis of Gynecologic Procedures in Patients ≥ 65 Years Old

Background: The elderly population is expanding worldwide but is underrepresented in clinical trials. We sought to assess the safety of robotic gynecologic surgery in an elderly cohort and to identify factors associated with unfavorable outcomes. Methods: All patients ≥ 65 years who underwent a robotically assisted procedure at a single institution between May 2007 to December 2016 were divided into three age groups: 65–74 (Group 1); 75–84 (Group 2); ≥ 85 (Group 3). Perioperative outcomes were recorded in patients who did not require conversion to laparotomy. We compared clinical variables among groups and performed multivariate logistic regression to detect variables associated with major complications (≥ Grade 3) or 90-day mortality. Results: We retrospectively identified 982 cases: 685 in Group 1; 249 in Group 2; 48 in Group 3. Median age = 71 years. Median BMI = 28.9. Malignancy was documented in 72.8% of cases; the majority were endometrial cancer (61.8%). Thirty-four patients (3.5%) were readmitted within 30 days. Seventy-seven (7.8%) had a postoperative complication, and 23 (2.3%) had a major complication. Ninety-day mortality was 0.5%. There was significant difference between groups with respect to body mass index (P = 0.026), ECOG PS (P ≤ 0.001), > 5 comorbidities (P = 0.005), hospital stay (P < 0.001), major complications (P = 0.001), and 90-day mortality (P < 0.001). On multivariable logistic regression, age ≥ 85 years was associated with major complications. Body mass index, age ≥ 85 years, and major complications were significantly associated with 90-day mortality. Conclusions: Robotic-assisted surgery appears to be safe in an elderly cohort. The incidence of overall and major complications is consistent with those reported in the literature. Patients ≥ 85 years old appear to be at higher risk of unfavorable outcomes.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2019

Perioperative Use of Nonsteroidal Anti-inflammatory Drugs Decreases the Risk of Recurrence of Cancer After Colorectal Resection: A Cohort Study Based on Prospective Data

Background: Perioperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) is known to reduce inflammatory response in relation to surgery. Inflammation may promote recurrence of cancer, thus inhibition by use of NSAIDs could reduce recurrence after surgery. Objective: The aim of this study was to examine the association between perioperative use of NSAIDs and cancer recurrence, as well as disease-free survival (DFS) and mortality after colorectal cancer surgery. Methods: This was a cohort study based on data from a prospective clinical database, electronic medical records, and nationwide registers, and included patients from six major colorectal centers in Denmark. The primary outcome was cancer recurrence, while secondary outcomes included 5-year mortality and DFS. Results: Overall, 2308 patients undergoing colorectal cancer surgery between 1 January 2006 and 31 December 2009 were included. A total of 909 patients received at least 2 days of treatment with NSAIDs, of whom 702 (77.2%) received ibuprofen and 204 (22.4%) received diclofenac. Cox regression analysis adjusting for NSAIDs resulted in decreased recurrence risk (adjusted hazard ratio [HR{sub adjusted}] 0.84, 95% confidence interval [CI] 0.72–0.99; p = 0.042). Competing risk analysis confirmed the finding, with an HR{sub adjusted} of 0.76 (95% CI 0.60–0.97; p = 0.026). There was no significant effect on mortality or DFS. Sensitivity analysis of the effect of ibuprofen reported an HR{sub adjusted} of 0.83 (95% CI 0.70–1.00; p = 0.047). In restricted analyses of localized disease only (Union for International Cancer Control [UICC] I–II) and elective surgery only, no effect was found (localized: HR{sub adjusted} 0.81, 95% CI 0.62–1.06, p = 0.12; elective: HR{sub adjusted} 0.85, 95% CI 0.72–1.01, p = 0.063). Conclusions: Perioperative use of NSAIDs was associated with a reduced risk of cancer recurrence after resection for colorectal cancer. No effect on 5-year mortality or DFS was found.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2011

Can Fish Morphological Characteristics be Used to Re-design Hydroelectric Turbines?

Safe fish passage affects not only migratory species, but also populations of resident fish by altering biomass, biodiversity, and gene flow. Consequently, it is important to estimate turbine passage survival of a wide range of susceptible fish. Although fish-friendly turbines show promise for reducing turbine passage mortality, experimental data on their beneficial effects are limited to only a few species, mainly salmon and trout. For thousands of untested species and sizes of fish, the particular causes of turbine passage mortality and the benefits of fish-friendly turbine designs remain unknown. It is not feasible to measure the turbine-passage survival of every species of fish in every hydroelectric turbine design. We are attempting to predict fish mortality based on an improved understanding of turbine-passage stresses (pressure, shear stress, turbulence, strike) and information about the morphological, behavioral, and physiological characteristics of different fish taxa that make them susceptible to the stresses. Computational fluid dynamics and blade strike models of the turbine environment are re-examined in light of laboratory and field studies of fish passage effects. Comparisons of model-predicted stresses to measured injuries and mortalities will help identify fish survival thresholds and the aspects of turbines that are most in need of re-design. The coupled model and fish morphology evaluations will enable us to make predictions of turbine-passage survival among untested fish species, for both conventional and advanced turbines, and to guide the design of hydroelectric turbines to improve fish passage survival.

09 BIOMASS FUELS↗

DOE OSTI2023

Grid Interconnection and Renewables Deployment Related Air Quality and Human Health Benefits in Southeast Asia

The Association of Southeast Asian Nations (ASEAN) has increasingly focused on multilateral electricity trade, improved grid resiliency and modernization. These opportunities in the power sector have been studied through the ASEAN Interconnection Masterplan Studies, the most recent of which is the ASEAN Interconnection Masterplan Study III (AIMS III). AIMS III assessed four different scenarios of power system in the ASEAN countries that include a base scenario and three additional scenarios (called optimum RE, ASEAN RE, and High RE) considering different levels of deployment of renewable energy (RE) and cross-border generation and trade of electricity for three years (2025, 2030, 2040). In this work, we quantify the potential air quality and public health co-benefits of AIMS III scenarios. For a rapidly expanding, energy hungry region like SE Asia generation is power generation is expected to increase significantly. The AIMS III scenarios' capacity expansion modeling suggest that: 1) Generation nearly doubles from 2025 to 2040 in all four AIMS III scenarios; 2) Most of the increased generation is met by coal in all four AIMS III scenarios; 3) While renewables generation increases in all four AIMS III scenarios, the fraction of total generation (its share) generally decreases because of the much greater increase in non-renewable sources, mostly coal. Only in the High RE Target scenario do renewables represent a higher share in 2040 than in 2025, though even here it is at the expense of natural gas rather than coal; 4) As a result, emissions of gaseous and aerosol pollutants increase significantly in all scenarios. Because emissions increase in 2040 compared to 2025 for all four AIMS III scenarios, so do PM2.5 concentrations. Even for the High RE Target scenario (the scenario with highest share of renewable energy), compared to the Base scenario in 2025, in 2040 PM2.5 concentrations are higher. Compared to the Base scenario in the same years, the Optimum RE and ASEAN RE Target scenarios do not differ very much from the Base in terms of PM2.5 concentration. The High RE Target scenario, on the other hand, yields noticeably lower PM2.5 concentration. For example, in 2040 the population-weighted decrease in annual average PM2.5 concentration in the High RE Target scenario relative to the Base scenario is 0.5 ug m-3. Compared to the Base scenario in 2040, each of the alternative AIMS III scenarios is estimated to result in net reductions in power-sector air quality-related excess mortality in the ASEAN region. Yet there are a few countries for which the Optimum RE and ASEAN RE Target result in increases in PM2.5-related excess mortality (Thailand and Vietnam for the ASEAN RE Target scenario and Thailand for the Optimum RE scenario). However, for the High RE Target scenario, all countries benefit and find reductions in excess mortality resulting from the power sector scenarios modeled in AIMS III with regionwide mortality decreasing by 16,000 compared to the Base scenario in 2040. In summary, our analysis finds that changing power generation emissions is a crucial lever for improving public health in ASEAN member countries and provides a pathway for policymakers to make decision backed by a realistic power sector expansion and air quality analyses.

air quality↗