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At least 145 records · Page 8

Space Radiation Heart Disease Risk Estimates for Lunar and Mars Missions

The NASA Space Radiation Program performs research on the risks of late effects from space radiation for cancer, neurological disorders, cataracts, and heart disease. For mortality risks, an aggregate over all risks should be considered as well as projection of the life loss per radiation induced death. We report on a triple detriment life-table approach to combine cancer and heart disease risks. Epidemiology results show extensive heterogeneity between populations for distinct components of the overall heart disease risks including hypertension, ischaemic heart disease, stroke, and cerebrovascular diseases. We report on an update to our previous heart disease estimates for Heart disease (ICD9 390-429) and Stroke (ICD9 430-438), and other sub-groups using recent meta-analysis results for various exposed radiation cohorts to low LET radiation. Results for multiplicative and additive risk transfer models are considered using baseline rates for US males and female. Uncertainty analysis indicated heart mortality risks as low as zero, assuming a threshold dose for deterministic effects, and projections approaching one-third of the overall cancer risk. Medan life-loss per death estimates were significantly less than that of solid cancer and leukemias. Critical research questions to improve risks estimates for heart disease are distinctions in mechanisms at high doses (>2 Gy) and low to moderate doses (<2 Gy), and data and basic understanding of radiation doserate and quality effects, and individual sensitivity.

Cucinotta, Francis A.↗

Cancer Risk Map for the Surface of Mars

We discuss calculations of the median and 95th percentile cancer risks on the surface of Mars for different solar conditions. The NASA Space Radiation Cancer Risk 2010 model is used to estimate gender and age specific cancer incidence and mortality risks for astronauts exploring Mars. Organ specific fluence spectra and doses for large solar particle events (SPE) and galactic cosmic rays (GCR) at various levels of solar activity are simulated using the HZETRN/QMSFRG computer code, and the 2010 version of the Badhwar and O Neill GCR model. The NASA JSC propensity model of SPE fluence and occurrence is used to consider upper bounds on SPE fluence for increasing mission lengths. In the transport of particles through the Mars atmosphere, a vertical distribution of Mars atmospheric thickness is calculated from the temperature and pressure data of Mars Global Surveyor, and the directional cosine distribution is implemented to describe the spherically distributed atmospheric distance along the slant path at each elevation on Mars. The resultant directional shielding by Mars atmosphere at each elevation is coupled with vehicle and body shielding for organ dose estimates. Astronaut cancer risks are mapped on the global topography of Mars, which was measured by the Mars Orbiter Laser Altimeter. Variation of cancer risk on the surface of Mars is due to a 16-km elevation range, and the large difference is obtained between the Tharsis Montes (Ascraeus, Pavonis, and Arsia) and the Hellas impact basin. Cancer incidence risks are found to be about 2-fold higher than mortality risks with a disproportionate increase in skin and thyroid cancers for all astronauts and breast cancer risk for female astronauts. The number of safe days on Mars to be below radiation limits at the 95th percent confidence level is reported for several Mission design scenarios.

Kim, Myung-Hee Y.↗

Downscaling MODIS Land Surface Temperature for Urban Public Health Applications

This study is part of a project funded by the NASA Applied Sciences Public Health Program, which focuses on Earth science applications of remote sensing data for enhancing public health decision-making. Heat related death is currently the number one weather-related killer in the United States. Mortality from these events is expected to increase as a function of climate change. This activity sought to augment current Heat Watch/Warning Systems (HWWS) with NASA remotely sensed data, and models used in conjunction with socioeconomic and heatrelated mortality data. The current HWWS do not take into account intra-urban spatial variation in risk assessment. The purpose of this effort is to evaluate a potential method to improve spatial delineation of risk from extreme heat events in urban environments by integrating sociodemographic risk factors with estimates of land surface temperature (LST) derived from thermal remote sensing data. In order to further improve the consideration of intra-urban variations in risk from extreme heat, we also developed and evaluated a number of spatial statistical techniques for downscaling the 1-km daily MODerate-resolution Imaging Spectroradiometer (MODIS) LST data to 60 m using Landsat-derived LST data, which have finer spatial but coarser temporal resolution than MODIS. In this paper, we will present these techniques, which have been demonstrated and validated for Phoenix, AZ using data from the summers of 2000-2006.

Al-Hamdan, Mohammad↗

Downscaling MODIS Land Surface Temperature for Urban Public Health Applications

This study is part of a project funded by the NASA Applied Sciences Public Health Program, which focuses on Earth science applications of remote sensing data for enhancing public health decision-making. Heat related death is currently the number one weather-related killer in the United States. Mortality from these events is expected to increase as a function of climate change. This activity sought to augment current Heat Watch/Warning Systems (HWWS) with NASA remotely sensed data, and models used in conjunction with socioeconomic and heatrelated mortality data. The current HWWS do not take into account intra-urban spatial variation in risk assessment. The purpose of this effort is to evaluate a potential method to improve spatial delineation of risk from extreme heat events in urban environments by integrating sociodemographic risk factors with estimates of land surface temperature (LST) derived from thermal remote sensing data. In order to further improve the consideration of intra-urban variations in risk from extreme heat, we also developed and evaluated a number of spatial statistical techniques for downscaling the 1-km daily MODerate-resolution Imaging Spectroradiometer (MODIS) LST data to 60 m using Landsat-derived LST data, which have finer spatial but coarser temporal resolution than MODIS. In this paper, we will present these techniques, which have been demonstrated and validated for Phoenix, AZ using data from the summers of 2000-2006.

Al-Hamdan, Mohammad↗

Tree Line Structure and Dynamics at the Northern Limit of the Larch Forest: Anabar Plateau, Siberia, Russia

The goal of the study was to provide an analysis of climate impact before, during, and after the Little Ice Age (LIA) on the larch (Larix gmelinii) tree line at the northern extreme of Siberian forests. Recent decadal climate change impacts on the tree line, regeneration abundance, and age structure were analyzed. The location of the study area was within the forest-tundra ecotone (elevation range 170-450 m) in the Anabar Plateau, northern Siberia. Field studies were conducted along elevational transects. Tree natality/mortality and radial increment were determined based on dendrochronology analyses. Tree morphology, number of living and subfossil trees, regeneration abundance, and age structure were studied. Locations of pre-LIA, LIA, and post-LIA tree lines and refugia boundaries were established. Long-term climate variables and drought index were included in the analysis. It was found that tree mortality from the 16th century through the beginning of the 19th century caused a downward tree line recession. Sparse larch stands experienced deforestation, transforming into tundra with isolated relict trees. The maximum tree mortality and radial growth decrease were observed to have occurred at the beginning of 18th century. Now larch, at its northern boundary in Siberia, is migrating into tundra areas. Upward tree migration was induced by warming in the middle of the 19th century. Refugia played an important role in repopulation of the forest-tundra ecotone by providing a seed source and shelter for recruitment of larch regeneration. Currently this ecotone is being repopulated mainly by tree cohorts that were established after the 1930s. The last two decades of warming did not result in an acceleration of regeneration recruitment because of increased drought conditions. The regeneration line reached (but did not exceed) the pre-LIA tree line location, although contemporary tree heights and stand densities are comparatively lower than in the pre-LIA period. The mean rate of tree line upward migration has been about 0.35 m/yr (with a range of 0.21-0.58), which translates to a tree line response to temperature of about 55 m/deg C.

Northern Limit↗

Service Life Extension of the Propulsion System of Long-Term Manned Orbital Stations

One of the critical non-replaceable systems of a long-term manned orbital station is the propulsion system. Since the propulsion system operates beginning with the launch of station elements into orbit, its service life determines the service life of the station overall. Weighing almost a million pounds, the International Space Station (ISS) is about four times as large as the Russian space station Mir and about five times as large as the U.S. Skylab. Constructed over a span of more than a decade with the help of over 100 space flights, elements and modules of the ISS provide more research space than any spacecraft ever built. Originally envisaged for a service life of fifteen years, this Earth orbiting laboratory has been in orbit since 1998. Some elements that have been launched later in the assembly sequence were not yet built when the first elements were placed in orbit. Hence, some of the early modules that were launched at the inception of the program were already nearing the end of their design life when the ISS was finally ready and operational. To maximize the return on global investments on ISS, it is essential for the valuable research on ISS to continue as long as the station can be sustained safely in orbit. This paper describes the work performed to extend the service life of the ISS propulsion system. A system comprises of many components with varying failure rates. Reliability of a system is the probability that it will perform its intended function under encountered operating conditions, for a specified period of time. As we are interested in finding out how reliable a system would be in the future, reliability expressed as a function of time provides valuable insight. In a hypothetical bathtub shaped failure rate curve, the failure rate, defined as the number of failures per unit time that a currently healthy component will suffer in a given future time interval, decreases during infant-mortality period, stays nearly constant during the service life and increases at the end when the design service life ends and wear-out phase begins. However, the component failure rates do not remain constant over the entire cycle life. The failure rate depends on various factors such as design complexity, current age of the component, operating conditions, severity of environmental stress factors, etc. Development, qualification and acceptance test processes provide rigorous screening of components to weed out imperfections that might otherwise cause infant mortality failures. If sufficient samples are tested to failure, the failure time versus failure quantity can be analyzed statistically to develop a failure probability distribution function (PDF), a statistical model of the probability of failure versus time. Driven by cost and schedule constraints however, spacecraft components are generally not tested in large numbers. Uncertainties in failure rate and remaining life estimates increase when fewer units are tested. To account for this, spacecraft operators prefer to limit useful operations to a period shorter than the maximum demonstrated service life of the weakest component. Running each component to its failure to determine the maximum possible service life of a system can become overly expensive and impractical. Spacecraft operators therefore, specify the required service life and an acceptable factor of safety (FOS). The designers use these requirements to limit the life test duration. Midway through the design life, when benefits justify additional investments, supplementary life test may be performed to demonstrate the capability to safely extend the service life of the system. An innovative approach is required to evaluate the entire system, without having to go through an elaborate test program of propulsion system elements. Evaluating every component through a brute force test program would be a cost prohibitive and time consuming endeavor. ISS propulsion system components were designed and built decades ago. There are no representative ground test articles for some of the components. A 'test everything' approach would require manufacturing new test articles. The paper outlines some of the techniques used for selective testing, by way of cherry picking candidate components based on failure mode effects analysis, system level impacts, hazard analysis, etc. The type of testing required for extending the service life depends on the design and criticality of the component, failure modes and failure mechanisms, life cycle margin provided by the original certification, operational and environmental stresses encountered, etc. When specific failure mechanism being considered and the underlying relationship of that mode to the stresses provided in the test can be correlated by supporting analysis, time and effort required for conducting life extension testing can be significantly reduced. Exposure to corrosive propellants over long periods of time, for instance, lead to specific failure mechanisms in several components used in the propulsion system. Using Arrhenius model, which is tied to chemically dependent failure mechanisms such as corrosion or chemical reactions, it is possible to subject carefully selected test articles to accelerated life test. Arrhenius model reflects the proportional relationship between time to failure of a component and the exponential of the inverse of absolute temperature acting on the component. The acceleration factor is used to perform tests at higher stresses that allow direct correlation between the times to failure at a high test temperature to the temperatures to be expected in actual use. As long as the temperatures are such that new failure mechanisms are not introduced, this becomes a very useful method for testing to failure a relatively small sample of items for a much shorter amount of time. In this article, based on the example of the propulsion system of the first ISS module Zarya, theoretical approaches and practical activities of extending the service life of the propulsion system are reviewed with the goal of determining the maximum duration of its safe operation.

Kamath, Ulhas↗

Desert Dust, Industrialization and Agricultural Fires: Health Impacts of Outdoor Air Pollution in Africa

The African continent continuously experiences extreme aerosol load conditions, during which the World Health Organizational (WHO) clean air standard of 10 μgm(exp ‐3) of PM(2.5) mass is systematically exceeded. Africa holds the world largest source of desert dust emissions, undergoes strong industrial growth, and produces approximately a third of the Earth's biomass burning aerosol particles. Sub‐Saharan biomass burning is driven by agricultural practices, such as burning fields and bushes in the post‐harvest season for fertilization, land management and pest control. Thus, these emissions are predominantly anthropogenic. Here we use global atmospheric composition, climate, and health models to simulate the chemical composition of the atmosphere and calculate the mortality rates for Africa by distinguishing between purely natural, industrial/domestic and biomass burning emissions. Air quality related deaths in Africa rank within the top leading causes of death in Africa. Our results of ~780,000 premature deaths annually point to the extensive health impacts of natural emissions, high mortality rate caused by industrialization in Nigeria and South Africa, and to a smaller extent by fire emissions in Central and West Africa. 43,000 premature deaths in Africa are linked to biomass burning mainly driven by agriculture. Our results also show that natural sources, in particular windblown dust emissions, have large impacts on air quality and human health in Africa.

fires↗

Cherokee Water Resources Project Summary - Mapping Forest Composition and Health in the Southern Appalachians Using NASA Earth Observations to Enhance Drought and Watershed Health-Related Forest Management for the Eastern Band of the Cherokee Indians

The Eastern Band of Cherokee Indians (EBCI) owns and manages more than 55,000 acres of land in the Southern Appalachian Mountains of western North Carolina. Most of these lands reside within the Oconaluftee River watershed. In this region and watershed, hemlock trees are a culturally significant foundation species that contribute to habitat biodiversity, regulate temperature and evapotranspiration of riparian environments, and provide economic value for tourism and recreation. The hemlock woolly adelgid (HWA), an invasive insect, has caused widespread hemlock mortality in recent decades, raising concerns about hemlock decline. Hemlock mortality leads to standing dead trees and increased evapotranspiration which can abet the spread of wildfires, especially during periods of drought. The DEVELOP team used satellite imagery from Landsat 5 Thematic Mapper (TM) to quantify and map possible hemlock decline by comparing changes in the normalized difference vegetation index (NDVI) values of winter season between 2003 and 2010. The project utilized the Shuttle Radar Topography Mission (SRTM) along with imagery from Landsat 8 Operational Land Imager (OLI) to create a weighted suitability analysis that maps topographic and environmental conditions favorable for hemlock habitat. This study found that 67%of evergreen and mixed forest cover in the Oconaluftee River valley exhibited a decrease in winter NDVI from 2003 to 2010. Additionally, the two-example weighted suitability analyses showed 4.5-9.5% of hemlock suitable land in 2018 in the Oconaluftee. The partners of this project can use the outputs to identify the extent of potential hemlock decline in the Oconaluftee and establish benchmark metrics for assessing changes in hemlock suitable areas over time.

DEVELOP Project Summary↗

Cherokee Water Resources - Mapping Hemlock Tree Composition and Health in the Southern Appalachians Using NASA Earth Observations to Enhance Drought and Watershed Health-Related Forest Management for the Eastern Band of the Cherokee Indians

The Eastern Band of Cherokee Indians (EBCI) owns and manages more than 55,000 acres of land in the Southern Appalachian Mountains of western North Carolina. Most of these lands reside within the Oconaluftee River watershed. In this region and watershed, hemlock trees are a culturally significant foundation species that contribute to habitat biodiversity, regulate temperature and evapotranspiration of riparian environments, and provide economic value for tourism and recreation. The hemlock woolly adelgid (HWA), an invasive insect, has caused widespread hemlock mortality in recent decades, raising concerns about hemlock decline. Hemlock mortality leads to standing dead trees and increased evapotranspiration which can abet the spread of wildfires, especially during periods of drought. The DEVELOP team used satellite imagery from Landsat 5 Thematic Mapper (TM) to quantify and map possible hemlock decline by comparing changes in the normalized difference vegetation index (NDVI) values of winter season between 2003 and 2010. The project utilized the Shuttle Radar Topography Mission (SRTM) along with imagery from Landsat 8 Operational Land Imager (OLI) to create a weighted suitability analysis that maps topographic and environmental conditions favorable for hemlock habitat. This study found that 67% of evergreen and mixed forest cover in the Oconaluftee River valley exhibited a decrease in winter NDVI from 2003 to 2010. Additionally, the two-example weighted suitability analyses showed 4.5-9.5% of hemlock suitable land in 2018 in the Oconaluftee. The partners of this project can use the outputs to identify the extent of potential hemlock decline in the Oconaluftee and establish benchmark metrics for assessing changes in hemlock suitable areas over time.

Richard Murray↗

Medical Countermeasure Requirements for Meeting Permissible Radiation Exposure Limits in Space

The space radiation environment consists of ionizing radiation that poses healthrisks to crew members who embark on a mission to Mars. NASA requiresthat astronaut career radiation limits for the Risk of Exposure Induced Death(REID) should not exceed 3% at the upper 95% confidence level for cancermortality. However, the lifetime career limit is likely to be exceeded for eventhe shortest round-trip mission scenario to Mars. As such, approaches fordirectly reducing the radiation risk, despite the large uncertainties, are beinginvestigated. A recent study showed that medical countermeasures (MCM)which reduced background cancer mortality rates may be effective in mitigatingthe REID, where the data employed in the sensitivity analysis were limited tocohort studies of aspirin and warfarin. The present work addresses the generalMCM requirements that are needed to meet the lifetime career exposure limitsby examining modifications to the background cancer mortality rates, radiationquality factor, and low-LET radiation risk models for a Mars mission scenario.These results may be used to help inform decision-makers about potentialexperimental measurements that facilitate the greatest propensity for MCM risk reduction.

Charles M Werneth↗

Satellite-Based Assessment of Grassland Conversion and Related Fire Disturbance in the Kenai Peninsula, Alaska

Spruce beetle-induced (Dendroctonus rufipennis (Kirby)) mortality on the Kenai Peninsula has been hypothesized by local ecologists to result in the conversion of forest to grassland and subsequent increased fire danger. This hypothesis stands in contrast to empirical studies in the continental US which suggested that beetle mortality has only a negligible effect on fire danger. In response, we conducted a study using Landsat data and modeling techniques to map land cover change in the Kenai Peninsula and to integrate change maps with other geospatial data to predictively map fire danger for the same region. We collected Landsat imagery to map land cover change at roughly five-year intervals following a severe, mid-1990s beetle infestation to the present. Landcover classification was performed at each time step and used to quantify grassland encroachment patterns over time. The maps of land cover change along with digital elevation models (DEMs),temperature, and historical fire data were used to map and assess wildfire danger across the study area. Results indicate the highest wildfire danger tended to occur in herbaceous and black spruce land cover types, suggesting that the relationship between spruce beetle damage and wildfire danger in costal Alaskan forested ecosystems differs from the relationship between the two in the forests of the coterminous United States. These change detection analyses and fire danger predictions provide the Kenai National Wildlife Refuge (KENWR) ecologists and other forest managers a better understanding of the extent and magnitude of grassland conversion and subsequent change in fire danger following the 1990s spruce beetle outbreak.

wildfire↗

San Diego Urban Development: Utilizing NASA Earth Observations to Identify Drivers of Extreme Urban Heat and Generate a High-Resolution Vulnerability Index for Urban Planning and Climate Resiliency in San Diego, California

Exposure to heat exacerbated by an increase in urbanization as well as increasing global temperatures has become a growing concern for cities and their residents. Excess heat can cause increased heat-related morbidity, mortality, and energy costs. Vulnerability to heat-related illnesses is oftentimes correlated to demographics, socioeconomic status, and pre-existing health conditions. The City of San Diego, California boasts 1.4 million residents and, like many other major cities, has experienced increases in heat-related hospitalizations and mortality. The burden of urban heat is also not equal amongst communities; areas with lower income and communities of color bear a disproportionate burden. In partnership with the City of San Diego, and American Geophysical Union’s (AGU) Thriving Earth Exchange, the DEVELOP team used Landsat 8 Operational Land Imager (OLI) and Thermal Infrared Sensor (TIRS), and ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) imagery to identify areas of highest heat based on land surface temperature from 2015-2020. Our analyses showed that health demographics such as obesity and cardiovascular health were the strongest indicators for heat vulnerability. In addition, various inputs (land use/land cover, tree canopy, and building intensity derived from the City of San Diego data along with albedo from Landsat 8) were used in the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) urban cooling model to investigate changes in cooling rates in current and future scenarios for the city. The model results showed that cooling is expected to occur due to a 5% increase in tree canopy. The City of San Diego can use these results to inform the development of the Climate Resilient San Diego plan and prioritize at-risk communities for cooling interventions.

John Dialesandro↗

Commercial fishery bycatch risk for large juvenile and adult smalltooth sawfish (Pristis pectinata) in Florida waters

1.Incidental catch of marine species can create ecological and economic issues, particularly for endangered species. The smalltooth sawfish (Pristis pectinata) is endemic to the Atlantic Ocean and listed as Endangered in the US Endangered Species Act. One of its major threats is bycatch mortality in commercial fisheries. 2.Despite the protection afforded by the US Endangered Species Act, smalltooth sawfish are still captured as bycatch in commercial fisheries. Acoustic and satellite tag data collected on 59 sawfish between 2011 and 2019 were analysed to assess commercial fishery bycatch risk for large juveniles and adults off Florida. This study focused on shrimp trawl, south-east coastal gillnet, and shark bottom longline fisheries, as these were identified in the recovery plan as having the greatest potential threats to recovery. 3.Bycatch risk associated with the shrimp trawl fishery was significantly higher than the other fisheries, indicating that this fishery currently poses the greatest threat to recovery. 4.Bycatch risk was concentrated in all seasons in the Gulf of Mexico adjacent to the lower Florida Keys for the shrimp trawl fishery, off Cape Canaveral in the south-east coastal gillnet fishery, and in the Atlantic Ocean adjacent to the Florida Keys in the shark bottom longline fishery. 5.Tagging location and sex were predictors of bycatch risk. Individuals tagged in Charlotte Harbor had the highest shrimp trawl bycatch risk. Females tagged in south Florida tended to reside in the deepest water, which is where shrimp trawl effort is highest. Therefore, females may be at more risk in these deeper waters. 6.Results from this study indicate a year-round closure of waters off south-west Florida to the shrimp trawl fishery between Charlotte Harbor and the western Florida Keys would reduce sawfish bycatch, and thus mortality, which is in line with recovery plan goals.

acoustic monitoring, bycatch, commercial fisheries↗

The Evolution of the Impact Evidence Library Methods – What We Learned

During fiscal years 2020-2022 NASA’s Human Research Program, Exploration Medical Capability Element has worked to source this evidence for the model. During the process several lessons learned have been identified and drive recommendations for future efforts. The ICL 1.0: Spaceflight Medical Operational expertise should be consulted regarding the addition of future conditions. A clinician experienced with the nuances of spaceflight is recommended to have a minimum of 20 hours per condition to adequately source the evidence. Condition definitions should be carefully crafted to maintain mutual exclusivity. Common side effects from medications, common and consequential incidental findings in laboratory studies, and consequential side effects of diagnostic and procedural capabilities should be considered for inclusion as unique conditions in future iterations of the ICL 1.0. Incidence: Spaceflight incidence, although based on small population sizes, is the gold standard. Terrestrial incidence should be applied cautiously. Probability of minor vs. severe cases of the condition: Data informing severity probability of the medical condition are nearly always terrestrial. Special attention should be paid to this metric as it drives outcomes in the model and terrestrial data often overestimate severity of expected cases in spaceflight. Condition duration: Three clinical phases currently exist in the model. They represent the time necessary for diagnosis, treatment/convalescence/recurrence, and the remaining duration of the mission after maximal recovery, respectively. Further subdivision of acute and convalescent treatment/recurrence is recommended. Probability of need for evacuation: Surrogates for “Return to Definitive Care” were chosen prior to data collection. In most cases these surrogates were “need for hospitalization” or “need for surgery.” For many conditions these may not be realistic drivers of “Return to Definitive Care” and should be re-examined. Probability of Crew Mortality: Terrestrial mortality data is difficult to apply to astronauts who, invariably, have less comorbidities than terrestrial subjects. It must be applied judiciously. The proportion of mission tasks impaired by the condition: “Task Impairment” was assigned to each condition prior to the condition duration data becoming available. Future efforts should assign Task Impairment as the final step in sourcing the evidence.

A.J. Kreykes↗

The Importance of Internal Climate Variability in Climate Impact Projections

Uncertainty in climate projections is driven by three components: scenario uncertainty, intermodel uncertainty, and internal variability. Although socioeconomic climate impact studies increasingly take into account the first two components, little attention has been paid to the role of internal variability, although underestimating this uncertainty may lead to underestimating the socioeconomic costs of climate change. Using large ensembles from seven coupled general circulation models with a total of 414 model runs, we partition the climate uncertainty in classic dose–response models relating county-level corn yield, mortality, and per-capita gross domestic product to temperature in the continental United States. The partitioning of uncertainty depends on the time frame of projection, the impact model, and the geographic region. Internal variability represents more than 50% of the total climate uncertainty in certain projections, including mortality projections for the early 21st century, although its relative influence decreases over time. We recommend including uncertainty due to internal variability for many projections of temperature-driven impacts, including early-century and midcentury projections, projections in regions with high internal variability such as the Upper Midwest United States, and impacts driven by nonlinear relationships.

climate impacts↗

Survival after aortic valve replacement for severe aortic stenosis with low transvalvular gradients and severe left ventricular dysfunction

OBJECTIVE: We sought to assess whether aortic valve replacement (AVR) among patients with severe aortic stenosis (AS), severe left ventricular (LV) dysfunction and a low transvalvular gradient (TVG) is associated with improved survival. BACKGROUND: The optimal management of patients with severe AS with severe LV dysfunction and a low TVG remains controversial. METHODS: Between 1990 and 1998, we evaluated 68 patients who underwent AVR at our institution (AVR group) and 89 patients who did not undergo AVR (control group), with an aortic valve area < or = 0.75 cm(2), LV ejection fraction < or = 35% and mean gradient < or = 30 mm Hg. Using propensity analysis, survival was compared between a cohort of 39 patients in the AVR group and 56 patients in the control group. RESULTS: Despite well-matched baseline characteristics among propensity-matched patients, the one- and four-year survival rates were markedly improved in patients in the AVR group (82% and 78%), as compared with patients in the control group (41% and 15%; p < 0.0001). By multivariable analysis, the main predictor of improved survival was AVR (adjusted risk ratio 0.19, 95% confidence interval 0.09 to 0.39; p < 0.0001). The only other predictors of mortality were age and the serum creatinine level. CONCLUSIONS: Among select patients with severe AS, severe LV dysfunction and a low TVG, AVR was associated with significantly improved survival.

NASA Discipline Cardiopulmonary↗

Safety in the operating theatre--part 1: interpersonal relationships and team performance

The authors examine the application of interpersonal human factors training on operating room (OR) personnel. Mortality studies of OR deaths and critical incident studies of anesthesia are examined to determine the role of human error in OR incidents. Theoretical models of system vulnerability to accidents are presented with emphasis on a systems approach to OR performance. Input, process, and outcome factors are discussed in detail.

Non-NASA Center↗

A mathematical model of physiological processes and its application to the study of aging

The behavior of a physiological system which, after displacement, returns by homeostatic mechanisms to its original condition can be described by a simple differential equation in which the "recovery time" is a parameter. Two such systems, which influence one another, can be linked mathematically by the use of "coupling" or "feedback" coefficients. These concepts are the basis for many mathematical models of physiological behavior, and we describe the general nature of such models. Next, we introduce the concept of a "fatal limit" for the displacement of a physiological system, and show how measures of such limits can be included in mathematical models. We show how the numerical values of such limits depend on the values of other system parameters, i.e., recovery times and coupling coefficients, and suggest ways of measuring all these parameters experimentally, for example by monitoring changes induced by X-irradiation. Next, we discuss age-related changes in these parameters, and show how the parameters of mortality statistics, such as the famous Gompertz parameters, can be derived from experimentally measurable changes. Concepts of onset-of-aging, critical or fatal limits, equilibrium value (homeostasis), recovery times and coupling constants are involved. Illustrations are given using published data from mouse and rat populations. We believe that this method of deriving survival patterns from model that is experimentally testable is unique.

Aging/physiology↗