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Cardiac interbeat interval dynamics from childhood to senescence : comparison of conventional and new measures based on fractals and chaos theory

BACKGROUND: New methods of R-R interval variability based on fractal scaling and nonlinear dynamics ("chaos theory") may give new insights into heart rate dynamics. The aims of this study were to (1) systematically characterize and quantify the effects of aging from early childhood to advanced age on 24-hour heart rate dynamics in healthy subjects; (2) compare age-related changes in conventional time- and frequency-domain measures with changes in newly derived measures based on fractal scaling and complexity (chaos) theory; and (3) further test the hypothesis that there is loss of complexity and altered fractal scaling of heart rate dynamics with advanced age. METHODS AND RESULTS: The relationship between age and cardiac interbeat (R-R) interval dynamics from childhood to senescence was studied in 114 healthy subjects (age range, 1 to 82 years) by measurement of the slope, beta, of the power-law regression line (log power-log frequency) of R-R interval variability (10(-4) to 10(-2) Hz), approximate entropy (ApEn), short-term (alpha(1)) and intermediate-term (alpha(2)) fractal scaling exponents obtained by detrended fluctuation analysis, and traditional time- and frequency-domain measures from 24-hour ECG recordings. Compared with young adults (<40 years old, n=29), children (<15 years old, n=27) showed similar complexity (ApEn) and fractal correlation properties (alpha(1), alpha(2), beta) of R-R interval dynamics despite lower spectral and time-domain measures. Progressive loss of complexity (decreased ApEn, r=-0.69, P<0.001) and alterations of long-term fractal-like heart rate behavior (increased alpha(2), r=0.63, decreased beta, r=-0.60, P<0.001 for both) were observed thereafter from middle age (40 to 60 years, n=29) to old age (>60 years, n=29). CONCLUSIONS: Cardiac interbeat interval dynamics change markedly from childhood to old age in healthy subjects. Children show complexity and fractal correlation properties of R-R interval time series comparable to those of young adults, despite lower overall heart rate variability. Healthy aging is associated with R-R interval dynamics showing higher regularity and altered fractal scaling consistent with a loss of complex variability.

NASA Discipline Cardiopulmonary↗

Tissue Doppler Imaging Combined with Advanced 12-Lead ECG Analysis Might Improve Early Diagnosis of Hypertrophic Cardiomyopathy in Childhood

Optimization of early diagnosis of childhood hypertrophic cardiomyopathy (HCM) is essential in lowering the risk of HCM complications. Standard echocardiography (ECHO) has shown to be less sensitive in this regard. In this study, we sought to assess whether spatial QRS-T angle deviation, which has shown to predict HCM in adults with high sensitivity, and myocardial Tissue Doppler Imaging (TDI) could be additional tools in early diagnosis of HCM in childhood. Methods: Children and adolescents with familial HCM (n=10, median age 16, range 5-27 years), and without obvious hypertrophy but with heredity for HCM (n=12, median age 16, range 4-25 years, HCM or sudden death with autopsy-verified HCM in greater than or equal to 1 first-degree relative, HCM-risk) were additionally investigated with TDI and advanced 12-lead ECG analysis using Cardiax(Registered trademark) (IMED Co Ltd, Budapest, Hungary and Houston). Spatial QRS-T angle (SA) was derived from Kors regression-related transformation. Healthy age-matched controls (n=21) were also studied. All participants underwent thorough clinical examination. Results: Spatial QRS-T angle (Figure/ Panel A) and septal E/Ea ratio (Figure/Panel B) were most increased in HCM group as compared to the HCM-risk and control groups (p less than 0.05). Of note, these 2 variables showed a trend toward higher levels in HCM-risk group than in control group (p=0.05 for E/Ea and 0.06 for QRS/T by ANOVA). In a logistic regression model, increased SA and septal E/Ea ratio appeared to significantly predict both the disease (Chi-square in HCM group: 9 and 5, respectively, p less than 0.05 for both) and the risk for HCM (Chi-square in HCM-risk group: 5 and 4 respectively, p less than 0.05 for both), with further increased predictability level when these 2 variables were combined (Chi-square 10 in HCM group, and 7 in HCM-risk group, p less than 0.01 for both). Conclusions: In this small material, Tissue Doppler Imaging and spatial mean QRS-T angle deviation, particularly when combined, appear to be sensitive in predicting the risk for developing childhood HCM. Large-scale, prospective studies are needed to confirm this hypothesis.

Femlund, E.↗

Early childhood education: Status trends, and issues related to electronic delivery

The status of, and trends and issues within, early childhood education which are related to the possibilities of electronic delivery of educational service are considered in a broader investigation of the role of large scale, satellite based educational telecommunications systems. Data are analyzed and trends and issues discussed to provide information useful to the system designer who wishes to identify and assess the opportunities for large scale electronic delivery in early childhood education.

Rothenberg, D.↗

Satellite-based Estimates of Ambient Air Pollution and Global Variations in Childhood Asthma Prevalence

Background: The effect of ambient air pollution on global variations and trends in asthma prevalence is unclear. Objectives: Our goal was to investigate community-level associations between asthma prevalence data from the International Study of Asthma and Allergies in Childhood (ISAAC) and satellite-based estimates of particulate matter with aerodynamic diameter < 2.5 microm (PM2.5) and nitrogen dioxide (NO2), and modelled estimates of ozone. Methods: We assigned satellite-based estimates of PM2.5 and NO2 at a spatial resolution of 0.1deg × 0.1deg and modeled estimates of ozone at a resolution of 1deg × 1deg to 183 ISAAC centers. We used center-level prevalence of severe asthma as the outcome and multilevel models to adjust for gross national income (GNI) and center- and country-level sex, climate, and population density. We examined associations (adjusting for GNI) between air pollution and asthma prevalence over time in centers with data from ISAAC Phase One (mid-1900s) and Phase Three (2001-2003). Results: For the 13- to 14-year age group (128 centers in 28 countries), the estimated average within-country change in center-level asthma prevalence per 100 children per 10% increase in center-level PM2.5 and NO2 was -0.043 [95% confidence interval (CI): -0.139, 0.053] and 0.017 (95% CI: -0.030, 0.064) respectively. For ozone the estimated change in prevalence per parts per billion by volume was -0.116 (95% CI: -0.234, 0.001). Equivalent results for the 6- to 7-year age group (83 centers in 20 countries), though slightly different, were not significantly positive. For the 13- to 14-year age group, change in center-level asthma prevalence over time per 100 children per 10% increase in PM2.5 from Phase One to Phase Three was -0.139 (95% CI: -0.347, 0.068). The corresponding association with ozone (per ppbV) was -0.171 (95% CI: -0.275, -0.067). Conclusion: In contrast to reports from within-community studies of individuals exposed to traffic pollution, we did not find evidence of a positive association between ambient air pollution and asthma prevalence as measured at the community level.

Air pollution↗

NASA Child Fitness Promotion Program in Young Children in South Korea

Childhood obesity is a serious global public health concern (WHO, 2015; Wang Y & Lobstein T, 2006). Low self-esteem and related mental health problems are common in obese children (Strauss RS, 2000) as well as poor academic performance and career development (Gurley-Calvez T, 2010).Westernized dietary habits and sedentary lifestyles are identified as the major risk factors of current alarming rate of obesity along with genetic susceptibility (Popkin BM, 1999). Children in many countries, including South Korea, have become increasingly sedentary due to urbanization changes in their respective societies (Ng SW, et al. 2009, Salmon J et al. 2011). In particular, South Korea had abundant dissemination of mobile technology, such as tablet and smart phone devices. Children have become reliant on mobile devices and are less likely to perform physical activities (Do, et al, 2013). Effective and sustainable intervention programs are needed to fight the global obesity epidemic (IOM, 2012; Wang Y et al, 2013; Wang Y et al, 2015). Previous studies suggested focus on prevention strategies that begin in early childhood, a period when children establish their life habits. (Salmon J et al. 2011). Recent systematic reviews and meta-analysis including ours found that obesity prevention programs for young children have a greater intervention effect (Waters E, et al, 2011; Wang Y et al, 2013; Wang Y et al, 2015). The NASA Mission X: Train Like an Astronaut (MX) program was developed to promote children's exercise and healthy eating with excitement for training like an astronaut (Lloyd C, 2012).At present, the NASA MX Program covered 28 countries, enrolled children through their teachers in school setting (MX report 2014, 2015). This pilot study adapted the NASA MX intervention program for young children in South Korea. We assessed its feasibility and effectiveness in promoting physical activity (PA) in children and in improving parents' perspectives. We also examined the status of PA in young children. More than 80% of five-year-old children go to a Kindergarten or day care center in South Korea (MH Suh et al, 2013).Thus, reaching young children through child care and education settings could be a good approach for early childhood obesity prevention.

Min, Jungwon↗

Effect of the Adapted NASA Mission X International Child Fitness Program on Young Children and their Parents in South Korea

Obesity has become a global epidemic. Childhood obesity is global public health concern including in South Korea where 16.2% of boys and 9.9% of girls are overweight or obese in 2011. Effective and sustainable intervention programs are needed for prevention of childhood obesity. Obesity prevention programs for young children may have a greater intervention effect than in older children. The NASA Mission X: Train Like an Astronaut (MX) program was developed to promote children's exercise and healthy eating by tapping into their excitement for training like an astronaut. This study aimed to examine the feasibility and effectiveness of the adapted NASA MX intervention in promoting PA in young children and in improving parents' related perspectives.

Min, Jungwon↗

Interview Questions with Bentham Scientific

John Mather answers questions for an interview for the Bentham Science Newsletter. He covers topics ranging from his childhood, his professional career and his thoughts on research, technology and today's scientists and engineers.

Childhood↗

Augmenting and updating NASA spacelink electronic information system

The development of Spacelink during its gestation, birth, infancy, and childhood are described. In addition to compiling and developing more material for implementation in Spacelink, Summer 1989 was spent scanning the insignias of the various manned missions into Spacelink. Material for the above was extracted from existing NASA publications, documents and photographs.

Blake, Jean A.↗

Carl Sagan and the Exploration of Mars and Venus

Inspired by childhood readings of books by Edgar Rice Burroughs, Carl Sagan's first interest in planetary science focused on Mars and Venus. Typical of much of his career he was skeptical of early views about these planets. Early in this century it was thought that the Martian wave of darkening, a seasonal albedo change on the planet, was biological in origin. He suggested instead that it was due to massive dust storms, as was later shown to be the case. He was the first to recognize that Mars has huge topography gradients across its surface. During the spacecraft era, as ancient river valleys were found on the planet, he directed studies of Mars' ancient climate. He suggested that changes in the planets orbit were involved in climate shifts on Mars, just as they are on Earth. Carl had an early interest in Venus. Contradictory observations led to a controversy about the surface temperature, and Carl was one of the first to recognize that Venus has a massive greenhouse effect at work warming its surface. His work on radiative transfer led to an algorithm that was extensively used by modelers of the Earth's climate and whose derivatives still dominate the calculation of radiative transfer in planetary atmospheres today. Carl inspired a vast number of young scientists through his enthusiasm for new ideas and discoveries, his skeptical approach, and his boundless energy. I had the privilege to work in Carl's laboratory during the peak of the era of Mars' initial exploration. It was an exciting time, and place. Carl made it a wonderful experience.

Toon, Owen B.↗

Environmental Public Health Tracking: Health and Environment Linked for Information Exchange-Atlanta (HEXIX-Atlanta: A cooperative Program Between CDC and NASA for Development of an Environmental Public Health Tracking Network in the Atlanta Metropolitan Area

The Centers for Disease Control and Prevention (CDC) is coordinating HELIX- Atlanta to provide information regarding the five-county Metropolitan Atlanta Area (Clayton, Cobb, DeKalb, Fulton, and Gwinett) via a network of integrated environmental monitoring and public health data systems so that all sectors can take action to prevent and control environmentally related health effects. The HELIX-Atlanta Network is a tool to access interoperable information systems with optional information technology linkage functionality driven by scientific rationale. HELIX-Atlanta is a collaborative effort with local, state, federal, and academic partners, including the NASA Marshall Space Flight Center. The HELIX-Atlanta Partners identified the following HELIX-Atlanta initial focus areas: childhood lead poisoning, short-latency cancers, developmental disabilities, birth defects, vital records, respiratory health, age of housing, remote sensing data, and environmental monitoring, HELIX-Atlanta Partners identified and evaluated information systems containing information on the above focus areas. The information system evaluations resulted in recommendations for what resources would be needed to interoperate selected information systems in compliance with the CDC Public Health Information Network (PHIN). This presentation will discuss the collaborative process of building a network that links health and environment data for information exchange, including NASA remote sensing data, for use in HELIX-Atlanta.

Quattrochi, Dale A.↗

Realizing the Dream of Flight: Biographical Essays in Honor of the Centennial of Flight, 1903-2003

While growing up in Cedar Rapids, Iowa, Milton Wright, The Wright Brothers Father, liked to purchase toys for his sons that he hoped would stimulate their imagination. One of the most memorable gifts was a toy helicopter that was designed by the French aeronautical experimenter Alphonse P naud. Milton gave his sons this gift in 1878, and, though it was a simple device with a stick bound to a four-blade rotor set in a spindle, it had the intended effect it caused them to dream. Twenty-five years separated the gift of this toy and their invention of the airplane, yet the Wright brothers were convinced it had exerted an important influence. Tom Crouch argued in The Bishop's Boys that toys like these perfectly illustrated the significance of play for technological innovation. He wrote, rotary-wing toys were to intrigue and inspire generations of children, a few of whom would, as adults, attempt to realize the dream of flight for themselves. If the first powered flight on 17 December 1903 represented a childhood dream realized, it was only the first step in the rapid evolution of the airplane from their flimsy kite-like contraption of wood and cloth to jet airliners and rockets in space. And, as extraordinary as the achievement of powered flight seemed in 1903, before the end of the century, space travel also would become a dream realized. Soviet astronaut Yuri Gagarin first circumnavigated Earth in April 1961, and, eight years later, American astronauts took the first steps for humankind on the Moon. It is with great pleasure that we introduce Realizing the Dream: Biographical Essays in Honor of the Centennial of Flight. These essays in celebration of the Wright brothers first flight 100 years ago grew out of presentations by a group of prominent scholars in 2003 at a conference sponsored by the NASA History Division and held at the Great Lakes Science Center in Cleveland, Ohio. The volume focuses on the careers of some of the many men and women who helped to realize the dream of flight both through the atmosphere and beyond.

Dawson, Virginia P.↗

Incidence of Latent Virus Shedding during Space Flight

Measurements of immune parameters of both cellular and innate immunity indicate alterations in immune function in astronauts. Immune changes are due to stress and perhaps other factors associated with launch, flight, and landing phases. Medical relevance of observed changes is not known. The reactivation of latent viruses has been identified as an important in vivo indicator of clinically relevant immune changes. The polymerase chain reaction (PCR) was used to detect the presence of specific viral DNA in body fluids. Initial studies demonstrated Epstein-Barr virus (EBV) reactivation during all 3 mission phases. EBV is shed in saliva following reactivation from B-cells. Incidence of EBV in saliva was higher than control subjects during all 3 mission phases. However, quantitative PCR revealed 10-fold higher levels of EBV DNA present in saliva collected during flight than found in pre- and post flight specimens. To determine if other latent viruses showed similar effects, cytomegalovirus (CMV), another herpes virus, shed in urine following reactivation was studied. A very low incidence (less than 2%) of CMV in urine is found in healthy, lowstressed individuals. However, 25-50% of astronauts shed CMV in their urine before, during, or after flight. Our studies are now focused on varicella-zoster virus (VZV), the etiological agent of chicken-pox during childhood and shingles later in life. We demonstrated reactivation of VZV and shedding of the virus during and after spaceflight in saliva of astronauts with no sign of active infection or symptoms. The maximum shedding of VZV occurred during the flight phase and diminishes rapidly during the first five days after landing. We have utilized the same PCR assay for VZV in a clinical study of shingles patients. Generally, shingles patients shed much more VZV in saliva than astronauts. However, the VZV levels in astronauts overlap with the lower range of VZV numbers in shingles patients. Saliva from shingles patients and astronauts were cultured and infectious VZV was recovered from both groups. We have concluded that multiple latent viruses do reactivate before, during, and after spaceflight and serve as very sensitive indicators for diminished cellular immunity. Future plans will be focused on the clinical risks posed by the reactivation of these viruses. Initial efforts will determine the effect of longer missions on the International Space Station on the reactivation patterns of these viruses.

Mehta, Satish K.↗

Evaluation of a Pilot Surveillance System: Health and Environment Linked for Information Exchange in Atlanta (HELIX-Atlanta)

CDC and its partners established the Health and Environment Linked for Information Exchange, Atlanta (HELIX-Atlanta) demonstration project, to develop linking and analysis methods that could be used by the National Environmental Public Health Tracking (EPHT) Network. Initiated in October 2003, the Metropolitan Atlanta-based collaborative conducted four projects: asthma and particulate air pollution, birth defects and ozone and particulate air pollution, childhood leukemia and traffic emissions, and children's blood lead testing and neighborhood risk factors for lead poisoning. This report provides an overview of the HELIX-Atlanta projects' goals, methods and outcomes. We discuss priority attributes and common issues and challenges and offer recommendations for implementation of the nascent national environmental public health tracking network.

Meyer, P.↗

Train Like an Astronaut Educational Outreach

In an effort to reduce the incidence of childhood obesity, the National Aeronautics and Space Administration (NASA), capitalizing on the theme of human spaceflight developed two educational outreach programs for children ages 8-12. To motivate young "fit explorers," the Train Like an Astronaut National (TLA) program and the Mission X: Train Like an Astronaut International Fitness Challenge (MX) were created. Based on the astronauts' physical training, these programs consist of activities developed by educators and experts in the areas of space life sciences and fitness. These Activities address components of physical fitness. The educational content hopes to promote students to pursue careers in science, technology, engineering, and math (STEM) fields. At the national level, in partnership with First Lady Michelle Obama's Let?s Move! Initiative, the TLA program consists of 10 physical and 2 educational activities. The program encourages families, schools, and communities to work collaboratively in order to reinforce in children and their families the importance of healthy lifestyle habits In contrast, the MX challenge is a cooperative outreach program involving numerous space agencies and other international partner institutions. During the six-week period, teams of students from around the world are challenged to improve their physical fitness and collectively accumulate points by completing 18 core activities. During the 2011 pilot year, a t otal of 137 teams and more than 4,000 students from 12 countries participated in the event. MX will be implemented within 24 countries during the 2012 challenge. It is projected that 7,000 children will "train like an astronaut".

Garcia, Yamil L.↗

Mission X: Train Like an Astronaut Challenge

The Mission X: Train Like an Astronaut Challenge was developed in 2011 to encourage proper exercise and nutrition at an early age by teaching young people to live and eat like space explorers. The strong correlation between an unhealthy childhood diet and adolescent fitness, and the onset of chronic diseases as an adult is the catalyst for Mission X. Mission X is dedicated to assisting people on a global scale to live healthier lifestyles and learn about human space exploration. The Mission X: Train Like an Astronaut 2015 (MX15) International Challenge hosted almost 40,000 children on 800 teams, 28 countries affiliated with 12 space agencies. The MX15 website included 17 languages. MX15, the fifth annual international fitness challenges sponsored by the NASA Human Research Program worked with the European Space Agency and other space agencies from around the world. In comparison to MX14, MX15 expanded to include four additional new countries, increased the number of students by approximately 68% and the number of teams by 29%. Chile' and South Korea participated in the new fall Astro Charlie Walk Around the Earth Challenge. Pre-challenge training materials were made more readily available from the website. South Korea completed a prospective assessment of the usability of the MX content for improving health and fitness in 212 preschool children and their families. Mission X is fortunate to have the support of the NASA, ESA and JAXA astronaut corps. In MX15, they participated in the opening and closing events as well as while on-board the International Space Station. Italian Astronaut Samantha Cristoretti participated as the MX15 Astronaut Ambassador for health and fitness providing the opening video and other videos from ISS. United Kingdom Astronaut Tim Peake and US Astronaut Kate Rubins have agreed to be the MX Ambassadors for 2016 and 2017 respectively. The MX15 International Working Group Face-to-Face meeting and Closing Event were held at the Agenzia Spaziale Italiana (ASI) in Rome, Italy. A record number of twenty-eight countries participated. Austria and Norway have offered to host the 2016 and 2017 working group meetings. MX16 planning began with the working group meetings and areas of improvement will include another second early challenge to accommodate countries in the Southern Hemisphere, recommended changes to the MX website, development of a more defined approach to metrics, a change to the format of future MX International Working Group meetings, and proposed new activities to be developed by the MX International Educator Working Group. We look forward to welcoming many new participants in 2016!

Lloyd, Charles W.↗

Fall 2015 NASA Internship, and Space Radiation Health Project

This fall, I was fortunate enough to have been able to participate in an internship at NASA's Lyndon B. Johnson Space Center. I was placed into the Human Health & Performance Directorate, where I was specifically tasked to work with Dr. Zarana Patel, researching the impacts of cosmic level radiation on human cells. Using different laboratory techniques, we were able to examine the cells to see if any damage had been done due to radiation exposure, and if so, how much damage was done. Cell culture samples were exposed at different doses, and fixed at different time points so that we could accumulate a large pool of quantifiable data. After examining quantifiable results relative to the impacts of space radiation on the human body at the cellular and chromosomal level, researchers can defer to different areas of the space program that have to do with astronaut safety, and research and development (extravehicular mobility unit construction, vehicle design and construction, etc.). This experience has been very eye-opening, and I was able to learn quite a bit. I learned some new laboratory techniques, and I did my best to try and learn new ways to balance such a hectic work and school schedule. I also learned some very intimate thing about working at NASA; I learned that far more people want to watch you succeed, rather than watch you fail, and I also learned that this is a place that is alive with innovators and explorers - people who have a sole purpose of exploring space for the betterment of humanity, and not for any other reason. It's truly inspiring. All of these experiences during my internship have impacted me in a really profound way, so much that my educational and career goals are completely different than when I started. I started out as a biotechnology major, and I discovered recently toward the end of the internship, that I don't want to work in a lab, nor was I as enthralled by biological life sciences as a believed myself to be. Taking that all into consideration, I've actually changed my major to mechanical engineering. I discovered that I enjoy building things, and I enjoy learning about materials and interactions between different things. And I quickly became obsessed with rocket and aerospace engineering, so I've decided that after a mechanical engineering degree, I will be pursuing an advanced degree in aerospace engineering. One final way that I was effected by this internship, is that I discovered that I don't want to have a career at NASA. I love this agency with all of my heart, but I refuse to allow my innovation to be bound by a scientifically illiterate congress. As such, I have decided to pursue commercial aerospace companies, such as Space, XCOR, Masten Space Systems, Orbital ATK, and many, many, more. Maybe one day I'll end up back here. I believe in what this agency is doing with my whole heart, and it's unfortunate to see them curtailed in some capacities as a result of budgetary constraints, brought on by people who don't fully understand the effort behind putting people in to space. All in all, this experience has been the best experience of my life - literally a childhood dream came true during this experience - and I cannot adequately explain how grateful I am to have been here for the past sixteen weeks.

Patience, Luke↗