Putting Women's Health Care Disparities on the Map: Examining Racial and Ethnic Disparities at the State Level

Assesses the racial/ethnic disparities in women's health status, access to and utilization of health care, and social factors such as poverty and gender wage gap by state. Examines how healthcare payment and worker shortages affect access to care

A 4-m evolvable space telescope configured for NASA's HabEx Mission: the initial stage of LUVOIR

Previous papers have described our concept for a large telescope that would be assembled in space in several stages (in different configurations) over a period of fifteen to 20 years. Spreading the telescope development, launch and operations cost over 20 years would minimize the impact on NASA’s annual budget and drastically shorten the time between program start and “first light” for this space observatory. The first Stage of this Evolvable Space Telescope (EST) would consist of an instrument module located at the prime focus of three 4-meter hexagonal mirrors arranged in a semi-circle to form one-half of a 12-m segmented mirror. After several years three additional 4-m mirrors would be added to create a 12-m filled aperture. Later, twelve more 4-m mirrors will be added to this Stage 2 telescope to create a 20-m filled aperture space telescope. At each stage the telescope would have an unparalleled capability for UVOIR observations, and the results of these observations will guide the evolution of the telescope and its instruments. In this paper we describe our design concept for an initial configuration of our Evolvable Space Telescope that can meet the requirements of the 4-m version of the HabEx spacecraft currently under consideration by NASA’s Habitable Exoplanet Science and Technology Definition Team. This “Stage Zero” configuration will have only one 4-m mirror segment with the same 30-m focal length and a prime focus coronagraph with normal incidence optics to minimize polarization effects. After assembly and checkout in cis-lunar space, the telescope would transfer to a Sun-Earth L2 halo orbit and obtain high sensitivity, high resolution, high contrast UVOIR observations that address the scientific objectives of the Habitable-Exoplanet Imaging Missions

An evolvable space telescope for future astronomical missions

Astronomical flagship missions after JWST will require affordable space telescopes and science instruments. Innovative spacecraft-electro-opto-mechanical system architectures matched to the science requirements are needed for observations for exoplanet characterization, cosmology, dark energy, galactic evolution formation of stars and planets, and many other research areas. The needs and requirements to perform this science will continue to drive us toward larger and larger apertures. Recent technology developments in precision station keeping of spacecraft, interplanetary transfer orbits, wavefront/sensing and control, laser engineering, macroscopic application of nano-technology, lossless optical designs, deployed structures, thermal management, interferometry, detectors and signal processing enable innovative telescope/system architectures with break-through performance. Unfortunately, NASA’s budget for Astrophysics is unlikely to be able to support the funding required for the 8 m to 16 m telescopes that have been studied as a follow-on to JWST using similar development/assembly approaches without decimating the rest of the Astrophysics Division’s budget. Consequently, we have been examining the feasibility of developing an “Evolvable Space Telescope” that would begin as a 3 to 4 m telescope when placed on orbit and then periodically be augmented with additional mirror segments, structures, and newer instruments to evolve the telescope and achieve the performance of a 16 m or larger space telescope. This paper reviews the approach for such a mission and identifies and discusses candidate architectures

Topological pupil segmentation and point spread function analysis for large aperture imaging systems

Future large aperture telescopes and high contrast imaging systems will often include segment gaps, structural obscurations, along with outer edges which produce diffraction effects that are disadvantageous to high contrast imaging (e.g., for exoplanet detection) or continuous wavefront control across the optical aperture. We present an optimization strategy for several pupil segment topologies for next-generation telescope concepts. Wave propagation results based on diffraction-limited point spread function analyses using Fraunhofer diffraction theory are presented using the Python-based POPPY simulation tool

An evolvable space telescope for future astronomical missions 2015 update

In 2014 we presented a concept for an Evolvable Space Telescope (EST) that was assembled on orbit in 3 stages, growing from a 4x12 meter telescope in Stage 1, to a 12-meter filled aperture in Stage 2, and then to a 20-meter filled aperture in Stage 3. Stage 1 is launched as a fully functional telescope and begins gathering science data immediately after checkout on orbit. This observatory is then periodically augmented in space with additional mirror segments, structures, and newer instruments to evolve the telescope over the years to a 20-meter space telescope. In this 2015 update of EST we focus upon three items: 1) a restructured Stage 1 EST with three mirror segments forming an off-axis telescope (half a 12-meter filled aperture); 2) more details on the value and architecture of the prime focus instrument accommodation; and 3) a more in depth discussion of the essential in-space infrastructure, early ground testing and a concept for an International Space Station testbed called MoDEST. In addition to the EST discussions we introduce a different alternative telescope architecture: a Rotating Synthetic Aperture (RSA). This is a rectangular primary mirror that can be rotated to fill the UV-plane. The original concept was developed by Raytheon Space and Airborne Systems for non-astronomical applications. In collaboration with Raytheon we have begun to explore the RSA approach as an astronomical space telescope and have initiated studies of science and cost performance

Astrophysical Adaptation of Points, the Precision Optical Interferometer in Space

POINTS (Precision Optical INTerferometer in Space) would perform microarcsecond optical astrometric measurements from space, yielding submicroarcsecond astrometric results from the mission. It comprises a pair of independent Michelson stellar interferometers and a laser metrology system that measures both the critical starlight paths and the angle between the baselines. The instrument has two baselines of 2 m, each with two subapertures of 35 cm; by articulating the angle between the baselines, it observes targets separated by 87 to 93 deg. POINTS does global astrometry, i.e., it measures widely separated targets, which yields closure calibration, numerous bright reference stars, and absolute parallax. Simplicity, stability, and the mitigation of systematic error are the central design themes. The instrument has only three moving-part mechanisms, and only one of these must move with sub-milliradian precision; the other two can tolerate a precision of several tenths of a degree. Optical surfaces preceding the beamsplitter or its fold flat are interferometrically critical; on each side of the interferometer, there are only three such. Thus, light loss and wavefront distortion are minimized. POINTS represents a minimalistic design developed ab initio for space. Since it is intended for astrometry, and therefore does not require the u-v-plane coverage of an imaging, instrument, each interferometer need have only two subapertures. The design relies on articulation of the angle between the interferometers and body pointing to select targets; the observations are restricted to the 'instrument plane.' That plane, which is fixed in the pointed instrument, is defined by the sensitive direction for the two interferometers. Thus, there is no need for siderostats and moving delay lines, which would have added many precision mechanisms with rolling and sliding parts that would be required to function throughout the mission. Further, there is no need for a third interferometer, as is required when out-of-plane observations are made. An instrument for astrometry, unlike those for imaging, can be compact and yet scientifically productive. The POINTS instrument is compact and therefore requires no deployment of precision structures, has no low-frequency (i.e., under 100 Hz) vibration modes, and is relatively easy to control thermally. Because of its small size and mass, it is easily and quickly repointed between observations. Further, because of the low mass, it can be economically launched into high Earth orbit which, in conjunction with a solar shield, yields nearly unrestricted sky coverage and a stable thermal environment

Recurrent patterns of DNA copy number alterations in tumors reflect metabolic selection pressures.

Copy number alteration (CNA) profiling of human tumors has revealed recurrent patterns of DNA amplifications and deletions across diverse cancer types. These patterns are suggestive of conserved selection pressures during tumor evolution but cannot be fully explained by known oncogenes and tumor suppressor genes. Using a pan-cancer analysis of CNA data from patient tumors and experimental systems, here we show that principal component analysis-defined CNA signatures are predictive of glycolytic phenotypes, including 18F-fluorodeoxy-glucose (FDG) avidity of patient tumors, and increased proliferation. The primary CNA signature is enriched for p53 mutations and is associated with glycolysis through coordinate amplification of glycolytic genes and other cancer-linked metabolic enzymes. A pan-cancer and cross-species comparison of CNAs highlighted 26 consistently altered DNA regions, containing 11 enzymes in the glycolysis pathway in addition to known cancer-driving genes. Furthermore, exogenous expression of hexokinase and enolase enzymes in an experimental immortalization system altered the subsequent copy number status of the corresponding endogenous loci, supporting the hypothesis that these metabolic genes act as drivers within the conserved CNA amplification regions. Taken together, these results demonstrate that metabolic stress acts as a selective pressure underlying the recurrent CNAs observed in human tumors, and further cast genomic instability as an enabling event in tumorigenesis and metabolic evolution

Low-scale warped extra dimension and its predilection for multiple top quarks

Within warped extra dimension models that explain flavor through geometry, flavor changing neutral current constraints generally force the Kaluza-Klein scale to be above many TeV. This creates tension with a natural electroweak scale. On the other hand, a much lower scale compatible with precision electroweak and flavor changing neutral current constraints is allowed if we decouple the Kaluza-Klein states of Standard Model gauge bosons from light fermions $c_{\rm light}\simeq c_b\simeq 0.5$ bulk mass parameters). The main signature for this approach is four top quark production via the Kaluza-Klein excitations' strong coupling to top quarks. We study single lepton, like-sign dilepton, and trilepton observables of four-top events at the Large Hadron Collider. The like-sign dilepton signature typically has the largest discovery potential for a strongly coupled right-handed top case (M_{KK} \sim 2-2.5 \TeV), while single lepton is the better when the left-handed top couples most strongly (M_{KK} \sim 2 \TeV). We also describe challenging lepton-jet collimation issues in the like-sign dilepton and trilepton channels. An alternative single lepton observable is considered which takes advantage of the many bottom quarks in the final state. Although searches of other particles may compete, we find that four top production via Kaluza-Klein gluons is most promising in a large region of this parameter space.Comment: 35 pages, 8 figures. discussions improved, references adde

Contribution of patient, physician, and environmental factors to demographic and health variation in colonoscopy follow-up for abnormal colorectal cancer screening test results

BACKGROUND: Patient, physician, and environmental factors were identified, and the authors examined the contribution of these factors to demographic and health variation in colonoscopy follow-up after a positive fecal occult blood test/fecal immunochemical test (FOBT/FIT) screening. METHODS: In total, 76,243 FOBT/FIT-positive patients were identified from 120 Veterans Health Administration (VHA) facilities between August 16, 2009 and March 20, 2011 and were followed for 6 months. Patient demographic (race/ethnicity, sex, age, marital status) and health characteristics (comorbidities), physician characteristics (training level, whether primary care provider) and behaviors (inappropriate FOBT/FIT screening), and environmental factors (geographic access, facility type) were identified from VHA administrative records. Patient behaviors (refusal, private sector colonoscopy use) were estimated with statistical text mining conducted on clinic notes, and follow-up predictors and adjusted rates were estimated using hierarchical logistic regression. RESULTS: Roughly 50% of individuals completed a colonoscopy at a VHA facility within 6 months. Age and comorbidity score were negatively associated with follow-up. Blacks were more likely to receive follow-up than whites. Environmental factors attenuated but did not fully account for these differences. Patient behaviors (refusal, private sector colonoscopy use) and physician behaviors (inappropriate screening) fully accounted for the small reverse race disparity and attenuated variation by age and comorbidity score. Patient behaviors (refusal and private sector colonoscopy use) contributed more to variation in follow-up rates than physician behaviors (inappropriate screening). CONCLUSIONS: In the VHA, blacks are more likely to receive colonoscopy follow-up for positive FOBT/FIT results than whites, and follow-up rates markedly decline with advancing age and comorbidity burden. Patient and physician behaviors explain race variation in follow-up rates and contribute to variation by age and comorbidity burden. Cancer 2017;123:3502-12. Published 2017. This article is a US Government work and is in the public domain in the USA