NASA Space Launch System Operations Outlook

The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center (MSFC), is working with the Ground Systems Development and Operations (GSDO) Program, based at the Kennedy Space Center (KSC), to deliver a new safe, affordable, and sustainable capability for human and scientific exploration beyond Earth's orbit (BEO). Larger than the Saturn V Moon rocket, SLS will provide 10 percent more thrust at liftoff in its initial 70 metric ton (t) configuration and 20 percent more in its evolved 130-t configuration. The primary mission of the SLS rocket will be to launch astronauts to deep space destinations in the Orion Multi-Purpose Crew Vehicle (MPCV), also in development and managed by the Johnson Space Center. Several high-priority science missions also may benefit from the increased payload volume and reduced trip times offered by this powerful, versatile rocket. Reducing the life-cycle costs for NASA's space transportation flagship will maximize the exploration and scientific discovery returned from the taxpayer's investment. To that end, decisions made during development of SLS and associated systems will impact the nation's space exploration capabilities for decades. This paper will provide an update to the operations strategy presented at SpaceOps 2012. It will focus on: 1) Preparations to streamline the processing flow and infrastructure needed to produce and launch the world's largest rocket (i.e., through incorporation and modification of proven, heritage systems into the vehicle and ground systems); 2) Implementation of a lean approach to reachback support of hardware manufacturing, green-run testing, and launch site processing and activities; and 3) Partnering between the vehicle design and operations communities on state-ofthe- art predictive operations analysis techniques. An example of innovation is testing the integrated vehicle at the processing facility in parallel, rather than sequentially, saving both time and money. These themes are accomplished under the context of a new cross-program integration model that emphasizes peer-to-peer accountability and collaboration towards a common, shared goal. Utilizing the lessons learned through 50 years of human space flight experience, SLS is assigning the right number of people from appropriate backgrounds, providing them the right tools, and exercising the right processes for the job. The result will be a powerful, versatile, and capable heavy-lift, human-rated asset for the future human and scientific exploration of space

WIYN Open Cluster Study. LXIII. Abundance in the Super-Metal-Rich Open Cluster NGC 6253 from Hydra Sprectroscopy of the 7774 Å Oxygen Triplet Region

We present a spectroscopic abundance analysis of the old, super-metal-rich open cluster NGC 6253, with emphasis on its O abundance. High-dispersion, 7774 Å O i triplet region spectra of 47 stars were obtained using Hydra II on the CTIO Blanco 4 m. Radial velocity analysis confirms 39 stars consistent with single star membership, primarily at the turnoff. Thirty-six of these are included in our abundance analysis. Our differential analysis relative to the Sun yields primarily scaled-solar values, with weighted cluster averages of [O/H] = +0.440 ± 0.020, [Fe/H] = +0.445 ± 0.014, [Al/H] = +0.487 ± 0.020, [Si/H] = +0.504 ± 0.018, and [Ni/H] = +0.702 ± 0.018 (where the errors are ${{\sigma }_{\mu }}$). We discuss possible origins for the three known super-metal-rich clusters based upon their abundance patterns, Galactic locations, and space motions. The abundance patterns of NGC 6253 are very similar to those of NGC 6791 and NGC 6583. With the possible exception of oxygen, the abundances of these clusters are all close to scaled-solar, and they are similar to patterns seen in metal-rich disk dwarfs and giants. However, they also seem to differ from those of metal-rich bulge stars. We demonstrate that NGC 6253 is unusually oxygen rich (in [O/H]) for its 3.3 Gyr age. While we find [O/Fe] to be scaled-solar for NGC 6253, the more recently reported values for NGC 6791 show a large variation, from values close to scaled-solar down to values at least a factor of two below scaled-solar. We discuss the possibility that the scaled-solar [O/Fe] abundances of NGC 6253 and NGC 6791 might reflect a flattening of the Galactic [O/Fe] versus [Fe/H] relationship. This possibility may be consistent with disk star abundance data, which show an apparent "floor" at [O/Fe] $\sim -0.1$ for [Fe/H] $\gt \;0$, and with chemical evolution model results, which may predict such a flattening due to a decrease in supernova Fe yields at super-solar-metallicities. Orbit solutions for NGC 6791 allow that it may have formed in the inner disk and was then kicked out, but the origins of the other two much younger clusters remain mysterious. We re-evaluate the age of NGC 6583 in view of the evidence that the cluster is super-metal-rich, and confirm a probable age less than 1 Gyr (best range: 500–900 Myr). We also argue that it is unlikely the cluster is more than 3 kpc away (best range: 2–3 kpc) if the apparent turnoff, main sequence, and giants are all cluster members

The impact of the demographic transition on dengue in Thailand: Insights from a statistical analysis and mathematical modeling

Background: An increase in the average age of dengue hemorrhagic fever (DHF) cases has been reported in Thailand. The cause of this increase is not known. Possible explanations include a reduction in transmission due to declining mosquito populations, declining contact between human and mosquito, and changes in reporting. We propose that a demographic shift toward lower birth and death rates has reduced dengue transmission and lengthened the interval between large epidemics. Methods and Findings: Using data from each of the 72 provinces of Thailand, we looked for associations between force of infection (a measure of hazard, defined as the rate per capita at which susceptible individuals become infected) and demographic and climactic variables. We estimated the force of infection from the age distribution of cases from 1985 to 2005. We find that the force of infection has declined by 2% each year since a peak in the late 1970s and early 1980s. Contrary to recent findings suggesting that the incidence of DHF has increased in Thailand, we find a small but statistically significant decline in DHF incidence since 1985 in a majority of provinces. The strongest predictor of the change in force of infection and the mean force of infection is the median age of the population. Using mathematical simulations of dengue transmission we show that a reduced birth rate and a shift in the population's age structure can explain the shift in the age distribution of cases, reduction of the force of infection, and increase in the periodicity of multiannual oscillations of DHF incidence in the absence of other changes. Conclusions: Lower birth and death rates decrease the flow of susceptible individuals into the population and increase the longevity of immune individuals. The increase in the proportion of the population that is immune increases the likelihood that an infectious mosquito will feed on an immune individual, reducing the force of infection. Though the force of infection has decreased by half, we find that the critical vaccination fraction has not changed significantly, declining from an average of 85% to 80%. Clinical guidelines should consider the impact of continued increases in the age of dengue cases in Thailand. Countries in the region lagging behind Thailand in the demographic transition may experience the same increase as their population ages. The impact of demographic changes on the force of infection has been hypothesized for other diseases, but, to our knowledge, this is the first observation of this phenomenon

Looking inside the black box : a theory-based process evaluation alongside a randomised controlled trial of printed educational materials (the Ontario printed educational message, OPEM) to improve referral and prescribing practices in primary care in Ontario, Canada

Background: Randomised controlled trials of implementation strategies tell us whether (or not) an intervention results in changes in professional behaviour but little about the causal mechanisms that produce any change. Theory-based process evaluations collect data on theoretical constructs alongside randomised trials to explore possible causal mechanisms and effect modifiers. This is similar to measuring intermediate endpoints in clinical trials to further understand the biological basis of any observed effects (for example, measuring lipid profiles alongside trials of lipid lowering drugs where the primary endpoint could be reduction in vascular related deaths). This study protocol describes a theory-based process evaluation alongside the Ontario Printed Educational Message (OPEM) trial. We hypothesize that the OPEM interventions are most likely to operate through changes in physicians' behavioural intentions due to improved attitudes or subjective norms with little or no change in perceived behavioural control. We will test this hypothesis using a well-validated social cognition model, the theory of planned behaviour (TPB) that incorporates these constructs. Methods/design: We will develop theory-based surveys using standard methods based upon the TPB for the second and third replications, and survey a subsample of Ontario family physicians from each arm of the trial two months before and six months after the dissemination of the index edition of informed, the evidence based newsletter used for the interventions. In the third replication, our study will converge with the "TRY-ME" protocol (a second study conducted alongside the OPEM trial), in which the content of educational messages was constructed using both standard methods and methods informed by psychological theory. We will modify Dillman's total design method to maximise response rates. Preliminary analyses will initially assess the internal reliability of the measures and use regression to explore the relationships between predictor and dependent variable (intention to advise diabetic patients to have annual retinopathy screening and to prescribe thiazide diuretics for first line treatment of uncomplicated hypertension). We will then compare groups using methods appropriate for comparing independent samples to determine whether there have been changes in the predicted constructs (attitudes, subjective norms, or intentions) across the study groups as hypothesised, and will assess the convergence between the process evaluation results and the main trial results.The OPEM trial and OPEM process evaluation are funded by the Canadian Institute of Health Research (CIHR). The OPEM process evaluation study was developed as part of the CIHR funded interdisciplinary capacity enhancement team KT-ICEBeRG. Gaston Godin, Jeremy Grimshaw and France Légaré hold Canada Research Chairs. Louise Lemyre holds an R.S. McLaughlin Research Chair

Dengue Dynamics in Binh Thuan Province, Southern Vietnam: Periodicity, Synchronicity and Climate Variability

Dengue has become a major international public health problem due to increasing geographic distribution and a transition from epidemic transmission with long inter-epidemic intervals to endemic transmission with seasonal fluctuation. Seasonal and multi-annual cycles in dengue incidence vary over time and space. We performed wavelet analyses on time series of monthly notified dengue cases in Binh Thuan province, southern Vietnam, from January 1994 to June 2009. We observed a continuous annual mode of oscillation with a non-stationary 2–3-year multi-annual cycle. We used phase differences to describe the spatio-temporal patterns which suggest that the seasonal wave of infection was either synchronous with all districts or moving away from Phan Thiet district, while the multi-annual wave of infection was moving towards Phan Thiet district. We also found a strong non-stationary association between ENSO indices and climate variables with dengue incidence. We provided insight in dengue population transmission dynamics over the past 14.5 years. Further studies on an extensive time series dataset are needed to test the hypothesis that epidemics emanate from larger cities in southern Vietnam

Common variants in the CRP gene in relation to longevity and cause-specific mortality in older adults: The Cardiovascular Health Study

Common polymorphisms in the CRP gene are associated with plasma CRP levels in population-based studies, but associations with age-related events are uncertain. A previous study of CRP haplotypes in older adults was broadened to include longevity and cause-specific mortality (all-cause, non-cardiovascular (nonCV), and cardiovascular (CV)). Common haplotypes were inferred from four tagSNPs in 4512 whites and five tagSNPs in 812 blacks from the Cardiovascular Health Study, a longitudinal cohort of adults over age 65. Exploratory analyses addressed early versus late mortality. CRP haplotypes were not associated with all-cause mortality or longevity overall in either population, but associations with all-cause mortality differed during early and late periods. In blacks, the haplotype tagged by 3872A (rs1205) was associated with increased risk of nonCV mortality, relative to other haplotypes (adjusted hazard ratio for each additional copy: 1.42, 95% CI: 1.07, 1.87). Relative to other haplotypes, this haplotype was associated with decreased risk of early but not decreased risk of late CV mortality in blacks; among whites, a haplotype tagged by 2667C (rs1800947) gave similar but nonsignificant findings. If confirmed, CRP genetic variants may be weakly associated with CV and nonCV mortality in older adults, particularly in self-identified blacks

Reporting Guidelines for Survey Research: An Analysis of Published Guidance and Reporting Practices

Carol Bennett and colleagues review the evidence and find that there is limited guidance and no consensus on the optimal reporting of survey research

Phylogeography of Recently Emerged DENV-2 in Southern Viet Nam

Revealing the dispersal of dengue viruses (DENV) in time and space is central to understanding their epidemiology. However, the processes that shape DENV transmission patterns at the scale of local populations are not well understood, particularly the impact of such factors as human population movement and urbanization. Herein, we investigated trends in the spatial dynamics of DENV-2 transmission in the highly endemic setting of southern Viet Nam. Through a phylogeographic analysis of 168 full-length DENV-2 genome sequences obtained from hospitalized dengue cases from 10 provinces in southern Viet Nam, we reveal substantial genetic diversity in both urban and rural areas, with multiple lineages identified in individual provinces within a single season, and indicative of frequent viral migration among communities. Focusing on the recently introduced Asian I genotype, we observed particularly high rates of viral exchange between adjacent geographic areas, and between Ho Chi Minh City, the primary urban center of this region, and populations across southern Viet Nam. Within Ho Chi Minh City, patterns of DENV movement appear consistent with a gravity model of virus dispersal, with viruses traveling across a gradient of population density. Overall, our analysis suggests that Ho Chi Minh City may act as a source population for the dispersal of DENV across southern Viet Nam, and provides further evidence that urban areas of Southeast Asia play a primary role in DENV transmission. However, these data also indicate that more rural areas are also capable of maintaining virus populations and hence fueling DENV evolution over multiple seasons

Quantifying the Emergence of Dengue in Hanoi, Vietnam: 1998–2009

Dengue is the most common vector-borne viral disease of humans, causing an estimated 50 million cases per year. The number of countries affected by dengue has increased dramatically in the last 50 years and dengue is now a major public health problem in large parts of the tropical and subtropical world. It is of considerable importance to understand the factors that determine how dengue becomes newly established in areas where the risk of dengue was previously small. Hanoi in North Vietnam is a large city where dengue appears to be emerging. We analyzed 12 years of dengue surveillance data in order to characterize the temporal and spatial epidemiology of dengue in Hanoi and to establish if dengue incidence has been increasing. After excluding the two major outbreak years of 1998 and 2009 and correcting for changes in population age structure over time, we found there was a significant annual increase in the incidence of notified dengue cases over the period 1999–2008. Dengue cases were concentrated in young adults in the highly urban central areas of Hanoi. This study indicates that dengue transmission is increasing in Hanoi and provides a platform for further studies of the underlying drivers of this emergence

24-Karat or fool’s gold? Consequences of real team and co-acting group membership in healthcare organizations

Although theory on team membership is emerging, limited empirical attention has been paid to the effects of different types of team membership on outcomes. We propose that an important but overlooked distinction is that between membership of real teams and membership of co-acting groups, with the former being characterized by members who report that their teams have shared objectives, and structural interdependence and engage in team reflexivity. We hypothesize that real team membership will be associated with more positive individual- and organizational-level outcomes. These predictions were tested in the English National Health Service, using data from 62,733 respondents from 147 acute hospitals. The results revealed that individuals reporting the characteristics of real team membership, in comparison with those reporting the characteristics of co-acting group membership, witnessed fewer errors and incidents, experienced fewer work related injuries and illness, were less likely to be victims of violence and harassment, and were less likely to intend to leave their current employment. At the organizational level, hospitals with higher proportions of staff reporting the characteristics of real team membership had lower levels of patient mortality and sickness absence. The results suggest the need to clearly delineate real team membership in order to advance scientific understanding of the processes and outcomes of organizational teamwork