Matching Items (17)
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Description
Heart transplantation is the final treatment option for end-stage heart failure. In the United States, 70 pediatric patients die annually on the waitlist while 800 well-functioning organs get discarded. Concern for potential size-mismatch is one source of allograft waste and high waitlist mortality. Clinicians use the donor-recipient body weight (DRBW)

Heart transplantation is the final treatment option for end-stage heart failure. In the United States, 70 pediatric patients die annually on the waitlist while 800 well-functioning organs get discarded. Concern for potential size-mismatch is one source of allograft waste and high waitlist mortality. Clinicians use the donor-recipient body weight (DRBW) ratio, a standalone metric, to evaluate allograft size-match. However, this body weight metric is far removed from cardiac anatomy and neglects an individual’s anatomical variations. This thesis body of work developed a novel virtual heart transplant fit assessment tool and investigated the tool’s clinical utility to help clinicians safely expand patient donor pools.

The tool allowed surgeons to take an allograft reconstruction and fuse it to a patient’s CT or MR medical image for virtual fit assessment. The allograft is either a reconstruction of the donor’s actual heart (from CT or MR images) or an analogue from a health heart library. The analogue allograft geometry is identified from gross donor parameters using a regression model build herein. The need for the regression model is donor images may not exist or they may not become available within the time-window clinicians have to make a provisional acceptance of an offer.

The tool’s assessment suggested > 20% of upper DRBW listings could have been increased at Phoenix Children’s Hospital (PCH). Upper DRBW listings in the UNOS national database was statistically smaller than at PCH (p-values: < 0.001). Delayed sternal closure and surgeon perceived complication variables had an association (p-value: 0.000016) with 9 of the 11 cases that surgeons had perceived fit-related complications had delayed closures (p-value: 0.034809).

A tool to assess allograft size-match has been developed. Findings warrant future preclinical and clinical prospective studies to further assess the tool’s clinical utility.
ContributorsPlasencia, Jonathan (Author) / Frakes, David H (Thesis advisor) / Kodibagkar, Vikram (Thesis advisor) / Sadleir, Rosalind (Committee member) / Kamarianakis, Yiannis (Committee member) / Zangwill, Steven (Committee member) / Pophal, Stephen (Committee member) / Arizona State University (Publisher)
Created2018
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Description

Heat vulnerability of urban populations is becoming a major issue of concern with climate change, particularly in the cities of the Southwest United States. In this article we discuss the importance of understanding coupled social and technical systems, how they constitute one another, and how they form the conditions and

Heat vulnerability of urban populations is becoming a major issue of concern with climate change, particularly in the cities of the Southwest United States. In this article we discuss the importance of understanding coupled social and technical systems, how they constitute one another, and how they form the conditions and circumstances in which people experience heat. We discuss the particular situation of Los Angeles and Maricopa Counties, their urban form and the electric grid. We show how vulnerable populations are created by virtue of the age and construction of buildings, the morphology of roads and distribution of buildings on the landscape. Further, the regulatory infrastructure of electricity generation and distribution also contributes to creating differential vulnerability. We contribute to a better understanding of the importance of sociotechnical systems. Social infrastructure includes codes, conventions, rules and regulations; technical systems are the hard systems of pipes, wires, buildings, roads, and power plants. These interact to create lock-in that is an obstacle to addressing issues such as urban heat stress in a novel and equitable manner.

Created2016-08-25
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Description

This study examines the distributional equity of urban tree canopy (UTC) cover for Baltimore, MD, Los Angeles, CA, New York, NY, Philadelphia, PA, Raleigh, NC, Sacramento, CA, and Washington, D.C. using high spatial resolution land cover data and census data. Data are analyzed at the Census Block Group levels using

This study examines the distributional equity of urban tree canopy (UTC) cover for Baltimore, MD, Los Angeles, CA, New York, NY, Philadelphia, PA, Raleigh, NC, Sacramento, CA, and Washington, D.C. using high spatial resolution land cover data and census data. Data are analyzed at the Census Block Group levels using Spearman’s correlation, ordinary least squares regression (OLS), and a spatial autoregressive model (SAR). Across all cities there is a strong positive correlation between UTC cover and median household income. Negative correlations between race and UTC cover exist in bivariate models for some cities, but they are generally not observed using multivariate regressions that include additional variables on income, education, and housing age. SAR models result in higher r-square values compared to the OLS models across all cities, suggesting that spatial autocorrelation is an important feature of our data. Similarities among cities can be found based on shared characteristics of climate, race/ethnicity, and size. Our findings suggest that a suite of variables, including income, contribute to the distribution of UTC cover. These findings can help target simultaneous strategies for UTC goals and environmental justice concerns.

ContributorsSchwarz, Kirsten (Author) / Fragkias, Michail (Author) / Boone, Christopher (Author) / Zhou, Weiqi (Author) / McHale, Melissa (Author) / Grove, J. Morgan (Author) / O'Neil-Dunne, Jarlath (Author) / McFadden, Joseph P. (Author) / Buckley, Geoffrey L. (Author) / Childers, Dan (Author) / Ogden, Laura (Author) / Pincetl, Stephanie Sabine, 1952- (Author) / Pataki, Diane (Author) / Whitmer, Ali (Author) / Cadenasso, Mary L. (Author) / Julie Ann Wrigley Global Institute of Sustainability (Contributor)
Created2015-04-01
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Description

The leading source of weather-related deaths in the United States is heat, and future projections show that the frequency, duration, and intensity of heat events will increase in the Southwest. Presently, there is a dearth of knowledge about how infrastructure may perform during heat waves or could contribute to social

The leading source of weather-related deaths in the United States is heat, and future projections show that the frequency, duration, and intensity of heat events will increase in the Southwest. Presently, there is a dearth of knowledge about how infrastructure may perform during heat waves or could contribute to social vulnerability. To understand how buildings perform in heat and potentially stress people, indoor air temperature changes when air conditioning is inaccessible are modeled for building archetypes in Los Angeles, California, and Phoenix, Arizona, when air conditioning is inaccessible is estimated.

An energy simulation model is used to estimate how quickly indoor air temperature changes when building archetypes are exposed to extreme heat. Building age and geometry (which together determine the building envelope material composition) are found to be the strongest indicators of thermal envelope performance. Older neighborhoods in Los Angeles and Phoenix (often more centrally located in the metropolitan areas) are found to contain the buildings whose interiors warm the fastest, raising particular concern because these regions are also forecast to experience temperature increases. To combat infrastructure vulnerability and provide heat refuge for residents, incentives should be adopted to strategically retrofit buildings where both socially vulnerable populations reside and increasing temperatures are forecast.

Created2015
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Description

Urban green space is purported to offset greenhouse‐gas (GHG) emissions, remove air and water pollutants, cool local climate, and improve public health. To use these services, municipalities have focused efforts on designing and implementing ecosystem‐services‐based “green infrastructure” in urban environments. In some cases the environmental benefits of this infrastructure have

Urban green space is purported to offset greenhouse‐gas (GHG) emissions, remove air and water pollutants, cool local climate, and improve public health. To use these services, municipalities have focused efforts on designing and implementing ecosystem‐services‐based “green infrastructure” in urban environments. In some cases the environmental benefits of this infrastructure have been well documented, but they are often unclear, unquantified, and/or outweighed by potential costs. Quantifying biogeochemical processes in urban green infrastructure can improve our understanding of urban ecosystem services and disservices (negative or unintended consequences) resulting from designed urban green spaces. Here we propose a framework to integrate biogeochemical processes into designing, implementing, and evaluating the net effectiveness of green infrastructure, and provide examples for GHG mitigation, stormwater runoff mitigation, and improvements in air quality and health.

ContributorsPataki, Diane E. (Author) / Carreiro, Margaret M. (Author) / Cherrier, Jennifer (Author) / Grulke, Nancy E. (Author) / Jennings, Viniece (Author) / Pincetl, Stephanie Sabine, 1952- (Author) / Pouyat, Richard V. (Author) / Whitlow, Thomas H. (Author) / Zipperer, Wayne C. (Author)
Created2011-02-01
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Description

The leading source of weather-related deaths in the United States is heat, and future projections show that the frequency, duration, and intensity of heat events will increase in the Southwest. Presently, there is a dearth of knowledge about how infrastructure may perform during heat waves or could contribute to social

The leading source of weather-related deaths in the United States is heat, and future projections show that the frequency, duration, and intensity of heat events will increase in the Southwest. Presently, there is a dearth of knowledge about how infrastructure may perform during heat waves or could contribute to social vulnerability. To understand how buildings perform in heat and potentially stress people, indoor air temperature changes when air conditioning is inaccessible are modeled for building archetypes in Los Angeles, California, and Phoenix, Arizona, when air conditioning is inaccessible is estimated.

An energy simulation model is used to estimate how quickly indoor air temperature changes when building archetypes are exposed to extreme heat. Building age and geometry (which together determine the building envelope material composition) are found to be the strongest indicators of thermal envelope performance. Older neighborhoods in Los Angeles and Phoenix (often more centrally located in the metropolitan areas) are found to contain the buildings whose interiors warm the fastest, raising particular concern because these regions are also forecast to experience temperature increases. To combat infrastructure vulnerability and provide heat refuge for residents, incentives should be adopted to strategically retrofit buildings where both socially vulnerable populations reside and increasing temperatures are forecast.

ContributorsNahlik, Matthew J. (Author) / Chester, Mikhail Vin (Author) / Pincetl, Stephanie Sabine, 1952- (Author) / Eisenman, David (Author) / Sivaraman, Deepak (Author) / English, Paul (Author)
Created2016-11-11
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Description

The impacts of land-cover composition on urban temperatures, including temperature extremes, are well documented. Much less attention has been devoted to the consequences of land-cover configuration, most of which addresses land surface temperatures. This study explores the role of both composition and configuration—or land system architecture—of residential neighborhoods in the

The impacts of land-cover composition on urban temperatures, including temperature extremes, are well documented. Much less attention has been devoted to the consequences of land-cover configuration, most of which addresses land surface temperatures. This study explores the role of both composition and configuration—or land system architecture—of residential neighborhoods in the Phoenix metropolitan area, on near-surface air temperature. It addresses two-dimensional, spatial attributes of buildings, impervious surfaces, bare soil/rock, vegetation and the “urbanscape” at large, from 50 m to 550 m at 100 m increments, for a representative 30-day high sun period. Linear mixed-effects models evaluate the significance of land system architecture metrics at different spatial aggregation levels. The results indicate that, controlling for land-cover composition and geographical variables, land-cover configuration, specifically the fractal dimension of buildings, is significantly associated with near-surface temperatures. In addition, statistically significant predictors related to composition and configuration appear to depend on the adopted level of spatial aggregation.

ContributorsKamarianakis, Yiannis (Author) / Li, Xiaoxiao (Author) / Turner II, B. L. (Author) / Brazel, Anthony J. (Author)
Created2017-12-05