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At least 685 records · Page 38

Graphene oxide exposure alters gut microbial community composition and metabolism in an in vitro human model

Graphene oxide (GO) nanomaterials have unique physicochemical properties that make them highly promising for biomedical, environmental, and agricultural applications. Despite the increasing interest and the use of GO, assessments of its nanotoxicity have largely not interrogated its potential impact on the gut microbiome. This study addresses an important knowledge gap by investigating the impact of GO exposure- both at low (25 ppm) and high (250ppm) doses and fed (nutrient rich) and fasted (nutrient deplete) conditions- on the gut microbial community structure and function, using an in vitro human colon bioreactor model. 16S rRNA amplicon sequencing revealed that GO exposure resulted in a restructuring of community composition. 25 ppm GO induced a marked decrease in the Bacteroidota phylum and increased the ratio of Firmicutes to Bacteroidota (F/B). Untargeted metabolomics on the supernatants indicated that 25 ppm GO impaired microbial utilization and metabolism of substrates (amino acids, carbohydrate metabolites) and reduced production of beneficial microbial metabolites such as 5-hydroxyindole-3-acetic acid and GABA. Exposure to 250 ppm GO resulted in community composition and metabolome profiles that were very similar to the controls that lacked both GO and digestive enzymes, suggesting that high concentrations of GO may interact with digestive enzymes to form protein coronas, causing their depletion in the gut environment. Differential abundance analyses revealed that 3 genera from the phylum Bacteroidota (Bacteroides, Dysgonomonas, and Parabacteroides) were more abundant after 250 ppm GO exposure, irrespective of feed state. Integrative correlation network analysis indicated that the phylum Bacteroidota showed strong positive correlations to multiple microbial metabolites including GABA and 3-indoleacetic acid, are much larger number of correlations compared to other phyla. These results show that GO exposure has a significant impact on gut microbial community composition and metabolism and different mechanisms are at play for low and high GO concentrations.

59 BASIC BIOLOGICAL SCIENCES↗

Control of airborne infectious disease in buildings: Evidence and research priorities

The evolution of SARS-CoV-2 virus has resulted in variants likely to be more readily transmitted through respiratory aerosols, underscoring the increased potential for indoor environmental controls to mitigate risk. Use of tight-fitting face masks to trap infectious aerosol in exhaled breath and reduce inhalation exposure to contaminated air is of critical importance for disease control. Administrative controls including the regulation of occupancy and interpersonal spacing are also important, while presenting social and economic challenges. Indoor engineering controls including ventilation, exhaust, air flow control, filtration, and disinfection by germicidal ultraviolet irradiation can reduce reliance on stringent occupancy restrictions. However, the effects of controls-individually and in combination-on reducing infectious aerosol transfer indoors remain to be clearly characterized to the extent needed to support widespread implementation by building operators. We review aerobiologic and epidemiologic evidence of indoor environmental controls against transmission and present a quantitative aerosol transfer scenario illustrating relative differences in exposure at close-interactive, room, and building scales. We identify an overarching need for investment to implement building controls and evaluate their effectiveness on infection in well-characterized and real-world settings, supported by specific, methodological advances. Finally, improved understanding of engineering control effectiveness guides implementation at scale while considering occupant comfort, operational challenges, and energy costs.

60 APPLIED LIFE SCIENCES↗

The Risk Assessment Information System Compendium of Ecological Screening Benchmarks for Chemicals and Radionuclides (2025) (Volume I – Text, Radionuclides for all Media, Chemicals for Air and Biota)

The Risk Assessment Information System Ecological Benchmark Tool compiles screening level benchmark values for assessing potential ecological risks posed by chemical and radionuclide contaminants. Drawing from a wide array of federal, state, and international sources, it consolidates benchmarks across environmental media, including soil, water, sediment, air, and biota, and presents values for a broad range of receptors and exposure pathways. The tool includes both effect-based and no-effect thresholds, with media- and organism-specific guidance derived from peer-reviewed literature and regulatory frameworks. By integrating diverse benchmark types into a unified reference, the tool supports consistent, scientifically grounded evaluations in ecological risk assessments and environmental management practices.

54 ENVIRONMENTAL SCIENCES↗

Nondestructive Evaluation (NDE) of Cable Moisture Exposure using Frequency Domain Reflectometry (FDR)

This Pacific Northwest National Laboratory (PNNL) milestone report assesses the capability of frequency domain reflectometry (FDR) to determine electrical cable submergence using PNNL’s Accelerated and Real-Time Environmental Nodal Assessment (ARENA) cable/motor test bed. This work includes a review of relevant literature as well as experimental tests. Nuclear power facilities have experienced various electrical cable failures related to water exposure. The current industry response involves actions to de-water cable vaults, manholes, and other cable locations. These efforts require considerable expenditure of resources, which makes it desirable for the industry to have information on cable condition and history regarding their submergence and water exposure (Mantey 2012). Two tests that are gaining favor within the nuclear industry are time-domain reflectometry (TDR) and FDR. These are low-voltage nondestructive tests that can be applied at a cable end. Testing from the cable end is important because local inspection along the cable length is very difficult due to cables being routed within trays, conduits, underground, and through walls. Both TDR and FDR techniques have been shown to locate cable insulation damage due to thermal, radiation, and mechanical damage. FDR measurements are also more sensitive than TDR to temperature changes, low-bend radius bends, and cable contact with various materials, including conductive materials like steel and water. This work evaluates the feasibility to extend FDR testing to characterizing whether an electrical cable is submerged or not and where it may be submerged using PNNL’s ARENA cable/motor test bed.

21 SPECIFIC NUCLEAR REACTORS AND ASSOCIATED PLANTS↗

Contribution of Spaceflight Environmental Factors to Vision Risks

The risk of visual impairment and elevated intracranial pressure as a result of low-earth orbit microgravity exposure has directed our attention and research efforts to the eye. While the alterations observed in astronauts returning from long duration missions include vision and neuroanatomical changes observed by non-invasive methods, other effects and subsequent tissue responses at the molecular and cellular level can only be studied by accessing the tissue itself. As a result of this need, several studies are currently taking place within the Human and Health Countermeasures Element (HHC) that use animal models for eye research. The rodent eye has many similarities to the human eye, and both rats and mice have historically been used as models of human eye disease, aiding in the identification of the disease genes, elucidation of mechanisms of disease, as well as in the assessment of therapeutic treatments. These studies attempt to answer two central questions in the etiology of possible vision alterations in the environment of space exploration missions. The first is: what effects and response mechanisms take place in the different eye structures at the cellular and molecular level? The second question is directed to elucidate the contribution of the various environmental stressors (radiation, nutrition, fluid shift) to these effects. Collaborative approaches with internal and external investigators have allowed performing these studies in a most cost-effective fashion, providing preliminary data and laying the bases for testing further hypotheses in future and specifically designed animal experiments. From a study centered on the radioadaptive response in mice, we have learned that the retina responds to low and high dose gamma radiation by elevating antioxidant-related genes at early time points (4hrs) and that this response returns to control levels after 1 day post-irradiation. We are expanding this research with another collaborative study that investigates the combined effects of radiation exposure and iron overload on sensitivity to radiation injury in rat eyes. All main eye structures will be analyzed in this study: retina, lens and cornea. A study in collaboration with the Space Human Factors and Habitability Element (SHFH) investigates the effects of lunar dust exposure on the rat cornea. It is anticipated that common underlying oxidative stress mechanisms of damage may be observed as a result of these three stressors: radiation, nutritional iron and lunar dust. The contribution of fluid shift is addressed by a study using rats subjected to hindlimb suspension. The hypothesis to be tested in this study is that the mechanical stress imparted by the pressure differential across the optic disc and lamina cribosa will impact oxygenation (therefore causing oxidative stress and hypoxia) and cell survival. This study also includes the assessment of two nutritional antioxidant countermeasures: epigallocatechin gallate (green tea) and resveratrol. Finally, as a result of two successful tissue sharing efforts, we are proceeding with the analysis of eye samples of mice aboard two shuttle missions: STS-133 and STS-135. Results from the STS-133 study are presented in an independent abstract. Briefly, the results show that spaceflight represents a source of environmental stress that directly translates into oxidative and cellular stress in the retina. Similar analysis is also planned for the cornea. These samples add large value to our current vision research as they provide data on the direct effects of low-earth orbit spaceflight on eye structures and physiology.

Zanello, Susana B.↗

A mixture parameterized biologically based dosimetry model to predict body burdens of polycyclic aromatic hydrocarbons in developmental zebrafish toxicity assays

Polycyclic aromatic hydrocarbons (PAHs) are a group of environmental toxicants found ubiquitously as complex mixtures in human-impacted environments. Developmental zebrafish exposures have been used widely to study PAH toxicity, but most studies report nominal exposure concentrations. Nominal exposure concentrations can be unreliable dose metrics due to differences in toxicant bioavailability resulting from disparate exposure methodologies and chemical properties. Toxicokinetic modeling can predict toxicant tissue doses to facilitate comparison between exposures of different chemicals, methodologies, and biological models. We parameterize a biologically based dosimetry model for developmental zebrafish toxicity assays for 9 PAHs. The model was optimized with measurements from media, tissue, and plastic plate walls throughout a static developmental exposure to a mixture of 10 PAHs of high abundance within the Portland Harbor Superfund Site. Plate binding, volatilization, zebrafish permeability, and tissue—media partitioning coefficients vary widely between PAHs. Model predictions accounted for 83% and 54% of 48 hpf body burdens within a factor of 2 resulting from exposures to mixtures and individual PAHs, respectively. Accounting for solubility significantly improves model performance. Competition for active sites in metabolizing enzymes may change biotransformation kinetics between individual PAH and mixture exposures. Area under the curve estimations of concentrations in zebrafish resulted in altered hazard rankings from nominal exposure concentrations. Future work will be oriented to generalizing the model to other PAHs. This PAH dosimetry model improves the interpretability of developmental zebrafish toxicity assays by providing time-resolved body burdens from nominal exposure concentrations.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

Transmission risk of Oropouche fever across the Americas

Abstract Background Vector-borne diseases (VBDs) are important contributors to the global burden of infectious diseases due to their epidemic potential, which can result in significant population and economic impacts. Oropouche fever, caused by Oropouche virus (OROV), is an understudied zoonotic VBD febrile illness reported in Central and South America. The epidemic potential and areas of likely OROV spread remain unexplored, limiting capacities to improve epidemiological surveillance. Methods To better understand the capacity for spread of OROV, we developed spatial epidemiology models using human outbreaks as OROV transmission-locality data, coupled with high-resolution satellite-derived vegetation phenology. Data were integrated using hypervolume modeling to infer likely areas of OROV transmission and emergence across the Americas. Results Models based on one-support vector machine hypervolumes consistently predicted risk areas for OROV transmission across the tropics of Latin America despite the inclusion of different parameters such as different study areas and environmental predictors. Models estimate that up to 5 million people are at risk of exposure to OROV. Nevertheless, the limited epidemiological data available generates uncertainty in projections. For example, some outbreaks have occurred under climatic conditions outside those where most transmission events occur. The distribution models also revealed that landscape variation, expressed as vegetation loss, is linked to OROV outbreaks. Conclusions Hotspots of OROV transmission risk were detected along the tropics of South America. Vegetation loss might be a driver of Oropouche fever emergence. Modeling based on hypervolumes in spatial epidemiology might be considered an exploratory tool for analyzing data-limited emerging infectious diseases for which little understanding exists on their sylvatic cycles. OROV transmission risk maps can be used to improve surveillance, investigate OROV ecology and epidemiology, and inform early detection.

60 APPLIED LIFE SCIENCES↗

Effects of helicopter noise and vibration on pilot performance (as measured in a fixed-base flight simulator)

The effects of noise and vibration on pilot performance are described. Pilot subjects were required to fly VTOL commercial IFR schedules using the computer simulation facilities. The routes flown simulated closely metropolitan routes flown currently by a helicopter airline. The duration of simulator flights ranged from 3 to 8 hours. Subjects were exposed to noise sound pressure levels ranging from 74dB (ambient) to 100dB and 17 Hz vibration stimuli ranging from .1 g to .3 g measured at the floor directly beneath the pilot's seat. Despite subject reports of extreme fatigue in these long flights, performance did not degrade. A curve of performance shows a slow improvement for the first three hours of exposure and a slight loss in performance during the remainder of the flight. As environmental stress conditions (noise, vibration, and time in the simulator) increased, subject performance improved. Within the limits of this study, the higher the stress the better the performance.

Stave, A. M.↗

The Evolution of Interfacial Sliding Stresses During Cyclic Push-in Testing of C- and BN-Coated Hi-Nicalon Fiber-Reinforced CMCs

Interfacial debond cracks and fiber/matrix sliding stresses in ceramic matrix composites (CMCs) can evolve under cyclic fatigue conditions as well as with changes in the environment, strongly affecting the crack growth behavior, and therefore, the useful service lifetime of the composite. In this study, room temperature cyclic fiber push-in testing was applied to monitor the evolution of frictional sliding stresses and fiber sliding distances with continued cycling in both C- and BN-coated Hi-Nicalon SiC fiber-reinforced CMCs. A SiC matrix composite reinforced with C-coated Hi-Nical on fibers as well as barium strontium aluminosilicate (BSAS) matrix composites reinforced with BN-coated (four different deposition processes compared) Hi-Nicalon fibers were examined. For failure at a C interface, test results indicated progressive increases in fiber sliding distances during cycling in room air but not in nitrogen. These results suggest the presence of moisture will promote crack growth when interfacial failure occurs at a C interface. While short-term testing environmental effects were not apparent for failure at the BN interfaces, long-term exposure of partially debonded BN-coated fibers to humid air resulted in large increases in fiber sliding distances and decreases in interfacial sliding stresses for all the BN coatings, presumably due to moisture attack. A wide variation was observed in debond and frictional sliding stresses among the different BN coatings.

Eldridge, J. I.↗

Strontium transfer from maternal skeleton to the fetus estimated on the basis of the Techa river data

Measurements of 90Sr in human bone of inhabitants of the Techa river region were started in 1951, and since 1974 the Techa river population has been studied with a whole-body counter. One of the dosimetric tasks that could be decided using data on 90Sr measurements is direct evaluation of strontium transfer to the fetus from the maternal skeleton. Six cases were selected for which 90Sr measurements were available both for stillborn infants and their mothers. The ratio of 90Sr concentrations in fetal bone to maternal bone for the year of pregnancy has been evaluated. Two clusters of values were found and the difference between clusters could be explained by age-dependent features of maternal bone formation and remodelling. When the mother's 90Sr intake occurred in the period of intensive compact bone growth, the transfer coefficient was very low (0.012-0.032). If 90Sr ingestion occurred during the woman's reproductive age, the transfer to fetus was equal to 0.21-0.26.

Non-NASA Center↗

Spatial Analysis of West Nile Virus: Predictive Risk Modeling of a Vector-borne Infectious Disease in Illinois by Means of NASA Earth Observation Systems

West Nile Virus is a mosquito-borne virus of the family Flaviviridae. It infects birds and various mammals, including humans, and can cause encephalitis that may prove fatal, notably among vulnerable populations. Since its identification in New York City in 1999, WNV has become established in a broad range of ecological settings throughout North America, infecting more than 25,300 people and killing 1133 as of 2008 (CDC,2009). WNV is transmitted by mosquitoes that feed on infected birds. As a result, the degree of human infection depends on local ecology and human exposure. This study hypothesizes that remote sensing and GIS can be used to analyze environmental determinants of WNV transmission, such as climate, elevation, land cover, and vegetation densities, to map areas of WNV risk for surveillance and intervention.

Renneboog, Nathan↗

Design for the Structure and the Mechanics of Moballs

The moball is envisioned to be a round, self-powered, and wind-driven multifunctioning sensor used in the Gone with the Wind ON-Mars (GOWON) [http://www.lpi.usra.edu/meetings/ marsconcepts2012/pdf/4238.pdf]: A Wind-Driven Networked System of Mobile sensors on Mars. The moballs would have sensing, processing, and communication capabilities. The moballs would perform in situ detection of key environmental elements such as vaporized water, trace gases, wind, dust, clouds, light and UV exposure, temperature, as well as minerals of interest, possible biosignatures, surface magnetic and electric fields, etc. The embedded various low-power micro instruments could include a Multispectral Microscopic Imager (to detect various minerals), a compact curved focal plane array camera (UV/Vis/NIR) with a large field of view, a compact UV/Visible spectrometer, a micro-weather station, etc. The moballs could communicate with each other and an orbiter. Their wind- or gravity-driven rolling movement could be used to harvest and store electric energy. They could also generate and store energy using the sunlight, when available, and the diurnal temperature variations on Mars. The moballs would be self-aware of their (and their neighbors ) positions, energy storage, and memory availability; they would have processing power and could intelligently cooperate with neighboring moballs by distributing tasks, sharing data, and fusing information. The major advantages of using the wind-driven and spherical moball network over rovers or other fixed sensor webs to explore Mars would be: (1) moballs could explore a much larger expanse of Mars in a much faster fashion, (2) they could explore the difficult terrains such as steep slopes and sand dunes, and (3) they would be self-energy- generating and could work together and move around autonomously. The challenge in designing the structure and the mechanics of the moball would be that it should be sturdy enough to withstand the impact of its initial fall, as well as other impacts from obstacles in its way. A mechanism would be needed that could enable hundreds of moballs to be carried while they would be deflated and compact, then would inflate them just after deploying them to their drop site. Furthermore, the moballs should also be light enough to allow them to move easily over obstacles by force of the wind. They also should have some kind of maneuvering mechanism in place to help them avoid very hazardous sharp objects or events, and to enable them to get closer to the objects of interest. The structure of the moballs was designed so that they would have different layers. The outer layer should comprise a sturdy, yet light, polymer that could withstand both the impact of the initial drop, as well as the impact of the different obstacles it would encounter while traversing the surface of Mars. This polymer should not deteriorate with the 100 K daily temperature swings on Mars. The inner layer should consist of a very light gas such as nitrogen or helium. In terms of maneuvering, six very light weights placed at strategic locations would give moballs the ability to turn, or even hop, over hazardous (e.g., sharp) obstacles, or even initiate a movement (before getting more help from the wind to be carried around) when stuck. Maneuvering would be necessary in order to get closer to objects of interest. If the weights would be allowed to move freely, they could also be used to generate energy.

Davoodi, Faranak↗

Ground Testing of the EMCS Seed Cassette for Biocompatibility with the Tardigrade, Hypsibius dujardini

The European Modular Cultivation System, EMCS, was developed by ESA for plant experiments. We performed ground testing to determine whether ARC EMCS seed cassettes could be adapted for use with tardigrades for future spaceflight experiments. Tardigrades (water bears) are small invertebrates that enter the tun state in response to desiccation or other environmental stresses. Tardigrade tuns have suspended metabolism and have been shown to be survive exposure to space vacuum, high pressure, temperature and other stresses. For spaceflight experiments using the EMCS, the organisms ideally must be able to survive desiccation and storage in the cassette at ambient temperature for several weeks prior to the initiation of the experiment by the infusion of water to the cassette during spaceflight. The ability of tardigrades to survive extremes by entering the tun state make them ideal candidates for growth experiments in the EMCS cassettes. The growth substratum in the cassettes is a gridded polyether sulfone (PES) membrane. A blotter beneath the PES membrane contains dried growth medium. The goals of our study were to (1) determine whether tardigrades survive and reproduce on PES membranes, (2) develop a consistent method for dehydration of the tardigrades with high recovery rates upon rehydration, (3) to determine an appropriate food source for the tardigrades that can also be dehydrated/rehydrated and (4) successful mock rehydration experiment in cassettes with appropriate food source. We present results that show successful multigenerational growth of tardigrades on PES membranes with a variety of wet food sources. We have successfully performed a mock rehydration with tardigrades and at least one candidate food, protonema of the moss Polytrichum, that supports multigenerational growth and whose spores germinate quickly enough to match tardigrade feeding patterns post rehydration. Our results indicate that experiments on the ISS using the tardigrade, Hypsibius dujardini and other similar species could successfully be performed in the flight verified hardware of the EMCS seed cassettes.

EMCS s↗

Studies of Young Hawai'ian Lava Tubes: Implications for Planetary Habitability and Human Exploration

Habitability: Subsurface environments may preserve records of habitability or biosignatures, with more stable environmental conditions compared to surface (e.g., smaller variations in temperature and humidity) and reduced exposure to radiation; Lava tubes are expected on Mars, and candidates are observed from orbit; Few detailed studies of microbial populations in terrestrial lava caves; Also contain a variety of secondary minerals; Microbial activity may play a role in mineral formation or be preserved in these minerals; Minerals can provide insight into fluids (e.g., pH, temperature).

McAdam, Amy↗

Spectra-to-exposure conversion using polynomial response models for gamma-ray field characterization

Accurate measurement of exposure rate from gamma-ray spectral data remains a critical challenge during radiological emergency response operations. Conventional methods rely on pre-defined static conversion factors derived from fixed geometries and isotopic compositions, which often fail to capture real-world environmental variability. This study presents a generalized approach as a "next-step" for converting gamma-ray spectral data into exposure rate using polynomial response models. The method introduces a flexible weighting scheme based on the in-situ detector response to distributed sources, enabling a pathway towards improved correspondence between measured spectra and "ground-truth" exposure rates. Experimental data from sodium iodide NaI(Tl) detectors were used to validate the approach as, at least equivalent to the current count-to-exposure method employed in emergency response CONOPS. Results show that the polynomial weighting model is sufficiently equal to the count-to-exposure method and may help improve accuracy given its adaptability to real-world conditions.

61 RADIATION PROTECTION AND DOSIMETRY↗

Simulation of the synergistic low Earth orbit effects of vacuum thermal cycling, vacuum UV radiation, and atomic oxygen

In order to assess the low Earth orbit (LEO) durability of candidate space materials, it is necessary to use ground laboratory facilities which provide LEO environmental effects. A facility combining vacuum thermal cycling and vacuum ultraviolet (VUV) radiation has been designed and constructed at NASA Lewis Research Center for this purpose. This facility can also be operated without the VUV lamps. An additional facility can be used to provide VUV exposure only. By utilizing these facilities, followed by atomic oxygen exposure in an RF plasma asher, the effects of the individual vacuum thermal cycling and VUV environments can be compared to the effect of the combined vacuum thermal cycling/VUV environment on the atomic oxygen durability of materials. The synergistic effects of simulated LEO environmental conditions on materials were evaluated by first exposing materials to vacuum thermal cycling, VUV, and vacuum thermal cycling/VUV environments followed by exposure to atomic oxygen in an RP plasma asher. Candidate space power materials such as atomic oxygen protected polyimides and solar concentrator mirrors were evaluated using these facilities. Characteristics of the Vacuum Thermal Cycling/VUV Exposure Facility which simulates the temperature sequences and solar ultraviolet radiation exposure that would be experienced by a spacecraft surface in LEO are discussed. Results of durability evaluations of some candidate space power materials to the simulated LEO environmental conditions will also be discussed. Such results have indicated that for some materials, atomic oxygen durability is affected by previous exposure to thermal cycling and/or VUV exposure.

Dever, Joyce A.↗

Comparative Analysis of Report-Back of Research Results Strategies for Personal Chemical Exposure Data

Background. Report-back of research results (RBRR) is ethically supported and highly requested by participants yet lacks broadly transferable guidelines for RBRR. Effective RBRR must be responsive to target audience needs and may not be addressed by a ‘one-size-fits-all’ approach. Objective. Within a subset of our 19 studies on RBRR, we had the unique opportunity to carry out a comparative analysis of RBRR strategies across cohorts with similar development and evaluation methods, yet distinct in life stage, geography, number and type of chemicals assessed, and community contexts. Methods. We highlight key outcomes from three environmental health studies: an ongoing New York, NY cohort (Fair Start; n=486) and a Detroit, MI cohort (CLEAR; n=34) assessing exposure to ambient urban pollution during pregnancy, and a longitudinal cohort in Houston, TX (Houston-3H) following Hurricane Harvey (n=312). Focus group and survey data were analyzed to identify lessons learned and explore how RBRR supports understanding of environmental health. Results. Commonalities emerged in RBRR development, design, organization, and data visualization, as well as in how RBRR can contribute to an understanding of health-environment connections. Differences included preferences for individual versus community level findings, as well as distinguishable contextual considerations. For pregnancy cohorts, messaging was framed with cultural sensitivity, and to avoid unintended consequences of parental guilt due to prenatal exposures. In the post-disaster Houston-3H study, participants requested additional transparency regarding sampling design and study rationale. Significance. All RBRR case studies reported chemicals without known regulatory or health guidelines, so results were contextualized within the study population. Participants across cohorts requested multi-study comparisons to better understand their results beyond their communities. While foundational RBRR elements (e.g. plain language, graphic organizers) may supersede cohort-specific differences, RBRR should be personalized to encompass perceptions of health across different life-stage, cultural, and environmental contexts.

Vogel, Taylor J.↗