In this paper we fit Cox proportional hazards models to a subset of data from the Hypobaric Decompression Sickness Databank. The data bank contains records on the time to decompression sickness (DCS) and venous gas emboli (VGE) for over 130,000 person-exposures to high altitude in chamber tests. The subset we use contains 1,321 records, with 87% censoring, and has the most recent experimental tests on DCS made available from Johnson Space Center. We build on previous analyses of this data set by considering more expanded models and more detailed model assessments specific to the Cox model. Our model - which is stratified on the quartiles of the final ambient pressure at altitude - includes the final ambient pressure at altitude as a nonlinear continuous predictor, the computed tissue partial pressure of nitrogen at altitude, and whether exercise was done at altitude. We conduct various assessments of our model, many of which are recently developed in the statistical literature, and conclude where the model needs improvement. We consider the addition of frailties to the stratified Cox model, but found that no significant gain was attained above a model that does not include frailties. Finally, we validate some of the models that we fit.Thompson, Laura A. and Chhikara, Raj S. and Conkin, JohnnyJohnson Space CenterDECOMPRESSION SICKNESS; EXTRAVEHICULAR ACTIVITY; DATA BASES; PARTIAL PRESSURE; HIGH ALTITUDE TESTS; HAZARDS; QUARTILES; PRESSURE; PHYSICAL EXERCISE; NONLINEARITY; NITROGEN; EXPOSURE; ALTITUDE SIMULATION; AEROEMBOLISM

Over the years, a large body of knowledge has developed regarding the ways in which space flight affects the health of the personnel involved. Now, for the first time, this clinical knowledge on how to diagnose and treat conditions that either develop during a mission or because of a mission has been compiled by Drs. Michael Barratt and Sam L. Pool of the NASA/Johnson Space Center. Complete with detailed information on the physiological and psychological affects of space flight as well as how to diagnose and treat everything from dental concerns to decompression to dermatological problems encountered, this text is a must have for all those associated with aerospace medicine.

The Undersea and Hyperbaric Medical Society (UHMS) is an international, non-profit organization serving over 2,400 members from more than 50 countries. The UHMS is the primary source of scientific information for diving and hyperbaric medicine physiology worldwide, the breadth of which is illustrated in the triennial report, Hyperbaric Oxygen Therapy Indications. With leading experts authoring chapters in their respective fields, this publication continues to provide the most current and up to date guidance and support for scientists and practitioners of hyperbaric oxygen therapy. Hyperbaric Oxygen Therapy Indications, currently in its thirteenth edition, has grown in size and depth to reflect the evolution of the literature on the approved use of hyperbarics from both a clinical practice standpoint and insurance coverage perspective. To date, the committee recognizes fourteen indications, including the new indication, idiopathic sudden sensorineural hearing loss. Additionally, this book continues to be used by the Centers for Medicare and Medicaid Services and other third party insurance carriers in determining payment for HBO2 services.

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