Culbertson holds a syringe kit in Destiny during Expedition Three

NASA Image and Video Library

2001-08-29

ISS003-E-5475 (29 August 2001) --- Astronaut Frank L. Culbertson, Expedition Three mission commander, holds a syringe kit to be used in the Quad Tissue Culture Module Assemblies (QTCMA) for the Biotechnology Specimen Temperature Controller (BSTC) experiment in the U.S. Laboratory.

Water Microbiology Kit/Microbial Capture Devices (WMK MCD)

NASA Image and Video Library

2009-08-04

ISS020-E-027318 (4 Aug. 2009) --- Canadian Space Agency astronaut Robert Thirsk, Expedition 20 flight engineer, performs a subsequent in-flight analysis with a Water Microbiology Kit/Microbial Capture Devices (WMK MCD) for microbial traces in the Destiny laboratory of the International Space Station.

Development and Certification of Station Development Test Objective (SDTO) Experiment # 15012-U, "Near RealTime Water Quality Monitoring Demonstration for ISS Biocides Using Colorimetric Solid Phase Extraction (CSPE)"

NASA Technical Reports Server (NTRS)

Gazda, Daniel B.; Nolan, Daniel J.; Rutz, Jeffrey A.; Shcultz, John R.; Siperko, Lorraine M.; Porter, Marc D,; Lipert, Robert J.; Limardo, Jose G.; McCoy, J. Torin

2009-01-01

Scientists and engineers from the Wyle Integrated Science and Engineering Group are working with researchers at the University of Utah and Iowa State University to develop and certify an experimental water quality monitoring kit based on Colorimetric Solid Phase Extraction (CSPE). The kit will be launched as a Station Development Test Objective (SDTO) experiment and evaluated on the International Space Station (ISS) to determine the acceptability of CSPE technology for routine inflight water quality monitoring. Iodine and silver, the biocides used in the US and Russian on-orbit water systems, will serve as test analytes for the technology evaluation. This manuscript provides an overview of the CSPE SDTO experiment and details the development and certification of the experimental water quality monitoring kit. Initial results from reagent and standard solution stability testing and environmental testing performed on the kit hardware are also reported.

Reiter works with SWAB ASD Filter Kit in the U.S. Laboratory during Expedition 13

NASA Image and Video Library

2006-09-10

ISS013-E-80066 (10 Sept. 2006) --- European Space Agency (ESA) astronaut Thomas Reiter, Expedition 13 flight engineer, works with the surface, water and air biocharacterization (SWAB) air sampling device (ASD) filter kit in the Destiny laboratory of the International Space Station.

STS-133 crew members Lindsey, Boe and Drew during Tool/Repair Kits training with instructor

NASA Image and Video Library

2010-01-26

JSC2010-E-014264 (26 Jan. 2010) --- NASA astronaut Eric Boe, STS-133 pilot, participates in an ISS tools and repair kits training session in the Space Vehicle Mock-up Facility at NASA's Johnson Space Center. Instructor Ivy Apostolakopoulos assisted Boe.

STS-133 crew members Lindsey, Boe and Drew during Tool/Repair Kits training with instructor

NASA Image and Video Library

2010-01-26

JSC2010-E-014266 (26 Jan. 2010) --- NASA astronauts Steve Lindsey (right), STS-133 commander; and Eric Boe, pilot, participate in an ISS tools and repair kits training session in the Space Vehicle Mock-up Facility at NASA's Johnson Space Center.

Stability Analysis of ISS Medications

NASA Technical Reports Server (NTRS)

Wotring, V. E.

2014-01-01

It is known that medications degrade over time, and that extreme storage conditions will hasten their degradation. The temperature and humidity conditions of the ISS have been shown to be within the ideal ranges for medication storage, but the effects of other environmental factors, like elevated exposure to radiation, have not yet been evaluated. Current operational procedures ensure that ISS medications are re-stocked before expiration, but this may not be possible on long duration exploration missions. For this reason, medications that have experienced long duration storage on the ISS were returned to JSC for analysis to determine any unusual effects of aging in the low- Earth orbit environment. METHODS Medications were obtained by the JSC Pharmacy from commercial distributors and were re-packaged by JSC pharmacists to conserve up mass and volume. All medication doses were part of the ISS crew medical kit and were transported to the International Space Station (ISS) via NASA's Shuttle Transportation System (Space Shuttle). After 568 days of storage, the medications were removed from the supply chain and returned to Earth on a Dragon (SpaceX) capsule. Upon return to Earth, medications were transferred to temperature and humidity controlled environmental chambers until analysis. Nine medications were chosen on the basis of their availability for study. The medications included several of the most heavily used by US crewmembers: 2 sleep aids, 2 antihistamines/decongestants, 3 pain relievers, an antidiarrheal and an alertness medication. Each medication was available at a single time point; analysis of the same medication at multiple time points was not possible. Because the samples examined in this study were obtained opportunistically from medical supplies, there were no control samples available (i.e. samples aged for a similar period of time on the ground); a significant limitation of this study. Medications were analyzed using the HPLC/MS methods described in the United States Pharmacopeia (USP) to measure the amount of intact active ingredient, identify degradation products and measure their amounts. Some analyses were conducted by an independent analytical laboratory, but certain (Schedule) medications could not be shipped to their facility and were analyzed at JSC. RESULTS Nine medications were analyzed with respect to active pharmaceutical ingredient (API) and degradant amounts. Results were compared to the USP requirements for API and degradants/impurities content for every FDA-approved medication. One medication met USP requirements at 5 months after its expiration date. Four of the nine (44% of those tested) medications tested met USP requirements up to 8 months post-expiration. Another 3 medications (33% of those tested) met USP guidelines 2-3 months before expiration. One medication, a compound classed by the FDA as a dietary supplement and sometimes used as a sleep aid, failed to meet USP requirements at 11 months post-expiration. CONCLUSION Analysis of each medication at a single time point provides limited information on the stability of a medication stored in particular conditions; it is not possible to predict how long a medication may be safe and effective from these data. Notwithstanding, five of the nine medications tested (56%) met USP requirements for API and degradants/impurities at least 5 months past expiration dates. The single compound that failed to meet USP requirements is not regulated as strictly as prescription medications are during manufacture; it is unknown if this medication would have met the requirements prior to flight. Notably, it was the furthest beyond its expiration date. Only more comprehensive analysis of flight-aged samples compared to appropriate ground controls will permit determination of spaceflight effects on medication stability.

SPHINX (SPaceflight of Huvec: an Integrated eXperiment) Biobox kit

NASA Image and Video Library

2010-10-31

ISS025-E-010145 (31 Oct. 2010) --- NASA astronaut Scott Kelly (left) and Russian cosmonaut Oleg Skripochka, both Expedition 25 flight engineers, are pictured during transfer activities of the European Space Agency?s SPHINX (SPaceflight of Huvec: an Integrated eXperiment) Biobox kit in the Unity node of the International Space Station.

SPHINX (SPaceflight of Huvec: an Integrated eXperiment) Biobox kit

NASA Image and Video Library

2010-10-31

ISS025-E-010146 (31 Oct. 2010) --- NASA astronaut Scott Kelly (left) and Russian cosmonaut Oleg Skripochka, both Expedition 25 flight engineers, are pictured during transfer activities of the European Space Agency?s SPHINX (SPaceflight of Huvec: an Integrated eXperiment) Biobox kit in the Unity node of the International Space Station.

STS-133 crew members Lindsey, Boe and Drew during Tool/Repair Kits training with instructor

NASA Image and Video Library

2010-01-26

JSC2010-E-014267 (26 Jan. 2010) --- NASA astronauts Steve Lindsey (center), STS-133 commander; Eric Boe (left), pilot; and Alvin Drew, mission specialist, participate in an ISS tools and repair kits training session in the Space Vehicle Mock-up Facility at NASA's Johnson Space Center.

STS-133 crew members Lindsey, Boe and Drew during Tool/Repair Kits training with instructor

NASA Image and Video Library

2010-01-26

JSC2010-E-014262 (26 Jan. 2010) --- NASA astronauts Eric Boe (left), STS-133 pilot; Steve Lindsey, commander; and Alvin Drew, mission specialist, participate in an ISS tools and repair kits training session in the Space Vehicle Mock-up Facility at NASA's Johnson Space Center. Instructor Ivy Apostolakopoulos assisted the crew members.

Voss retrieves a small tool from a tool kit in ISS Node 1/Unity

NASA Image and Video Library

2001-08-13

STS105-E-5175 (13 August 2001) --- Astronaut James S. Voss, retrieves a small tool from a tool case in the U.S.-built Unity node aboard the International Space Station (ISS). The Expedition Two flight engineer is only days away from returning to Earth following five months aboard the orbital outpost. The image was recorded with a digital still camera.

Node 3 Relocation Environmental Control and Life Support System Modification Kit Verification and Updated Status

NASA Technical Reports Server (NTRS)

Williams, David E.; Spector, Lawrence N.

2009-01-01

Node 1 (Unity) flew to International Space Station (ISS) on Flight 2A. Node 1 was the first module of the United States On-Orbit Segment (USOS) launched to ISS. The Node 1 ISS Environmental Control and Life Support (ECLS) design featured limited ECLS capability. The main purpose of Node 1 was to provide internal storage by providing four stowage rack locations within the module and to allow docking of multiple modules and a truss segment to it. The ECLS subsystems inside Node 1 were routed through the element prior to launch to allow for easy integration of the attached future elements, particularly the Habitation Module which was planned to be located at the nadir docking port of Node 1. After Node 1 was on-orbit, the Program decided not to launch the Habitation Module and instead, to replace it with Node 3 (Tranquility). In 2007, the Program became concerned with a potential Russian docking port approach issue for the Russian FGB nadir docking port after Node 3 is attached to Node 1. To solve this concern the Program decided to relocate Node 3 from Node 1 nadir to Node 1 port. To support the movement of Node 3 the Program decided to build a modification kit for Node 1, an on-orbit feedthrough leak test device, and new vestibule jumpers to support the ECLS part of the relocation. This paper provides a design overview of the modification kit, a summary of the Node 1 ECLS re-verification to support the Node 3 relocation from Node 1 nadir to Node 1 port, and a status of the ECLS modification kit installation into Node 1.

Node 3 Relocation Environmental Control and Life Support System Modification Kit Verification and Updated Status

NASA Technical Reports Server (NTRS)

Williams, David E.; Spector Lawrence N.

2010-01-01

Node 1 (Unity) flew to International Space Station (ISS) on Flight 2A. Node 1 was the first module of the United States On-Orbit Segment (USOS) launched to ISS. The Node 1 ISS Environmental Control and Life Support (ECLS) design featured limited ECLS capability. The main purpose of Node 1 was to provide internal storage by providing four stowage rack locations within the module and to allow docking of multiple modules and a truss segment to it. The ECLS subsystems inside Node 1 were routed through the element prior to launch to allow for easy integration of the attached future elements, particularly the Habitation Module which was planned to be located at the nadir docking port of Node 1. After Node I was on-orbit, the Program decided not to launch the Habitation Module and instead, to replace it with Node 3 (Tranquility). In 2007, the Program became concerned with a potential Russian docking port approach issue for the Russian FGB nadir docking port after Node 3 is attached to Node 1. To solve this concern the Program decided to relocate Node 3 from Node I nadir to Node 1 port. To support the movement of Node 3 the Program decided to build a modification kit for Node 1, an on-orbit feedthrough leak test device, and new vestibule jumpers to support the ECLS part of the relocation. This paper provides a design overview of the modification kit for Node 1, a summary of the Node 1 ECLS re-verification to support the Node 3 relocation from Node 1 nadir to Node 1 port, and a status of the ECLS modification kit installation into Node 1.

CDRA

NASA Image and Video Library

2009-07-31

ISS020-E-026695 (31 July 2009) --- European Space Agency astronaut Frank De Winne, Expedition 20 flight engineer, works with a carbon dioxide removal kit adapter in the Unity node of the International Space Station.

Lab-on-a-Chip: From Astrobiology to the International Space Station

NASA Technical Reports Server (NTRS)

Maule, Jake; Wainwright, Nor; Steele, Andrew; Gunter, Dan; Monaco, Lisa A.; Wells, Mark E.; Morris, Heather C.; Boudreaux, Mark E.

2008-01-01

The continual and long-term habitation of enclosed environments, such as Antarctic stations, nuclear submarines and space stations, raises unique engineering, medical and operational challenges. There is no easy way out and no easy way to get supplies in. This situation elevates the importance of monitoring technology that can rapidly detect events within the habitat that affect crew safety such as fire, release of toxic chemicals and hazardous microorganisms. Traditional methods to monitor microorganisms on the International Space Station (ISS) have consisted of culturing samples for 3-5 days and eventual sample return to Earth. To augment these culture methods with new, rapid molecular techniques, we developed the Lab-on-a-Chip Application Development - Portable Test System (LOCAD-PTS). The system consists of a hand-held spectrophotometer, a series of interchangeable cartridges and a surface sampling/dilution kit that enables crew to collect samples and detect a range of biological molecules, all within 15 minutes. LOCAD-PTS was launched to the ISS aboard Space Shuttle Discovery in December 2006, where it was operated for the first time during March-May 2007. The surfaces of five separate sites in the US Lab and Node 1 of ISS were analyzed for endotoxin, using cartridges that employ the Limulus Amebocyte Lysate (LAL) assay; results of these tests will be presented. LOCAD-PTS will remain permanently onboard ISS with new cartridges scheduled for launch in February and October of 2008 for the detection of fungi (Beta-glucan) and Gram-positive bacteria (lipoteichoic acid), respectively.

View of a standard tool kit left on the ISS

NASA Image and Video Library

2000-09-17

S106-E-5259 (17 September 2000) --- Tools that look much like those that you might find in any residential garage are being left onboard the International Space Station (ISS) for its future residents. Holding this set is astronaut Richard A. Mastracchio, partially out of frame. As any "handy person" will tell you, a variety of basic tools are a life-saver when any one of a number of contingencies arise.

Organization and Management of the International Space Station (ISS) Multilateral Medical Operations

NASA Technical Reports Server (NTRS)

Duncan, J. M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

2007-01-01

The goal of this work is to review the principles, design, and function of the ISS multilateral medical authority and the medical support system of the ISS Program. Multilateral boards and panels provide operational framework, direct, and supervise the ISS joint medical operational activities. The Integrated Medical Group (IMG) provides front-line medical support of the crews. Results of ongoing activities are reviewed weekly by physician managers. A broader status review is conducted monthly to project the state of crew health and medical support for the following month. All boards, panels, and groups function effectively and without interruptions. Consensus prevails as the primary nature of decisions made by all ISS medical groups, including the ISS medical certification board. The sustained efforts of all partners have resulted in favorable medical outcomes of the initial fourteen long-duration expeditions. The medical support system appears to be mature and ready for further expansion of the roles of all Partners, and for the anticipated increase in the size of ISS crews.

CDRA

NASA Image and Video Library

2009-07-31

ISS020-E-026697 (31 July 2009) --- NASA astronaut Tim Kopra (foreground) and European Space Agency astronaut Frank De Winne, both Expedition 20 flight engineers, work with a carbon dioxide removal kit adapter in the Unity node of the International Space Station.

Colorimetric Solid Phase Extraction for the Measurement of Total I (Iodine, Iodide, and Triiodide) in Spacecraft Drinking Water

NASA Technical Reports Server (NTRS)

Lipert, Robert J.; Porter, Marc D.; Siperko, Lorraine M.; Gazda, Daniel B.; Rutz, Jeff A.; Schultz, John R.; Carrizales, Stephanie M.; McCoy, J. Torin

2009-01-01

An experimental drinking water monitoring kit for the measurement of iodine and silver(I) was recently delivered to the International Space Station (ISS). The kit is based on Colorimetric Solid Phase Extraction (CSPE) technology, which measures the change in diffuse reflectance of indicator disks following exposure to a water sample. To satisfy additional spacecraft water monitoring requirements, CSPE has now been extended to encompass the measurement of total I (iodine, iodide, and triiodide) through the introduction of an oxidizing agent, which converts iodide and triiodide to iodine, for measurement using the same indicator disks currently being tested on ISS. These disks detect iodine, but are insensitive to iodide and triiodide. We report here the operational considerations, design, and ground-based performance of the CSPE method for total I. The results demonstrate that CSPE technology is poised to meet NASA's total I monitoring requirements.

Organization, Management and Function of International Space Station (ISS) Multilateral Medical Operations

NASA Technical Reports Server (NTRS)

Duncan, James M.; Bogomolov, V. V.; Castrucci, F.; Koike, Y.; Comtois, J. M.; Sargsyan, A. E.

2007-01-01

Long duration crews have inhabited the ISS since November of 2000. The favorable medical outcomes of its missions can be largely attributed to sustained collective efforts of all ISS Partners medical organizations. In-flight medical monitoring and support, although crucial, is just a component of the ISS system of Joint Medical Operations. The goal of this work is to review the principles, design, and function of the multilateral medical support of the ISS Program. The governing documents, which describe the relationships among all ISS partner medical organizations, were evaluated, followed by analysis of the roles, responsibilities, and decision-making processes of the ISS medical boards, panels, and working groups. The degree of integration of the medical support system was evaluated by reviewing the multiple levels of the status reviews and mission assurance activities carried out throughout the last six years. The Integrated Medical Group, consisting of physicians and other essential personnel in the mission control centers represents the front-line medical support of the ISS. Data from their day-to-day activities are presented weekly at the Space Medicine Operations Team (SMOT), where known or potential concerns are addressed by an international group of physicians. A broader status review is conducted monthly to project the state of crew health and medical support for the following month, and to determine measures to return to nominal state. Finally, a comprehensive readiness review is conducted during preparations for each ISS mission. The Multilateral Medical Policy Board (MMPB) issues medical policy decisions and oversees all health and medical matters. The Multilateral Space Medicine Board (MSMB) certifies crewmembers and visitors for training and space flight to the Station, and physicians to practice space medicine for the ISS. The Multilateral Medical Operations Panel (MMOP) develops medical requirements, defines and supervises implementation of operational countermeasures, environmental monitoring, medical care, and emergency medical services. MMOP assures the medical readiness of the Station for each subsequent mission or critical event. All boards and panels have functioned effectively and without interruptions even in various challenging circumstances. Based on the experience of the authors, consensus has prevailed as the primary nature of decisions made by all ISS medical groups, at all levels. The six first years of piloted operation have demonstrated the ability of the ISS medical authority groups and the medical infrastructure to implement medical policies and requirements, effectively interface with non-medical groups, and maintain the health and productivity of the crew in an integrated, multilaterally coordinated fashion. The medical support system appears to be mature and ready for further expansion of all Partners roles, and for the anticipated increase in the size of ISS crews.

Wakata prepares for Surface Sample Kit (SSK) Collection/Incubation

NASA Image and Video Library

2009-04-29

ISS019-E-012393 (29 April 2009) --- Japan Aerospace Exploration Agency (JAXA) astronaut Koichi Wakata, Expedition 19/20 flight engineer, is pictured near a Microbial Air Sampler floating freely in the Kibo laboratory of the International Space Station.

Hadfield installs a UBNT sensor in the U.S. Laboratory

NASA Image and Video Library

2013-01-31

ISS034-E-037330 (31 Jan. 2013) --- Canadian Space Agency astronaut Chris Hadfield, Expedition 34 flight engineer, installs a Ultra-Sonic Background Noise Tests (UBNT) sensor kit behind a rack in the Destiny of the International Space Station.

Tokarev assembles the RadioSkaf antenna during Expedition 12

NASA Image and Video Library

2006-01-24

ISS012-E-17050 (24 Jan. 2006) --- Cosmonaut Valery I. Tokarev, Expedition 12 flight engineer representing Russia's Federal Space Agency, assembles the antenna kit for the Radioskaf (SuitSat) payload in the Zvezda Service Module on the International Space Station.

Thirsk with SSK in JPM

NASA Image and Video Library

2009-07-15

ISS020-E-020652 (15 July 2009) --- Canadian Space Agency astronaut Robert Thirsk, Expedition 20 flight engineer, uses the Surface Sample Kit (SSK) to collect microbiology samples from specific sampling locations in the Harmony node and other modules of the International Space Station.

Expedition 16 FE Malenchenko working on the Conjugation Experiment Hardware in the SM

NASA Image and Video Library

2007-10-13

ISS015-E-34287 (13 Oct. 2007) --- Cosmonaut Yuri I. Malenchenko, Expedition 16 flight engineer representing Russia's Federal Space Agency, places hybridizers in orange Rekomb-kit in the Zvezda Service Module of the International Space Station.

International Space Station medical standards and certification for space flight participants.

PubMed

Bogomolov, Valery V; Castrucci, Filippo; Comtois, Jean-Marc; Damann, Volker; Davis, Jeffrey R; Duncan, J Michael; Johnston, Smith L; Gray, Gary W; Grigoriev, Anatoly I; Koike, Yu; Kuklinski, Paul; Matveyev, Vladimir P; Morgun, Valery V; Pochuev, Vladimir I; Sargsyan, Ashot E; Shimada, Kazuhito; Straube, Ulrich; Tachibana, Shoichi; Voronkov, Yuri V; Williams, Richard S

2007-12-01

The medical community of the International Space Station (ISS) has developed joint medical standards and evaluation requirements for Space Flight Participants ("space tourists") which are used by the ISS medical certification board to determine medical eligibility of individuals other than professional astronauts (cosmonauts) for short-duration space flight to the ISS. These individuals are generally fare-paying passengers without operational responsibilities. By means of this publication, the medical standards and evaluation requirements for the ISS Space Flight Participants are offered to the aerospace medicine and commercial spaceflight communities for reference purposes. It is emphasized that the criteria applied to the ISS spaceflight participant candidates are substantially less stringent than those for professional astronauts and/or crewmembers of visiting and long-duration missions to the ISS. These medical standards are released by the government space agencies to facilitate the development of robust medical screening and medical risk assessment approaches in the context of the evolving commercial human spaceflight industry.

Optimizing Medical Kits for Spaceflight

NASA Technical Reports Server (NTRS)

Keenan, A. B,; Foy, Millennia; Myers, G.

2014-01-01

The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulation outcomes describing the impact of medical events on the mission may be used to optimize the allocation of resources in medical kits. Efficient allocation of medical resources, subject to certain mass and volume constraints, is crucial to ensuring the best outcomes of in-flight medical events. We implement a new approach to this medical kit optimization problem. METHODS We frame medical kit optimization as a modified knapsack problem and implement an algorithm utilizing a dynamic programming technique. Using this algorithm, optimized medical kits were generated for 3 different mission scenarios with the goal of minimizing the probability of evacuation and maximizing the Crew Health Index (CHI) for each mission subject to mass and volume constraints. Simulation outcomes using these kits were also compared to outcomes using kits optimized..RESULTS The optimized medical kits generated by the algorithm described here resulted in predicted mission outcomes more closely approached the unlimited-resource scenario for Crew Health Index (CHI) than the implementation in under all optimization priorities. Furthermore, the approach described here improves upon in reducing evacuation when the optimization priority is minimizing the probability of evacuation. CONCLUSIONS This algorithm provides an efficient, effective means to objectively allocate medical resources for spaceflight missions using the Integrated Medical Model.

Sample Collection for the Russian Biodegradatsiya Experiment

NASA Image and Video Library

2007-10-01

ISS015-E-32031 (October 2007) --- Cosmonaut Oleg V. Kotov, Expedition 15 flight engineer representing Russia's Federal Space Agency, uses a Bioproby Kit to collect surface samples for analysis for the Russian Biodegradation experiment in the Zvezda Service Module of the International Space Station.

FE-2 Stott analyzes Water Samples using the CQQMK in the US Lab

NASA Image and Video Library

2009-10-20

ISS021-E-010311 (20 Oct. 2009) --- NASA astronaut Nicole Stott, Expedition 21 flight engineer, conducts a water quality analysis using the Colorimetric Water Quality Monitoring Kit (CWQMK) in the Destiny laboratory of the International Space Station.

AsMA Medical Guidelines for Air Travel: In-Flight Medical Care.

PubMed

Thibeault, Claude; Evans, Anthony D; Pettyjohn, Frank S; Alves, Paulo M

2015-06-01

Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. All airlines are required to provide first aid training for cabin crew, and the crew are responsible for managing any in-flight medical events. There are also regulatory requirements for the carriage of first aid and medical kits. AsMA has developed recommendations for first aid kits, emergency medical kits, and universal precaution kits.

Exploring the value and role of integrated supportive science courses in the reformed medical curriculum iMED: a mixed methods study.

PubMed

Eisenbarth, Sophie; Tilling, Thomas; Lueerss, Eva; Meyer, Jelka; Sehner, Susanne; Guse, Andreas H; Guse Nee Kurré, Jennifer

2016-04-29

Heterogeneous basic science knowledge of medical students is an important challenge for medical education. In this study, the authors aimed at exploring the value and role of integrated supportive science (ISS) courses as a novel approach to address this challenge and to promote learning basic science concepts in medical education. ISS courses were embedded in a reformed medical curriculum. The authors used a mixed methods approach including four focus groups involving ISS course lecturers and students (two each), and five surveys of one student cohort covering the results of regular student evaluations including the ISS courses across one study year. They conducted their study at the University Medical Center Hamburg-Eppendorf between December 2013 and July 2014. Fourteen first-year medical students and thirteen ISS course lecturers participated in the focus groups. The authors identified several themes focused on the temporal integration of ISS courses into the medical curriculum, the integration of ISS course contents into core curriculum contents, the value and role of ISS courses, and the courses' setting and atmosphere. The integrated course concept was positively accepted by both groups, with participants suggesting that it promotes retention of basic science knowledge. Values and roles identified by focus group participants included promotion of basic understanding of science concepts, integration of foundational and applied learning, and maximization of students' engagement and motivation. Building close links between ISS course contents and the core curriculum appeared to be crucial. Survey results confirmed qualitative findings regarding students' satisfaction, with some courses still requiring optimization. Integration of supportive basic science courses, traditionally rather part of premedical education, into the medical curriculum appears to be a feasible strategy to improve medical students' understanding of basic science concepts and to increase their motivation and engagement.

Commander De Winne poses for a photo during Air Sampling

NASA Image and Video Library

2009-11-11

ISS021-E-024700 (11 Nov. 2009) --- European Space Agency astronaut Frank De Winne, Expedition 21 commander, uses the Microbial Air Sampler kit (floating freely near De Winne) to obtain microbiology (bacterial & fungal) air samples in the Kibo laboratory of the International Space Station.

Documentation of Plant Growth in an EPO-Kit C Chamber taken during Expedition 15

NASA Image and Video Library

2007-08-20

ISS015-E-23475 (20 Aug. 2007) --- Close-up view of a plant growth experiment in an Education Payload Operations experiment collapsible growth chamber (labeled "Lettuce") photographed in the U.S. Laboratory or Destiny module aboard the International Space Station during Expedition 15.

Expedition 16 FE Malenchenko working on the Conjugation Experiment Hardware in the SM

NASA Image and Video Library

2007-10-13

ISS015-E-34286 (13 Oct. 2007) --- Cosmonaut Yuri I. Malenchenko, Expedition 16 flight engineer representing Russia's Federal Space Agency, works with a hybridizer from the Rekomb-K kit used in the Konyugatsia (Conjugation) experiment in the Zvezda Service Module of the International Space Station.

Medical Updates Number 5 to the International Space Station Probability Risk Assessment (PRA) Model Using the Integrated Medical Model

NASA Technical Reports Server (NTRS)

Butler, Doug; Bauman, David; Johnson-Throop, Kathy

2011-01-01

The Integrated Medical Model (IMM) Project has been developing a probabilistic risk assessment tool, the IMM, to help evaluate in-flight crew health needs and impacts to the mission due to medical events. This package is a follow-up to a data package provided in June 2009. The IMM currently represents 83 medical conditions and associated ISS resources required to mitigate medical events. IMM end state forecasts relevant to the ISS PRA model include evacuation (EVAC) and loss of crew life (LOCL). The current version of the IMM provides the basis for the operational version of IMM expected in the January 2011 timeframe. The objectives of this data package are: 1. To provide a preliminary understanding of medical risk data used to update the ISS PRA Model. The IMM has had limited validation and an initial characterization of maturity has been completed using NASA STD 7009 Standard for Models and Simulation. The IMM has been internally validated by IMM personnel but has not been validated by an independent body external to the IMM Project. 2. To support a continued dialogue between the ISS PRA and IMM teams. To ensure accurate data interpretation, and that IMM output format and content meets the needs of the ISS Risk Management Office and ISS PRA Model, periodic discussions are anticipated between the risk teams. 3. To help assess the differences between the current ISS PRA and IMM medical risk forecasts of EVAC and LOCL. Follow-on activities are anticipated based on the differences between the current ISS PRA medical risk data and the latest medical risk data produced by IMM.

[Enhancement of the medical care system for crews on space missions].

PubMed

Bogomolov, V V; Egorov, A D

2013-01-01

An overview of structural, operational and research aspects of the Russian system of medical support to health and performance of cosmonauts on the International space station (ISS) is presented. The backbone of the current tactics of cosmonauts' health maintenance is the original Russian medical care system developed for long-term piloted space fights. Over 12 years of its existence, the ISS has been operated by 33 main crews. The ISS program entrusted the established multilateral medical boards and panels with laying down the health standards as well as the generic and specific medical and engineering requirements mandatory to all international partners. Due to the program international nature, MedOps planning and implementation are coordinated within the network of working level groups with members designated by each IP. The article sums up the experiences and outlines future trends of the Russian medical care system for ISS cosmonauts. The authors pay tribute to academician Anatoli I. Grigoriev for his contribution to creation of the national system of medical safety in long-term piloted space missions, setting the ISS health and environmental standards and uniform principles of integrated crew health management, and gaining consensus on medical policy and operational issues equally during the ISS construction and utilization.

Evaluation of Human Research Facility Ultrasound With the ISS Video System

NASA Technical Reports Server (NTRS)

Melton, Shannon; Sargsyan, Ashot

2003-01-01

Most medical equipment on the International Space Station (ISS) is manifested as part of the U.S. or the Russian medical hardware systems. However, certain medical hardware is also available as part of the Human Research Facility. The HRF and the JSC Medical Operations Branch established a Memorandum of Agreement for joint use of certain medical hardware, including the HRF ultrasound system, the only diagnostic imaging device currently manifested to fly on ISS. The outcome of a medical contingency may be changed drastically, or an unnecessary evacuation may be prevented, if clinical decisions are supported by timely and objective diagnostic information. In many higher-probability medical scenarios, diagnostic ultrasound is a first-choice modality or provides significant diagnostic information. Accordingly, the Clinical Care Capability Development Project is evaluating the HRF ultrasound system for its utility in relevant clinical situations on board ISS. For effective management of these ultrasound-supported ISS medical scenarios, the resulting data should be available for viewing and interpretation on the ground, and bidirectional voice communication should be readily available to allow ground experts (sonographers, physicians) to provide guidance to the Crew Medical Officer. It may also be vitally important to have the capability of real-time guidance via video uplink to the CMO-operator during an exam to facilitate the diagnosis in a timely fashion. In this document, we strove to verify that the HRF ultrasound video output is compatible with the ISS video system, identify ISS video system field rates and resolutions that are acceptable for varying clinical scenaiios, and evaluate the HRF ultrasound video with a commercial, off-the-shelf video converter, and compare it with the ISS video system.

Mass and Volume Optimization of Space Flight Medical Kits

NASA Technical Reports Server (NTRS)

Keenan, A. B.; Foy, Millennia Hope; Myers, Jerry

2014-01-01

Resource allocation is a critical aspect of space mission planning. All resources, including medical resources, are subject to a number of mission constraints such a maximum mass and volume. However, unlike many resources, there is often limited understanding in how to optimize medical resources for a mission. The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulates outcomes and describes the impact of medical events in terms of lost crew time, medical resource usage, and the potential for medically required evacuation. Previously published work describes an approach that uses the IMM to generate optimized medical kits that maximize benefit to the crew subject to mass and volume constraints. We improve upon the results obtained previously and extend our approach to minimize mass and volume while meeting some benefit threshold. METHODS We frame the medical kit optimization problem as a modified knapsack problem and implement an algorithm utilizing dynamic programming. Using this algorithm, optimized medical kits were generated for 3 mission scenarios with the goal of minimizing the medical kit mass and volume for a specified likelihood of evacuation or Crew Health Index (CHI) threshold. The algorithm was expanded to generate medical kits that maximize likelihood of evacuation or CHI subject to mass and volume constraints. RESULTS AND CONCLUSIONS In maximizing benefit to crew health subject to certain constraints, our algorithm generates medical kits that more closely resemble the unlimited-resource scenario than previous approaches which leverage medical risk information generated by the IMM. Our work here demonstrates that this algorithm provides an efficient and effective means to objectively allocate medical resources for spaceflight missions and provides an effective means of addressing tradeoffs in medical resource allocations and crew mission success parameters.

International Space Station Medical Operations

NASA Technical Reports Server (NTRS)

Jones, Jeffrey A.

2008-01-01

NASA is currently the leader, in conjunction with our Russian counterpart co-leads, of the Multilateral Medical Policy Board (MMPB), the Multilateral Medical Operations Panel (MMOP), which coordinates medical system support for International Space Station (ISS) crews, and the Multilateral Space Medicine Board (MSMB), which medically certifies all crewmembers for space flight on-board the ISS. These three organizations have representatives from NASA, RSA-IMBP (Russian Space Agency- Institute for Biomedical Problems), GCTC (Gagarin Cosmonaut Training Center), ESA (European Space Agency), JAXA (Japanese Space Agency), and CSA (Canadian Space Agency). The policy and strategic coordination of ISS medical operations occurs at this level, and includes interactions with MMOP working groups in Radiation Health, Countermeasures, Extra Vehicular Activity (EVA), Informatics, Environmental Health, Behavioral Health and Performance, Nutrition, Clinical Medicine, Standards, Post-flight Activities and Rehabilitation, and Training. Each ISS Expedition has a lead Crew Surgeon from NASA and a Russian Crew Surgeon from GCTC assigned to the mission. Day-to-day issues are worked real-time by the flight surgeons and biomedical engineers (also called the Integrated Medical Group) on consoles at the MCC (Mission Control Center) in Houston and the TsUP (Center for Flight Control) in Moscow/Korolev. In the future, this may also include mission control centers in Europe and Japan, when their modules are added onto the ISS. Private medical conferences (PMCs) are conducted regularly and upon crew request with the ISS crew via private audio and video communication links from the biomedical MPSR (multipurpose support room) at MCC Houston. When issues arise in the day-to-day medical support of ISS crews, they are discussed and resolved at the SMOT (space medical operations team) meetings, which occur weekly among the International Partners. Any medical or life science issue that is not resolved at the SMOT can be taken to the Mission Management Team meeting, which occurs biweekly from MCC-Houston. This meeting includes the other International Partners and all flight support and console position representatives via teleconference. ISS Crew Surgeons have handled many medical conditions on orbit; including skin rashes, dental abscesses, lacerations, and STT segment EKG changes. Fortunately to date, there have not been any forced medical evacuations from the ISS. This speaks well for the implementation of the primary, secondary and even tertiary prevention strategies invoked by the Integrated Medical Group, as there were several medical evacuations during the previous Russian space stations.

Electrochemical Disinfection Feasibility Assessment Materials Evaluation for the International Space Station

NASA Technical Reports Server (NTRS)

Rodriquez, Branelle; Shindo, David; Montgomery, Eliza

2013-01-01

The International Space Station (ISS) Program recognizes the risk of microbial contamination in their potable and non-potable water sources. The end of the Space Shuttle Program limited the ability to send up shock kits of biocides in the event of an outbreak. Currently, the United States Orbital Segment water system relies primarily on iodine to mitigate contamination concerns, which has been successful in remediating the small cases of contamination documented. However, a secondary method of disinfection is a necessary investment for future space flight. Over the past year, NASA Johnson Space Center has investigated the development of electrochemically generated systems for use on the ISS. These systems include: hydrogen peroxide, ozone, sodium hypochlorite, and peracetic acid. To use these biocides on deployed water systems, NASA must understand of the effect these biocides have on current ISS materials prior to proceeding forward with possible on-orbit applications. This paper will discuss the material testing that was conducted to assess the effects of the biocides on current ISS materials.

Kennedy Space Center Medical Operations and Medical Kit

NASA Technical Reports Server (NTRS)

Scarpa, Philip

2011-01-01

This slide presentation reviews the emergency medical operations at Kennedy Space center, the KSC launch and landing contingency modes, the triage site, the medical kit, and the medications available.

Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Enrolled in Medication Assisted Therapy Clinics in North Carolina.

PubMed

Khatiwoda, Prasana; Proeschold-Bell, Rae Jean; Meade, Christina S; Park, Lawrence P; Proescholdbell, Scott

2018-01-01

BACKGROUND Naloxone-an opioid antagonist that reverses the effects of opioids-is increasingly being distributed in non-medical settings. We sought to identify the facilitators of, and barriers to, opioid users using naloxone kits in North Carolina. METHODS In 2015, we administered a 15-item survey to a convenience sample of 100 treatment seekers at 4 methadone/buprenorphine Medication Assisted Therapy (MAT) clinics in North Carolina. RESULTS Seventy-four percent of participants reported having ever gotten a naloxone kit; this percentage was higher for females (81%) than males (63%) ( P = .06). The primary reason given for not having a kit was not knowing where to get one. Only 6% had heard of kits from the media and only 5% received one from a medical provider. Among kit recipients, 56% of both females and males reported mostly or sometimes carrying the kit, with additional participants reporting always. Reasons for not carrying a kit were no longer being around drugs, forgetting it, and the kit being too large. Men discussed the difficulties of carrying the naloxone kits, which are currently too large to fit in a pocket. Ninety-four percent of naloxone users reported intending to call emergency services in case of an overdose emergency. LIMITATIONS Study limitations included a small sample, participants limited to MAT clinics, and a predominantly white sample. CONCLUSIONS MAT treatment seekers reported a willingness to carry and use naloxone kits. Education, outreach, media, and medical providers need to promote naloxone kits. A smaller kit may increase the likelihood of men carrying one. ©2018 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

UPA Fill Drain Valve Modification kit installation

NASA Image and Video Library

2016-01-25

ISS046e023885 (01/25/2016) --- NASA astronaut Tim Kopra performs regular maintenance on the Urine Processing Assembly (UPA) aboard the International Space Station. The UPA is used by the crew to recycle water for use on the station. The image shows Tim replacing the brine filter from the UPA Fill Drain Valve enclosure.

CHeCS (Crew Health Care Systems): International Space Station (ISS) Medical Hardware Catalog. Version 10.0

NASA Technical Reports Server (NTRS)

2011-01-01

The purpose of this catalog is to provide a detailed description of each piece of hardware in the Crew Health Care System (CHeCS), including subpacks associated with the hardware, and to briefly describe the interfaces between the hardware and the ISS. The primary user of this document is the Space Medicine/Medical Operations ISS Biomedical Flight Controllers (ISS BMEs).

Overview and Results of ISS Space Medicine Operations Team (SMOT) Activities

NASA Technical Reports Server (NTRS)

Johnson, H. Magee; Sargsyan, Ashot E.; Armstrong, Cheryl; McDonald, P. Vernon; Duncan, James M.; Bogomolov, V. V.

2007-01-01

The Space Medicine Operations Team (SMOT) was created to integrate International Space Station (ISS) Medical Operations, promote awareness of all Partners, provide emergency response capability and management, provide operational input from all Partners for medically relevant concerns, and provide a source of medical input to ISS Mission Management. The viewgraph presentation provides an overview of educational objectives, purpose, operations, products, statistics, and its use in off-nominal situations.

International Space Station United States Orbital Segment Oxygen Generation System On-Orbit Operational Experience

NASA Technical Reports Server (NTRS)

Erickson, Robert J.; Howe, John, Jr.; Kulp, Galen W.; VanKeuren, Steven P.

2008-01-01

The International Space Station (ISS) United States Orbital Segment (USOS) Oxygen Generation System (OGS) was originally intended to be installed in ISS Node 3. The OGS rack delivery was accelerated, and it was launched to ISS in July of 2006 and installed in the US Laboratory Module. Various modification kits were installed to provide its interfaces, and the OGS was first activated in July of 2007 for 15 hours, In October of 2007 it was again activated for 76 hours with varied production rates and day/night cycling. Operational time in each instance was limited by the quantity of feedwater in a Payload Water Reservoir (PWR) bag. Feedwater will be provided by PWR bag until the USOS Water Recovery System (WRS) is delivered to SS in fall of 2008. This paper will discuss operating experience and characteristics of the OGS, as well as operational issues and their resolution.

Emergency medical kit for commercial airlines: an update.

PubMed

Thibeault, Claude

2002-06-01

As expected, the issue of medical kits for commercial airlines continues to attract attention, especially in light of the recent United States regulation on the subject. As promised in its first recommendation in 1998, the Air Transport Medicine (ATM) Committee has continued to monitor medical kit usage as well as pharmaceutical scientific developments and wishes to propose an update to its 1998 recommendation. Lists of contents are provided for emergency medical kits of two types: 1) those without defibrillator/monitor or monitor; and 2) those with defibrillator/monitor or monitor alone. Follow up and updates on this issue will be an ongoing task of the ATM Committee.

Response capability during civil air carrier inflight medical emergencies.

DOT National Transportation Integrated Search

1991-03-01

Expanded civil aircraft medical emergency kits have been mandated on U.S. carriers since August 1986. Airlines provided the Federal Aviation Agency reports on medical kit usage and outcomes of the associated medical emergencies; 1,016 inflight medica...

An Independent Human Factors Analysis and Evaluation of the Emergency Medical Protocol Checklist for the International Space Station

NASA Technical Reports Server (NTRS)

Marshburn, Thomas; Whitmore, Mihriban; Ortiz, Rosie; Segal, Michele; Smart, Kieran; Hughes, Catherine

2003-01-01

Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS Crewmembers to more speedily and accurately respond to medical situations on the ISS.

Performance Support Tools for Space Medical Operations

NASA Technical Reports Server (NTRS)

Byrne, Vicky E.; Schmidt, Josef; Barshi, Immanuel

2009-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Human factors personnel at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground. This area of research involved the feasibility of Just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction were captured. Information needed by the FS during ISS mission support, especially for an emergency situation (e.g. fire onboard ISS), may be located in many different places around the FS s console. A performance support tool prototype is being developed to address this issue by bringing all of the relevant information together in one place. The tool is designed to include procedures and other information needed by a FS during an emergency, as well as procedures and information to be used after the emergency is resolved. Several walkthroughs of the prototype with FSs have been completed within a mockup of an ISS FS console. Feedback on the current tool design as well as recommendations for existing ISS FS displays were captured.

CHeCS: International Space Station Medical Hardware Catalog

NASA Technical Reports Server (NTRS)

2008-01-01

The purpose of this catalog is to provide a detailed description of each piece of hardware in the Crew Health Care System (CHeCS), including subpacks associated with the hardware, and to briefly describe the interfaces between the hardware and the ISS. The primary user of this document is the Space Medicine/Medical Operations ISS Biomedical Flight Controllers (ISS BMEs).

Halophilic life on Mars ?

NASA Astrophysics Data System (ADS)

Stan-Lotter, Helga; Fendrihan, Sergiu; Dornmayr-Pfaffenhuemer, Marion; Holzinger, Anita; Polacsek, Tatjana K.; Legat, Andrea; Grösbacher, Michael; Weigl, Andreas

2010-05-01

Background: The search for extraterrestrial life has been declared as a goal for the 21th century by several space agencies. Potential candidates are microorganisms on or in the surface of moons and planets, such as Mars. Extremely halophilic archaea (haloarchaea) are of astrobiological interest since viable strains have been isolated from million years old salt deposits (1) and halite has been found in Martian meteorites and in surface pools. Therefore, haloarchaeal responses to simulated and real space conditions were explored. Immuno assays for a potential Life Marker Chip experiment were developed with antisera against the universal enzyme ATP synthase. Methods: The focus of these studies was on the application of fluorescent probes since they provide strong signals, and detection devices are suitable for miniaturization. Viability of haloarchaeal strains (Halococcus dombrowskii and Halobacterium salinarum NRC-1) was probed with the LIVE/DEAD BacLight™ kit and the BacLight™ Bacterial Membrane Potential kit. Cyclobutane pyrimidine dimers (CPD) in the DNA, following exposure to simulated and real space conditions (UV irradiation from 200 - 400 nm; 18 months exposure on the International Space Station [ISS] within the ADAPT experiment by Dr. P. Rettberg), were detected with fluorescent Alexa-Fluor-488-coupled antibodies. Immuno assays with antisera against the A-ATPase subunits from Halorubrum saccharovorum were carried out with the highly sensitive Immun-Star ™ WesternC ™ chemiluminescent kit (Bio-Rad). Results: Using the LIVE/DEAD BacLight™ kit, the D37 (dose of 37% survival) for Hcc. dombrowskii and Hbt. salinarum NRC-1, following exposure to UV (200-400 nm) was about 400 kJ/m2, when cells were embedded in halite and about 1 kJ/m2, when cells were in liquid cultures. Fluorescent staining indicated a slightly higher cellular activity than that which was derived from the determination of colony forming units. Assessment of viability with the BacLight™ Bacterial Membrane Potential kit gave strong signals with Hcc. dombrowskii and the control microorganism E. coli; as expected, the uncoupler CCCP diminished the membrane potential. Reaction times were generally longer with Hcc. dombrowskii than with E. coli. Hcc. dombrowskii from the ISS experiment showed > 80% viable cells when judged with the LIVE/DEAD kit. CPD formation was detectable in about 3-5 % of the total cells. It is not yet known if growing cells of Hcc. dombrowskii were recovered from the ISS. ATPase subunits were detected in crude membrane preparations, in whole haloarchaeal and bacterial cells, and even in spores (from Geobacillus stearothermophilus), suggesting the usefulness of the ATP synthase as a molecular target for life detection. Conclusions: Fluorescent dyes provide strong signals, which are suitable for remote detection and are compatible with high ionic strength. The advantages of staining with fluorescent dyes are rapid results on membrane intactness, membrane potential, and the presence of certain biomolecules. But more data are needed for a better correlation to cellular viability. (1) Stan-Lotter H, Pfaffenhuemer M, Legat A, Busse H-J, Radax C, Gruber C (2002) Halococcus dombrowskii sp. nov., an archaeal isolate from a Permian alpine salt deposit. Int System Evol Microbiol 52, 1807-1814.

Using Modified-ISS Model to Evaluate Medication Administration Safety During Bar Code Medication Administration Implementation in Taiwan Regional Teaching Hospital.

PubMed

Ma, Pei-Luen; Jheng, Yan-Wun; Jheng, Bi-Wei; Hou, I-Ching

2017-01-01

Bar code medication administration (BCMA) could reduce medical errors and promote patient safety. This research uses modified information systems success model (M-ISS model) to evaluate nurses' acceptance to BCMA. The result showed moderate correlation between medication administration safety (MAS) to system quality, information quality, service quality, user satisfaction, and limited satisfaction.

International Space Station (ISS) External Thermal Control System (ETCS) Loop A Pump Module (PM) Jettison Options Assessment

NASA Technical Reports Server (NTRS)

Murri, Daniel G.; Dwyer Cianciolo, Alicia; Shidner, Jeremy D.; Powell, Richard W.

2014-01-01

On December 11, 2013, the International Space Station (ISS) experienced a failure of the External Thermal Control System (ETCS) Loop A Pump Module (PM). To minimize the number of extravehicular activities (EVA) required to replace the PM, jettisoning the faulty pump was evaluated. The objective of this study was to independently evaluate the jettison options considered by the ISS Trajectory Operations Officer (TOPO) and to provide recommendations for safe jettison of the ETCS Loop A PM. The simulation selected to evaluate the TOPO options was the NASA Engineering and Safety Center's (NESC) version of Program to Optimize Simulated Trajectories II (POST2) developed to support another NESC assessment. The objective of the jettison analysis was twofold: (1) to independently verify TOPO posigrade and retrograde jettison results, and (2) to determine jettison guidelines based on additional sensitivity, trade study, and Monte Carlo (MC) analysis that would prevent PM recontact. Recontact in this study designates a propagated PM trajectory that comes within 500 m of the ISS propagated trajectory. An additional simulation using Systems Tool Kit (STK) was run for independent verification of the POST2 simulation results. Ultimately, the ISS Program removed the PM jettison option from consideration. However, prior to the Program decision, the retrograde jettison option remained part of the EVA contingency plan. The jettison analysis presented showed that, in addition to separation velocity/direction and the atmosphere conditions, the key variables in determining the time to recontact the ISS is highly dependent on the ballistic number (BN) difference between the object being jettisoned and the ISS.

Software for Remote Monitoring of Space-Station Payloads

NASA Technical Reports Server (NTRS)

Schneider, Michelle; Lippincott, Jeff; Chubb, Steve; Whitaker, Jimmy; Gillis, Robert; Sellers, Donna; Sims, Chris; Rice, James

2003-01-01

Telescience Resource Kit (TReK) is a suite of application programs that enable geographically dispersed users to monitor scientific payloads aboard the International Space Station (ISS). TReK provides local ground support services that can simultaneously receive, process, record, playback, and display data from multiple sources. TReK also provides interfaces to use the remote services provided by the Payload Operations Integration Center which manages all ISS payloads. An application programming interface (API) allows for payload users to gain access to all data processed by TReK and allows payload-specific tools and programs to be built or integrated with TReK. Used in conjunction with other ISS-provided tools, TReK provides the ability to integrate payloads with the operational ground system early in the lifecycle. This reduces the potential for operational problems and provides "cradle-to-grave" end-to-end operations. TReK contains user guides and self-paced tutorials along with training applications to allow the user to become familiar with the system.

The ISS flight of Richard Garriott: a template for medicine and science investigation on future spaceflight participant missions.

PubMed

Jennings, Richard T; Garriott, Owen K; Bogomolov, Valery V; Pochuev, Vladimir I; Morgun, Valery V; Garriott, Richard A

2010-02-01

A total of eight commercial spaceflight participants have launched to the International Space Station (ISS) on Soyuz vehicles. Based on an older mean age compared to career astronauts and an increased prevalence of medical conditions, spaceflight participants have provided the opportunity to learn about the effect of space travel on crewmembers with medical problems. The 12-d Soyuz TMA-13/12 ISS flight of spaceflight participant Richard Garriott included medical factors that required preflight intervention, risk mitigation strategies, and provided the opportunity for medical study on-orbit. Equally important, Mr. Garriott conducted extensive medical, scientific, and educational payload operations during the flight. These included 7 medical experiments and a total of 15 scientific projects such as protein crystal growth, Earth observations/photography, educational projects with schools, and amateur radio. The medical studies included the effect of microgravity on immune function, sleep, bone loss, corneal refractive surgery, low back pain, motion perception, and intraocular pressure. The overall mission success resulted from non-bureaucratic agility in mission planning, cooperation with investigators from NASA, ISS, International Partners, and the Korean Aerospace Research Institute, in-flight support and leadership from a team with spaceflight and Capcom experience, and overall mission support from the ISS program. This article focuses on science opportunities that suborbital and orbital spaceflight participant flights offer and suggests that the science program on Richard Garriott's flight be considered a model for future orbital and suborbital missions. The medical challenges are presented in a companion article.

21 CFR 868.1100 - Arterial blood sampling kit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Arterial blood sampling kit. 868.1100 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1100 Arterial blood sampling kit. (a) Identification. An arterial blood sampling kit is a device, in kit form, used to obtain arterial blood samples...

21 CFR 868.1100 - Arterial blood sampling kit.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Arterial blood sampling kit. 868.1100 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1100 Arterial blood sampling kit. (a) Identification. An arterial blood sampling kit is a device, in kit form, used to obtain arterial blood samples...

21 CFR 868.1100 - Arterial blood sampling kit.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Arterial blood sampling kit. 868.1100 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1100 Arterial blood sampling kit. (a) Identification. An arterial blood sampling kit is a device, in kit form, used to obtain arterial blood samples...

21 CFR 868.1100 - Arterial blood sampling kit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Arterial blood sampling kit. 868.1100 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1100 Arterial blood sampling kit. (a) Identification. An arterial blood sampling kit is a device, in kit form, used to obtain arterial blood samples...

21 CFR 868.1100 - Arterial blood sampling kit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Arterial blood sampling kit. 868.1100 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1100 Arterial blood sampling kit. (a) Identification. An arterial blood sampling kit is a device, in kit form, used to obtain arterial blood samples...

Colorimetric Solid Phase Extraction (CSPE): Using Color to Monitor Spacecraft Water Quality

NASA Technical Reports Server (NTRS)

Gazda, Daniel B.; Nolan, Daniel J.; Rutz, Jeffrey A.; Schultz, John R.; Siperko, Lorraine M.; Porter, Marc D.; Lipert, Robert J.; Flint, Stephanie M.; McCoy, J. Torin

2010-01-01

In August 2009, an experimental water quality monitoring kit based on Colorimetric Solid Phase Extraction (CSPE) technology was delivered to the International Space Station (ISS). The kit, called the Colorimetric Water Quality Monitoring Kit (CWQMK), was launched as a Station Development Test Objective (SDTO) experiment to evaluate the suitability of CSPE technology for routine use monitoring water quality on the ISS. CSPE is a sorption-spectrophotometric technique that combines colorimetric reagents, solid-phase extraction, and diffuse reflectance spectroscopy to quantify trace analytes in water samples. In CSPE, a known volume of sample is metered through a membrane disk that has been impregnated with an analyte-specific colorimetric reagent and any additives required to optimize the formation of the analyte-reagent complex. As the sample flows through the membrane disk, the target analyte is selectively extracted, concentrated, and complexed. Formation of the analyte-reagent complex causes a detectable change in the color of the membrane disk that is proportional to the amount of analyte present in the sample. The analyte is then quantified by measuring the color of the membrane disk surface using a hand-held diffuse reflectance spectrophotometer (DRS). The CWQMK provides the capability to measure the ionic silver (Ag +) and molecular iodine (I2) in water samples on-orbit. These analytes were selected for the evaluation of CSPE technology because they are the biocides used in the potable water storage and distribution systems on the ISS. Biocides are added to the potable water systems on spacecraft to inhibit microbial growth. On the United States (US) segment of the ISS molecular iodine serves as the biocide, while the Russian space agency utilizes silver as a biocide in their systems. In both cases, the biocides must be maintained at a level sufficient to control bacterial growth, but low enough to avoid any negative effects on crew health. For example, the presence of high levels of iodine in water can cause taste and odor issues that result in decreased water consumption by the crew. There are also concerns about potential impacts on thyroid function following exposure to high levels of iodine. With silver, there is a risk of developing argyria, an irreversible blue-gray discoloration of the skin, associated with long term consumption of water containing high concentrations of silver. The need to ensure that safe, effective levels of biocide are maintained in the potable water systems on the ISS provides a perfect platform for evaluating the suitability of CSPE technology for in-flight water quality monitoring. This paper provides an overview of CSPE technology and details on the silver and iodine methods used in the CWQMK. It also reports results obtained during in-flight analyses performed with the CWQMK and briefly discusses other potential applications for CSPE technology in both the spacecraft and terrestrial environments.

Stimulant medication use and response to growth hormone therapy: an NCGS database analysis.

PubMed

Frindik, J Paul; Morales, Alba; Fowlkes, John; Kemp, Stephen; Thrailkill, Kathryn; Lippe, Barbara; Dana, Ken

2009-01-01

Determine (1) frequency of attention-deficit hyperactivity disorder (ADHD) treatment and (2) growth responses in growth hormone (GH)-treated children who are receiving ADHD medication versus GH alone. Prepubertal children with idiopathic short stature (ISS) or GH deficiency (IGHD) enrolled in Genentech's National Cooperative Growth Study. ADHD treatment was determined by documentation of psycho-stimulant medication use at enrollment. ADHD medication use increased from 0.8% (7/850) in 1985 to 5.8% (752/12,113) in 2005. First-year GH treatment response for ADHD + IGHD versus IGHD: 8.5 +/- 2.0 vs. 9.4 +/- 2.6 cm/year, but when adjusted for age, sex, and enrollment body mass index, the difference is clinically insignificant (-0.4 cm/year). First-year growth was similar in all ISS: 8.1 +/- 1.9 versus 8.6 +/- 2.1 cm/year (ADHD + ISS vs. ISS, an adjusted -0.2-cm/year difference). Increasing numbers of GH-treated children are taking ADHD medications and their growth responses during the first year of GH therapy are similar to those not taking ADHD medications. Copyright 2009 S. Karger AG, Basel.

Qualitative Validation of the IMM Model for ISS and STS Programs

NASA Technical Reports Server (NTRS)

Kerstman, E.; Walton, M.; Reyes, D.; Boley, L.; Saile, L.; Young, M.; Arellano, J.; Garcia, Y.; Myers, J. G.

2016-01-01

To validate and further improve the Integrated Medical Model (IMM), medical event data were obtained from 32 ISS and 122 STS person-missions. Using the crew characteristics from these observed missions, IMM v4.0 was used to forecast medical events and medical resource utilization. The IMM medical condition incidence values were compared to the actual observed medical event incidence values, and the IMM forecasted medical resource utilization was compared to actual observed medical resource utilization. Qualitative comparisons of these parameters were conducted for both the ISS and STS programs. The results of these analyses will provide validation of IMM v4.0 and reveal areas of the model requiring adjustments to improve the overall accuracy of IMM outputs. This validation effort should result in enhanced credibility of the IMM and improved confidence in the use of IMM as a decision support tool for human space flight.

Optimizing Medical Kits for Space Flight

NASA Technical Reports Server (NTRS)

Minard, Charles G.; FreiredeCarvalho, Mary H.; Iyengar, M. Sriram

2010-01-01

The Integrated Medical Model (IMM) uses Monte Carlo methodologies to predict the occurrence of medical events, their mitigation, and the resources required during space flight. The model includes two modules that utilize output from a single model simulation to identify an optimized medical kit for a specified mission scenario. This poster describes two flexible optimization routines built into SAS 9.1. The first routine utilizes a systematic process of elimination to maximize (or minimize) outcomes subject to attribute constraints. The second routine uses a search and mutate approach to minimize medical kit attributes given a set of outcome constraints. There are currently 273 unique resources identified that are used to treat at least one of 83 medical conditions currently in the model.

Lunar Surface Reference Missions: A Description of Human and Robotic Surface Activities

NASA Technical Reports Server (NTRS)

Duke, Michael B.; Hoffman, Stephen J.; Snook, Kelly

2003-01-01

Most medical equipment to the International Space Station (ISS) is manisfested as part of the U.S. or the Russian medical hardware systems. However, certain medical hardware is also available as part of the Human Research Facility. The HRF and the JSC Medical Operations Branch established a Memorandum of Agreement for joint use of certain medical hardware, including the HRF ultrasound system, the only diagnostic imaging device currently manifested to fly on ISS. The outcome of a medical contingency may be changed drastically, or an unnecessary evacuation may be prevented, if clinical decisions are supported by timely and objective diagnostic information. In many higher-probability medical scenarios, diagnostic ultrasound is a first-choice modality or provides significant diagnostic information. Accordingly, the Clinical Care Capability Development Project is evaluating the HRF ultrasound system for its utility in relevant clinical siruations on board ISS. For effective management of these ultrasound-supported ISS medical scenarios, the resulting data should be available for viewing and interpretation on the ground, and bidirectional voice communication should be readily available to allow ground experts (sonographers, physicians) to provide guidance to the Crew Medical Officer. It may also be vitally important to have the capability of real-time guidance via video uplink to the CMO-opertor during an exam to facilitate the diagnosis in a timely fashion.

Travel Medical Kit.

PubMed

Terry, Anne C; Haulman, N Jean

2016-03-01

"The traveler's medical kit is an essential tool for both the novice and expert traveler. It is designed to treat travel-related illness and injury and to ensure preexisting medical conditions are managed appropriately. Travelers are at increased risk for common gastrointestinal issues during travel. Respiratory illnesses make up approximately 8% of the ailments present in returned international travelers. Approximately 12% of travelers experience a travel-related skin condition. First aid treatment for minor injuries is essential to all travel medical kits. The complexity ranges from a small, simple case for the urban traveler to a larger, extensive case for wilderness travel." Copyright © 2016 Elsevier Inc. All rights reserved.

21 CFR 868.5140 - Anesthesia conduction kit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Anesthesia conduction kit. 868.5140 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5140 Anesthesia conduction kit. (a) Identification. An anesthesia conduction kit is a device used to administer to a patient conduction, regional, or...

21 CFR 868.5140 - Anesthesia conduction kit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Anesthesia conduction kit. 868.5140 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5140 Anesthesia conduction kit. (a) Identification. An anesthesia conduction kit is a device used to administer to a patient conduction, regional, or...

21 CFR 876.5210 - Enema kit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Enema kit. 876.5210 Section 876.5210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5210 Enema kit. (a) Identification. An enema kit is a...

21 CFR 868.5140 - Anesthesia conduction kit.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Anesthesia conduction kit. 868.5140 Section 868...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5140 Anesthesia conduction kit. (a) Identification. An anesthesia conduction kit is a device used to administer to a patient conduction, regional, or...

21 CFR 872.3600 - Partially fabricated denture kit.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Partially fabricated denture kit. 872.3600 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3600 Partially fabricated denture kit. (a) Identification. A partially fabricated denture kit is a device composed of connected preformed teeth that is...

21 CFR 872.3600 - Partially fabricated denture kit.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Partially fabricated denture kit. 872.3600 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3600 Partially fabricated denture kit. (a) Identification. A partially fabricated denture kit is a device composed of connected preformed teeth that is...

21 CFR 872.3600 - Partially fabricated denture kit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Partially fabricated denture kit. 872.3600 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3600 Partially fabricated denture kit. (a) Identification. A partially fabricated denture kit is a device composed of connected preformed teeth that is...

21 CFR 872.3600 - Partially fabricated denture kit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Partially fabricated denture kit. 872.3600 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3600 Partially fabricated denture kit. (a) Identification. A partially fabricated denture kit is a device composed of connected preformed teeth that is...

21 CFR 876.5210 - Enema kit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Enema kit. 876.5210 Section 876.5210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5210 Enema kit. (a) Identification. An enema kit is a...

21 CFR 876.5210 - Enema kit.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Enema kit. 876.5210 Section 876.5210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5210 Enema kit. (a) Identification. An enema kit is a...

21 CFR 876.5210 - Enema kit.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Enema kit. 876.5210 Section 876.5210 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5210 Enema kit. (a) Identification. An enema kit is a...

21 CFR 878.3925 - Plastic surgery kit and accessories.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended to...

21 CFR 878.3925 - Plastic surgery kit and accessories.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended to...

21 CFR 878.3925 - Plastic surgery kit and accessories.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended to...

21 CFR 878.3925 - Plastic surgery kit and accessories.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended to...

21 CFR 878.3925 - Plastic surgery kit and accessories.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended to...

Burbank performs Part 1 of the WRS-1 Repair

NASA Image and Video Library

2012-03-08

ISS030-E-128752 (8 March 2012) --- NASA astronaut Dan Burbank, Expedition 30 commander, performs part one of the Water Recovery System-1 (WRS-1) repair in the Tranquility node of the International Space Station. Burbank removed and replaced the failed Catalytic Reactor (CR), and installed a temporary filter kit between the new CR and the Microbial Check Valve (MCV) to support a system flush of the new Orbital Replacement Unit (ORU).

Development and Operation of a Modern Information Portal for the ISS Medical Groups

NASA Technical Reports Server (NTRS)

Damann, V.; Johnson, MaGee; Sargsyan, Ashot; McDonald, P. Vernon; Armstrong, C.; Scheer, M.; Duncan, J. Michael

2007-01-01

This viewgraph presentation begins with a review of some of the problems inherent in running medical services for the International Space Station. Part of the solution for the problems is the development of the information portal for the ISS medical groups. The presentation shows the tools that have been developed to assist in collaboration for the medical services, the security system and the capabilities of the portal.

Optimization Routine for Generating Medical Kits for Spaceflight Using the Integrated Medical Model

NASA Technical Reports Server (NTRS)

Graham, Kimberli; Myers, Jerry; Goodenow, Deb

2017-01-01

The Integrated Medical Model (IMM) is a MATLAB model that provides probabilistic assessment of the medical risk associated with human spaceflight missions.Different simulations or profiles can be run in which input conditions regarding both mission characteristics and crew characteristics may vary. For each simulation, the IMM records the total medical events that occur and “treats” each event with resources drawn from import scripts. IMM outputs include Total Medical Events (TME), Crew Health Index (CHI), probability of Evacuation (pEVAC), and probability of Loss of Crew Life (pLOCL).The Crew Health Index is determined by the amount of quality time lost (QTL). Previously, an optimization code was implemented in order to efficiently generate medical kits. The kits were optimized to have the greatest benefit possible, given amass and/or volume constraint. A 6-crew, 14-day lunar mission was chosen for the simulation and run through the IMM for 100,000 trials. A built-in MATLAB solver, mixed-integer linear programming, was used for the optimization routine. Kits were generated in 10% increments ranging from 10%-100% of the benefit constraints. Conditions wheremass alone was minimized, volume alone was minimized, and where mass and volume were minimizedjointly were tested.

Medical issues in flight and updating the emergency medical kit.

PubMed

Verjee, Mohamud A; Crone, Robert; Ostrovskiy, Grigory

2018-01-01

Airline travel is more affordable than ever and likely safer than ever too. Within half a day, a passenger can be on the other side of the world. However, medical care in-flight has been an issue for those with medical conditions and for those who fall sick during a journey. While airlines have the advice of multiple recognized organizations on needs and standards of care, in-flight emergencies occur at various levels. An emergency medical kit (EMK) together with trained cabin crew can be very effective at resolving the minor problems that arise and reducing the risk of escalation. On occasion, an overhead plea may be announced for additional medical expertise. Having the right content in a medical kit is more important in modern day travel, coupled with advances in equipment and passenger expectations. The authors address current issues of illness and other relevant conditions and suggest a content enhancement for an onboard EMK.

Medical issues in flight and updating the emergency medical kit

PubMed Central

Verjee, Mohamud A; Crone, Robert; Ostrovskiy, Grigory

2018-01-01

Airline travel is more affordable than ever and likely safer than ever too. Within half a day, a passenger can be on the other side of the world. However, medical care in-flight has been an issue for those with medical conditions and for those who fall sick during a journey. While airlines have the advice of multiple recognized organizations on needs and standards of care, in-flight emergencies occur at various levels. An emergency medical kit (EMK) together with trained cabin crew can be very effective at resolving the minor problems that arise and reducing the risk of escalation. On occasion, an overhead plea may be announced for additional medical expertise. Having the right content in a medical kit is more important in modern day travel, coupled with advances in equipment and passenger expectations. The authors address current issues of illness and other relevant conditions and suggest a content enhancement for an onboard EMK. PMID:29750057

Developing an electronic system to manage and track emergency medications.

PubMed

Hamm, Mark W; Calabrese, Samuel V; Knoer, Scott J; Duty, Ashley M

2018-03-01

The development of a Web-based program to track and manage emergency medications with radio frequency identification (RFID) is described. At the Cleveland Clinic, medication kit restocking records and dispense locations were historically documented using a paper record-keeping system. The Cleveland Clinic investigated options to replace the paper-based tracking logs with a Web-based program that could track the real-time location and inventory of emergency medication kits. Vendor collaboration with a board of pharmacy (BOP) compliance inspector and pharmacy personnel resulted in the creation of a dual barcoding system using medication and pocket labels. The Web-based program was integrated with a Cleveland Clinic-developed asset tracking system using active RFID tags to give the real-time location of the medication kit. The Web-based program and the asset tracking system allowed identification of kits nearing expiration or containing recalled medications. Conversion from a paper-based system to a Web-based program began in October 2013. After 119 days, data were evaluated to assess the success of the conversion. Pharmacists spent an average of 27 minutes per day approving medication kits during the postimplementation period versus 102 minutes daily using the paper-based system, representing a 74% decrease in pharmacist time spent on this task. Prospective reports are generated monthly to allow the manager to assess the expected workload and adjust staffing for the next month. Implementation of a BOP-approved Web-based system for managing and tracking emergency medications with RFID integration decreased pharmacist review time, minimized compliance risk, and increased access to real-time data. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Effect of planecta and ROSE™ on the frequency characteristics of blood pressure-transducer kits.

PubMed

Fujiwara, Shigeki; Kawakubo, Yoshifumi; Mori, Satoshi; Tachihara, Keiichi; Toyoguchi, Izumi; Yokoyama, Takeshi

2015-12-01

Pressure-transducer kits have frequency characteristics such as natural frequency and damping coefficient, which affect the monitoring accuracy. The aim of the present study was to investigate the effect of planecta ports and a damping device (ROSE™, Argon Medical Devices, TX, USA) on the frequency characteristics of pressure-transducer kits. The FloTrac sensor kit (Edwards Lifesciences, CA, USA) and the DTXplus transducer kit (Argon Medical Devices) were prepared with planecta ports, and their frequency characteristics were tested with or without ROSE™. The natural frequency and damping coefficient of each kit were obtained using frequency characteristics analysis software and evaluated by plotting them on the Gardner's chart. By inserting a planecta port, the natural frequency markedly decreased in both the FloTrac sensor kit (from 40 to 22 Hz) and the DTXplus transducer kit (from 35 to 22 Hz). In both kits with one planecta port, the damping coefficient markedly increased by insertion of ROSE™ from 0.2 to 0.5, optimising frequency characteristics. In both kits with two planecta ports, however, the natural frequency decreased from 22 to 12 Hz. The damping coefficient increased from 0.2 to 0.8 by insertion of ROSE™; however, optimisation was not achieved even by ROSE™ insertion. Planecta ports decrease the natural frequency of the kit. ROSE™ is useful to optimise the frequency characteristics in the kits without or with one planecta port. However, optimisation is difficult with two or more planecta ports, even with the ROSE™ device.

Human Factors and ISS Medical Systems: Highlights of Procedures and Equipment Findings

NASA Technical Reports Server (NTRS)

Byrne, V. E.; Hudy, C.; Smith, D.; Whitmore, M.

2005-01-01

As part of the Space Human Factors Engineering Critical Questions Roadmap, a three year Technology Development Project (TDP) was funded by NASA Headquarters to examine emergency medical procedures on ISS. The overall aim of the emergency medical procedures project was to determine the human factors issues in the procedures, training, communications and equipment, and to recommend solutions that will improve the survival rate of crewmembers in the event of a medical emergency. Currently, each ISS crew remains on orbit for six month intervals. As there is not standing requirement for a physician crewmember, during such time, the maintenance of crew health is dependant on individual crewmembers. Further, in the event of an emergency, crew will need to provide prolonged maintenance care, as well as emergency treatment, to an injured crewmember while awaiting transport to Earth. In addition to the isolation of the crew, medical procedures must be carried out within the further limitations imposed by the physical environment of the space station. For example, in order to administer care on ISS without the benefit of gravity, the Crew Medical Officers (CMOs) must restrain the equipment required to perform the task, restrain the injured crewmember, and finally, restrain themselves. Both the physical environment and the physical space available further limit the technology that can be used onboard. Equipment must be compact, yet able to withstand high levels of radiation and function without gravity. The focus here is to highlight the human factors impacts from our three year project involving the procedures and equipment areas that have been investigated and provided valuable to ISS and provide groundwork for human factors requirements for medical applications for exploration missions.

Asteroid Redirect Crewed Mission Space Suit and EVA System Architecture Trade Study

NASA Technical Reports Server (NTRS)

Blanco, Raul A.; Bowie, Jonathan T.; Watson, Richard D.; Sipila, Stephanie A.

2014-01-01

The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability for Orion. The EVAs will involve a two-person crew for approximately four hours. Currently, two EVAs are planned with one contingency EVA in reserve. Providing this EVA capability is very challenging due to system level constraints and a new and unknown environment. The goal of the EVA architecture for ARCM is one that builds upon previously developed technologies and lessons learned, and that accomplishes the ARCM mission while providing a stepping stone to future missions and destinations. The primary system level constraints are to 1) minimize system mass and volume and 2) minimize the interfacing impacts to the baseline Orion design. In order to minimize the interfacing impacts and to not perturb the baseline Orion schedule, the concept of adding "kits" to the baseline system is proposed. These kits consist of: an EVA kit (converts LEA suit to EVA suit), EVA Servicing and Recharge Kit (provides suit consumables), the EVA Tools, Translation Aids & Sample Container Kit (the tools and mobility aids to complete the tasks), the EVA Communications Kit (interface between the EVA radio and the MPCV), and the Cabin Repress Kit (represses the MPCV between EVAs). This paper will focus on the trade space, analysis, and testing regarding the space suit (pressure garment and life support system). Historical approaches and lessons learned from all past EVA operations were researched. Previous and current, successfully operated EVA hardware and high technology readiness level (TRL) hardware were evaluated, and a trade study was conducted for all possible pressure garment and life support options. Testing and analysis was conducted and a recommended EVA system architecture was proposed. Pressure garment options that were considered for this mission include the currently in-use ISS EVA Mobility Unit (EMU), all variations of the Advanced Crew Escape Suit (ACES), and the Exploration Z-suit. For this mission, the pressure garment that was selected is the Modified ACES (MACES) with EVA enhancements. Life support options that were considered included short closed-loop umbilicals, long open-loop umbilicals, the currently in-use ISS EMU Portable Life Support System (PLSS), and the currently in development Exploration PLSS. For this mission, the life support option that was selected is the Exploration PLSS. The greatest risk in the proposed architecture is viewed to be the comfort and mobility of the baseline MACES and the delicate balance between adding more mobility features while not compromising landing safety. Feasibility testing was accomplished in low fidelity analogs and in the JSC Neutral Buoyancy Laboratory (NBL) to validate the concept before a final recommendation on the architecture was made. The proposed architecture was found to meet the mission constraints, but much more work is required to determine the details of the required suit upgrades, the integration with the PLSS, and the rest of the tools and equipment required to accomplish the mission. This work and further definition of the remaining kits will be conducted in government fiscal year 14.

SHOX gene defects and selected dysmorphic signs in patients of idiopathic short stature and Léri-Weill dyschondrosteosis.

PubMed

Hirschfeldova, K; Solc, R; Baxova, A; Zapletalova, J; Kebrdlova, V; Gaillyova, R; Prasilova, S; Soukalova, J; Mihalova, R; Lnenicka, P; Florianova, M; Stekrova, J

2012-01-10

The aim of the study was to analyze frequency of SHOX gene defects and selected dysmorphic signs in patients of both idiopathic short stature (ISS) and Léri-Weill dyschondrosteosis (LWD), all derived from the Czech population. Overall, 98 subjects were analyzed in the study. Inclusion criteria were the presence of short stature (-2.0 SD), in combination with at least one of the selected dysmorphic signs for the ISS+ group; and the presence of Madelung deformity, without positive karyotyping for the LWD+ group. Each proband was analyzed by use of P018 MLPA kit, which covers SHOX and its regulatory sequences. Additionally, mutational analysis was done of the coding portions of the SHOX. Both extent and breakpoint localizations in the deletions/duplications found were quite variable. Some PAR1 rearrangements were detected, without obvious phenotypic association. In the ISS+ group, MLPA analysis detected four PAR1 deletions associated with a SHOX gene defect, PAR1 duplication with an ambiguous effect, and two SHOX mutations (13.7%). In the LWD+ group, MLPA analysis detected nine deletions in PAR1 region, with a deleterious effect on SHOX, first reported case of isolated SHOX enhancer duplication, and SHOX mutation (68.8%). In both ISS+ and LWD+ groups were positivity associated with a disproportionately short stature; in the ISS+ group, in combination with muscular hypertrophy. It seems that small PAR1 rearrangements might be quite frequent in the population. Our study suggests disproportionateness, especially in combination with muscular hypertrophy, as relevant indicators of ISS to be the effect of SHOX defect. Copyright © 2011 Elsevier B.V. All rights reserved.

In-Flight Personalized Medication Management

NASA Technical Reports Server (NTRS)

Peletskaya, E.; Griko, Y. V.

2016-01-01

Current medication selection for treatment of astronauts during spaceflight missions is primarily dictated by the task of efficiently treating the widest possible range of physiological conditions and illnesses with a limited set of medications. Dosage and recommendations on the combination of drugs are based on the assumption of genetically equal drug sensitivity and unchanged metabolism. To our knowledge, there was no pre-flight drug sensitivity testing on a genetic level for any of the previous manned NASA space missions. Although many of the common, binary drug-drug interactions are, most likely, already considered in the ISS Medical kit composition, multi-drug and multi-drug-gene factors are not incorporated in the medication selection or prescription. Furthermore, due to the physiological changes occurring in microgravity environments, astronauts might be susceptible to potential increased drug toxicity as a result of decreased clearance of numerous drugs. In particular, perturbation of CYP450 enzymes which contribute to the hepatic metabolism of the majority of drugs may have significant effects on therapeutic efficacy and increase treatment-related toxicity5. The genes encoding the CYP450 enzymes are highly variable in humans. Inheritable variations of CYP450 hepatic metabolizer enzymes and transport proteins play a crucial role in the inter-individual variability of drug efficiency and risks of adverse drug reactions5. Additionally, there are some reports that document changes in the levels of production of drug-metabolizing enzymes in microgravity. These data can be extrapolated to provide reasonable assumptions of decreased levels of expression for most CYP450 enzymes in human body during prolonged space travel. If the prescribed medication regiment is not fully effective or causes undesirable side effects, the ability of the astronauts to function and maintain peak performance levels during space flight could be seriously compromised. Therefore, technologies capable of predicting and managing medication side effects, interactions, and toxicity of drugs during spaceflight are needed. We propose to develop and customize for NASAs applications available on the market Personalized Prescribing System (PPS) that would provide a comprehensive, non-invasive solution for safer, targeted medication management for every crew member resulting in safer and more effective treatment and, consequently, better performance. PPS will function as both decision support and record-keeping tool for flight surgeons and astronauts in applying the recommended medications for situations arising in flight. The information on individual drug sensitivity will translate into personalized risk assessment for adverse drug reactions and treatment failures for each drug from the medication kit as well as predefined outcome of any combination of them. Dosage recommendations will also be made individually. The mobile app will facilitate ease of use by crew and medical professionals during training and flight missions.

A model "go-kit" for use at Strategic National Stockpile Points of Dispensing.

PubMed

May, Larissa; Cote, Timothy; Hardeman, Bernard; Gonzalez, Gabriela R; Adams, Sherry B; Blair, Roderick K; Pane, Gregg

2007-01-01

The Strategic National Stockpile (SNS) is a national repository of pharmaceuticals and other medical supplies forseeably needed during a medical disaster. In the event of SNS deployment, state and local public health authorities must be prepared to receive, distribute, and dispense the materials. We propose a cache of supplies, termed the "POD go-kit," prepared in advance and locally available prior to the establishment of Points of Dispensing (POD) for SNS material. Characteristics of the preassembled go-kit are its multiplicity of use, ease of storage and transportation, minimal redundancy with SNS material, and packaging in a manner consistent with POD function. The POD go-kit is assembled into 4 separate "subkits": administrative supplies, patient routing supplies, dispensing supplies, and POD staff protection supplies. Incorporating existing practices from the SNS Listserv, this article itemizes the contents of the POD go-kit and its subkits and provides a rationale for its packaging. The Division of Strategic National Stockpile (DSNS) has not certified the proposed "POD go-kit" as a standardized POD go-kit.

Mobile chemical detector (AP2C+SP4E) as an aid for medical decision making in the battlefield.

PubMed

Eisenkraft, Arik; Markel, Gal; Simovich, Shirley; Layish, Ido; Hoffman, Azik; Finkelstein, Arseny; Rotman, Eran; Dushnitsky, Tsvika; Krivoy, Amir

2007-09-01

The combination of the AP2C unit with the SP4E kit composes a lightweight mobile detector of chemical warfare agents (CWA), such as nerve and mustard agents, with both vapor- and liquid-sampling capabilities. This apparatus was recently introduced into our military medical units as an aid for detection of CWA on casualties. Importantly, critical information regarding the applicability in the battlefield was absent. In view of the serious consequences that might follow a proclamation of CWA recognition in battlefield, a high false-positive rate positions the utilization of this apparatus as a medical decision tool in question. We have therefore conducted a field experiment to test the false-positive rate as well as analyze possible factors leading to false-positive readings with this device. The experiment was carried out before and after a 4-day army field exercise, using a standard AP2C device, a SP4E surface sampling kit, and a specially designed medical sampling kit for casualties, intended for medical teams. Soldiers were examined at rest, after mild exercise, and after 4 days in the field. The readings with AP2C alone were compared to the combination of AP2C and SP4E and to the medical sampling kit. Various body fluids served as negative controls. Remarkably, we found a false-positive rate of 57% at rest and after mild exercise, and an even higher rate of 64% after the 4-day field exercise with the AP2C detector alone, as compared to almost no false-positive readings with the combination of AP2C and SP4E. Strikingly, the medical sampling kit has yielded numerous false-positive readings, even in normal body fluids such as blood, urine, and saliva. We therefore see no place for using the medical sampling kit due to an unaccepted high rate of false-positive readings. Finally, we have designed an algorithm that uses the entire apparatus of AP2C and SP4E as a reliable validation tool for medical triage in the setting of exposure to nerve agents in the battlefield.

Kaleri sets up Russian MBI-12 Payload in the SM

NASA Image and Video Library

2010-12-09

ISS026-E-008718 (8 Dec. 2010) --- Russian cosmonaut Alexander Kaleri, Expedition 26 flight engineer, sets up the Russian MBI-12 payload for a Sonokard experiment session in the Zvezda Service Module of the International Space Station. Kaleri used a sports shirt from the Sonokard kit with a special device in the pocket for testing a new method for acquiring physiological data without using direct contact on the skin. Measurements are recorded on a data card for return to Earth.

Kondratvez sets up Sonokard Experiment in the SM during Expedition 26

NASA Image and Video Library

2011-01-03

ISS026-E-014250 (3 Jan. 2011) --- Russian cosmonaut Dmitry Kondratyev, Expedition 26 flight engineer, sets up the Russian MBI-12 payload for a Sonokard experiment session in the Zvezda Service Module of the International Space Station. Kondratyev used a sports shirt from the Sonokard kit with a special device in the pocket for testing a new method for acquiring physiological data without using direct contact on the skin. Measurements are recorded on a data card for return to Earth.

21 CFR 868.5140 - Anesthesia conduction kit.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Anesthesia conduction kit. 868.5140 Section 868.5140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5140 Anesthesia conduction kit. (a...

21 CFR 868.5140 - Anesthesia conduction kit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Anesthesia conduction kit. 868.5140 Section 868.5140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5140 Anesthesia conduction kit. (a...

Human Factors in Training: Space Medical Proficiency Training

NASA Technical Reports Server (NTRS)

Byrne, Vicky E.; Barshi, I.; Arsintescu, L.; Connell, E.

2010-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and the International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to the ISS, medical equipment will be located on the ISS, and carried into CEV in the event of an emergency. Flight surgeons (FS) on the ground in Mission Control will be expected to direct the crew medical officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). This is a joint project consisting of human factors team from the Ames Research Center (ARC) with Immanuel Barshi as Principal Investigator and the Johnson Space Center (JSC). Human factors researchers at JSC have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. Work on medical training has been conducted in collaboration with the Medical Training Group at the Johnson Space Center (JSC) and with Wyle Laboratories that provides medical training to crew members, biomedical engineers (BMEs), and to flight surgeons under the Bioastronautics contract. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. A second area of research involves FS performance support tools. Information needed by the FS during the ISS mission support, especially for an emergency situation (e.g., fire onboard ISS), may be located in many different places around the FS s console. A performance support tool prototype is being developed to address this issue by bringing all of the relevant information together in one place. The tool is designed to include procedures and other information needed by a FS during an emergency, as well as procedures and information to be used after the emergency is resolved. Several walkthroughs of the prototype with FSs have been completed within a mockup of an ISS FS console. Feedback on the current tool design as well as recommendations for existing ISS FS displays were captured. The tool could have different uses depending on the situation and the skill of the user. An experienced flight surgeon could use it during an emergency situation as a decision and performance support tool, whereas a new flight surgeon could use it as JITT, or part of his/her regular training. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research.

[The set of wearable medical equipment for medical and nursing teams].

PubMed

Efimenko, N a; Valevskii, V V; Lyutov, V V; Makhnovskii, A I; Sorokin, S I; Blinda, I V

2015-06-01

The kit is designed in accordance with the list of the first medical aid procedures and syndromic standards of emergency medical care providing. The kit contains modern local hemostatic agents, vent tubes, cricothyrotomy, needles to eliminate pneumothorax, portable oxygen machine, sets for intravenous and intraosseous infusion therapy, collapsible plastic tires, anti-shock pelvic girdle, and other medical products and pharmaceuticals. As containers used backpack and trolley bag on wheels camouflage colours. For the convenience and safety of the personnel of the vest is designed discharge to be converted in the body armour.

Effectiveness of Needles Vial Adaptors and Blunt Cannulas for Drug Administration in a Microgravity Environment

NASA Technical Reports Server (NTRS)

Hailey, Melinda; Bayuse, Tina

2009-01-01

The need for a new system of injectable medications aboard the International Space Station (ISS) was identified. It is desired that this system fly medications in their original manufacturer's packaging, allowing the system to comply with United States Pharmacopeia (USP) guidelines while minimizing the resupply frequency due to medication expiration. Pre-filled syringes are desired, however, the evolving nature of the healthcare marketplace requires flexibility in the redesign. If medications must be supplied in a vial, a system is required that allows for the safe withdrawal of medication from the vial into a syringe for administration in microgravity. During two reduced gravity flights, the effectiveness of two versions of a blunt cannula and needleless vial adaptors was evaluated to facilitate the withdrawal of liquid medication from a vial into a syringe for injection. Other parameters assessed included the ability to withdraw the required amount of medication and whether this is dependent on vial size, liquid, or the total volume of fluid within the vial. Injectable medications proposed for flight on ISS were used for this evaluation. Due to differing sizes of vials and the fluid properties of the medications, the needleless vial adaptors proved to be too cumbersome to recommend for use on the ISS. The blunt cannula, specifically the plastic version, proved to be more effective at removing medication from the various sizes of vials and are the recommended hardware for ISS. Fluid isolation within the vials and syringes is an important step in preparing medication for injection regardless of the hardware used. Although isolation is a challenge in the relatively short parabolas during flight, it is not an obstacle for sustained microgravity. This presentation will provide an overview of the products tested as well as the challenges identified during the microgravity flights.

A Survey of Staphylococcus sp and its Methicillin Resistance aboard the International Space Station

NASA Technical Reports Server (NTRS)

Bassinger, V. J.; Fontenot, S. L.; Castro, V. A.; Ott, C.; Healy, M.; Pierson, D. L.

2004-01-01

Background: Within the past few years, methicillin-resistant Staphylococcus aureus has emerged in environments with susceptible hosts in close proximity, such as hospitals and nursing homes. As the International Space Station (ISS) represents a semi-closed environment with a high level of crewmember interaction, an evaluation of isolates of clinical and environmental Staphylococcus aureus and coagulase negative Staphylococcus was performed to determine if this trend was also present in astronauts occupying ISS or on surfaces of the space station itself. Methods: Identification of isolates was completed using VITEK (GPI cards, BioMerieux), 16S ribosomal DNA analysis (MicroSeq 500, ABI), and Rep-PCR DNA fingerprinting (Divemilab, Bacterial Barcodes). Susceptibility tests were performed using VITEK (GPS-105 cards, BioMerieux) and resistance characteristics were evaluated by testing for the presence of the mecA gene (PBP2' MRSA test kit, Oxoid). Results: Rep-PCR analysis indicated the transfer of S. aureus between crewmembers and between crewmembers and ISS surfaces. While a variety of S. aureus were identified from both the crewmembers and environment, evaluations of the microbial population indicated minimal methicillin resistance. Results of this study indicated that within the semi-closed ISS environment, transfer of bacteria between crewmembers and their environment has been occurring, although there was no indication of a high concentration of methicillin resistant Staphylococcus species. Conclusions: While this study suggests that the spread of methicillin resistant S. aureus is not currently a concern aboard ISS, the increasing incidence of Earth-based antibiotic resistance indicates a need for continued clinical and environmental monitoring.

The European Astronaut Centre prepares for International Space Station operations.

PubMed

Messerschmid, E; Haignere, J P; Damian, K; Damann, V

2004-04-01

The European Space Agency (ESA) contribution to the International Space Station (ISS) goes much beyond the delivery of hardware like the Columbus Laboratory, its payloads and the Automated Transfer Vehicles. ESA Astronauts will be members of the ISS crew. ESA, according to its commitments as ISS international partner, will be responsible to provide training on its elements and payloads to all ISS crewmembers and medical support for ESA astronauts. The European Astronaut Centre (EAC) in Cologne has developed over more than a decade into the centre of expertise for manned space activities within ESA by contributing to a number of important co-operative spaceflight missions. This role will be significantly extended for ISS manned operations. Apart from its support to ESA astronauts and their onboard operations, EAC will have a key role in training all ISS astronauts on ESA elements and payloads. The medical support of ISS crew, in particular of ESA astronauts has already started. This paper provides an overview on status and further plans in building up this homebase function for ESA astronauts and on the preparation towards Training Readiness for ISS crew training at EAC, Cologne. Copyright 2001 by the European Space Agency. Published by the American Institute of Aeronautics and Astronautics, Inc., with permission. Released to IAF/IAA/AIAA to publish in all forms. c2003 Elsevier Ltd. All rights reserved.

21 CFR 864.9650 - Quality control kit for blood banking reagents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Quality control kit for blood banking reagents... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Products Used In Establishments That Manufacture Blood and Blood Products § 864.9650 Quality control kit for blood banking reagents. (a...

EAC training and medical support for International Space Station astronauts.

PubMed

Messerschmid, E; Haignere, J P; Damian, K; Damann, V

2000-11-01

The operation of the International Space Station (ISS) will be a global multilateral endeavour. Each International Partner will be responsible for the operation of its elements and for providing a crew complement proportional to its share of the overall resources. The preparations of the European Astronaut Centre to furnish training and medical support for the ISS astronauts are described.

Medical and Urologic Issues in Space Flight and Lunar/Mars Exploration

NASA Technical Reports Server (NTRS)

Jones, Jeffrey A.

2004-01-01

Dr. Jeffrey Jones will be talking about medical issues in space flight secondary to microgravity: fluid shifts, orthostatic changes, muscle and endurance losses, bone mineral losses, radiation exposure, etc. He will discuss the International Space Station (ISS) benefits to medicine. He will show the ISS crew video and share the President's new vision as per the speaker's bureau direction.

Cognitive Assessment During Long-Duration Space Flight

NASA Technical Reports Server (NTRS)

Seaton, Kimberly; Kane, R. L.; Sipes, Walter

2010-01-01

The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a computer-based, self-administered battery of five cognitive assessment tests developed for medical operations at NASA's Johnson Space Center in Houston, Texas. WinSCAT is a medical requirement for U.S. long-duration astronauts and has been implemented with U.S. astronauts from one NASA/Mir mission (NASA-7 mission) and all expeditions to date on the International Space Station (ISS). Its purpose is to provide ISS crew surgeons with an objective clinical tool after an unexpected traumatic event, a medical condition, or the cumulative effects of space flight that could negatively affect an astronaut's cognitive status and threaten mission success. WinSCAT was recently updated to add network capability to support a 6-person crew on the station support computers. Additionally, WinSCAT Version 2.0.28 has increased difficulty of items in Mathematics, increased number of items in Match-to-Sample, incorporates a moving rather than a fixed baseline, and implements stricter interpretation rules. ISS performance data were assessed to compare initial to modified interpretation rules for detecting potential changes in cognitive functioning during space flight. WinSCAT tests are routinely taken monthly during an ISS mission. Performance data from these ISS missions do not indicate significant cognitive decrements due to microgravity/space flight alone but have shown decrements. Applying the newly derived rules to ISS data results in a number of off-nominal performances at various times during and after flight.. Correlation to actual events is needed, but possible explanations for off-nominal performances could include actual physical factors such as toxic exposure, medication effects, or fatigue; emotional factors including stress from the mission or life events; or failure to exert adequate effort on the tests.

Diagnostic Imaging in the Medical Support of the Future Missions to the Moon

NASA Technical Reports Server (NTRS)

Sargsyan, Ashot E.; Jones, Jeffrey A.; Hamilton, Douglas R.; Dulchavsky, Scott A.; Duncan, J. Michael

2007-01-01

This viewgraph presentation is a course that reviews the diagnostic imaging techniques available for medical support on the future moon missions. The educational objectives of the course are to: 1) Update the audience on the curreultrasound imaging in space flight; 2) Discuss the unique aspects of conducting ultrasound imaging on ISS, interplanetary transit, ultrasound imaging on ISS, interplanetary transit, and lunar surface operations; and 3) Review preliminary data obtained in simulations of medical imaging in lunar surface operations.

Telescience Resource Kit (TReK)

NASA Technical Reports Server (NTRS)

Lippincott, Jeff

2015-01-01

Telescience Resource Kit (TReK) is one of the Huntsville Operations Support Center (HOSC) remote operations solutions. It can be used to monitor and control International Space Station (ISS) payloads from anywhere in the world. It is comprised of a suite of software applications and libraries that provide generic data system capabilities and access to HOSC services. The TReK Software has been operational since 2000. A new cross-platform version of TReK is under development. The new software is being released in phases during the 2014-2016 timeframe. The TReK Release 3.x series of software is the original TReK software that has been operational since 2000. This software runs on Windows. It contains capabilities to support traditional telemetry and commanding using CCSDS (Consultative Committee for Space Data Systems) packets. The TReK Release 4.x series of software is the new cross platform software. It runs on Windows and Linux. The new TReK software will support communication using standard IP protocols and traditional telemetry and commanding. All the software listed above is compatible and can be installed and run together on Windows. The new TReK software contains a suite of software that can be used by payload developers on the ground and onboard (TReK Toolkit). TReK Toolkit is a suite of lightweight libraries and utility applications for use onboard and on the ground. TReK Desktop is the full suite of TReK software -most useful on the ground. When TReK Desktop is released, the TReK installation program will provide the option to choose just the TReK Toolkit portion of the software or the full TReK Desktop suite. The ISS program is providing the TReK Toolkit software as a generic flight software capability offered as a standard service to payloads. TReK Software Verification was conducted during the April/May 2015 timeframe. Payload teams using the TReK software onboard can reference the TReK software verification. TReK will be demonstrated on-orbit running on an ISS provided T61p laptop. Target Timeframe: September 2015 -2016. The on-orbit demonstration will collect benchmark metrics, and will be used in the future to provide live demonstrations during ISS Payload Conferences. Benchmark metrics and demonstrations will address the protocols described in SSP 52050-0047 Ku Forward section 3.3.7. (Associated term: CCSDS File Delivery Protocol (CFDP)).

Performance of the Extravehicular Mobility Unit (EMU): Airlock Coolant Loop Recovery (A/L CLR) Hardware - Phase II

NASA Technical Reports Server (NTRS)

Steele, John; Rector, tony; Gazda, Daniel; Lewis, John

2009-01-01

An EMU water processing kit (Airlock Coolant Loop Recovery A/L CLR) was developed as a corrective action to Extravehicular Mobility Unit (EMU) coolant flow disruptions experienced on the International Space Station (ISS) in May of 2004 and thereafter. Conservative schedules for A/L CLR use and component life were initially developed and implemented based on prior analysis results and analytical modeling. The examination of postflight samples and EMU hardware in November of 2006 indicated that the A/L CLR kits were functioning well and had excess capacity that would allow a relaxation of the initially conservative schedules of use and component life. A relaxed use schedule and list of component lives was implemented thereafter. Since the adoption of the relaxed A/L CLR schedules of use and component lives, several A/L CLR kit components, transport loop water samples and sensitive EMU transport loop components have been examined to gage the impact of the relaxed requirements. The intent of this paper is to summarize the findings of that evaluation, and to outline updated schedules for A/L CLR use and component life.

Clarifying the learning experiences of healthcare professionals with in situ and off-site simulation-based medical education: a qualitative study

PubMed Central

Sørensen, Jette Led; Navne, Laura Emdal; Martin, Helle Max; Ottesen, Bent; Albrecthsen, Charlotte Krebs; Pedersen, Berit Woetmann; Kjærgaard, Hanne; van der Vleuten, Cees

2015-01-01

Objective To examine how the setting in in situ simulation (ISS) and off-site simulation (OSS) in simulation-based medical education affects the perceptions and learning experience of healthcare professionals. Design Qualitative study using focus groups and content analysis. Participants Twenty-five healthcare professionals (obstetricians, midwives, auxiliary nurses, anaesthesiologists, a nurse anaesthetist and operating theatre nurse) participated in four focus groups and were recruited due to their exposure to either ISS or OSS in multidisciplinary obstetric emergencies in a randomised trial. Setting Departments of obstetrics and anaesthesia, Rigshospitalet, Copenhagen, Denmark. Results Initially participants preferred ISS, but this changed after the training when the simulation site became of less importance. There was a strong preference for simulation in authentic roles. These perceptions were independent of the ISS or OSS setting. Several positive and negative factors in simulation were identified, but these had no relation to the simulation setting. Participants from ISS and OSS generated a better understanding of and collaboration with the various health professionals. They also provided individual and team reflections on learning. ISS participants described more experiences that would involve organisational changes than the OSS participants did. Conclusions Many psychological and sociological aspects related to the authenticity of the learning experience are important in simulation, but the physical setting of the simulation as an ISS and OSS is the least important. Based on these focus groups OSS can be used provided that all other authenticity elements are taken into consideration and respected. The only difference was that ISS had an organisational impact and ISS participants talked more about issues that would involve practical organisational changes. ISS and OSS participants did, however, go through similar individual and team learning experiences. PMID:26443655

Shuttle Kit Freezer Refrigeration Unit Conceptual Design

NASA Technical Reports Server (NTRS)

Copeland, R. J.

1975-01-01

The refrigerated food/medical sample storage compartment as a kit to the space shuttle orbiter is examined. To maintain the -10 F in the freezer kit, an active refrigeration unit is required, and an air cooled Stirling Cycle refrigerator was selected. The freezer kit contains two subsystems, the refrigeration unit, and the storage volume. The freezer must provide two basic capabilities in one unit. One requirement is to store 215 lbs of food which is consumed in a 30-day period by 7 people. The other requirement is to store 128.3 lbs of medical samples consisting of both urine and feces. The unit can be mounted on the lower deck of the shuttle cabin, and will occupy four standard payload module compartments on the forward bulkhead. The freezer contains four storage compartments.

33 CFR 149.323 - What are the requirements for first aid kits?

Code of Federal Regulations, 2014 CFR

2014-07-01

... organization, such as the American Red Cross, for the maximum number of persons on the deepwater port. (b) The first aid kit must be maintained in a space designated as a medical treatment room or, if there is no medical treatment room, under the custody of the person in charge. (c) The operator must ensure that each...

33 CFR 149.323 - What are the requirements for first aid kits?

Code of Federal Regulations, 2012 CFR

2012-07-01

... organization, such as the American Red Cross, for the maximum number of persons on the deepwater port. (b) The first aid kit must be maintained in a space designated as a medical treatment room or, if there is no medical treatment room, under the custody of the person in charge. (c) The operator must ensure that each...

33 CFR 149.323 - What are the requirements for first aid kits?

Code of Federal Regulations, 2011 CFR

2011-07-01

... organization, such as the American Red Cross, for the maximum number of persons on the deepwater port. (b) The first aid kit must be maintained in a space designated as a medical treatment room or, if there is no medical treatment room, under the custody of the person in charge. (c) The operator must ensure that each...

33 CFR 149.323 - What are the requirements for first aid kits?

Code of Federal Regulations, 2013 CFR

2013-07-01

... organization, such as the American Red Cross, for the maximum number of persons on the deepwater port. (b) The first aid kit must be maintained in a space designated as a medical treatment room or, if there is no medical treatment room, under the custody of the person in charge. (c) The operator must ensure that each...

Capabilities, Calibration, and Impact of the ISS-RAD Fast Neutron Detector

NASA Technical Reports Server (NTRS)

Leitgab, Martin

2015-01-01

In the current NASA crew radiation health risk assessment framework, estimates for the neutron contributions to crew radiation exposure largely rely on simulated data with sizeable uncertainties due to the lack of experimental measurements inside the ISS. Integrated in the ISS-RAD instrument, the ISS-RAD Fast Neutron Detector (FND) will deploy to the ISS on one of the next cargo supply missions. Together with the ISS-RAD Charged Particle Detector, the FND will perform, for the first time, routine and precise direct neutron measurements inside the ISS between 0.5 and 80 MeV. The measurements will close the NASA Medical Operations Requirement to monitor neutrons inside the ISS and impact crew radiation health risk assessments by reducing uncertainties on the neutron contribution to crew exposure, enabling more efficient mission planning. The presentation will focus on the FND detection mechanism, calibration results and expectations about the FND's interaction with the mixed radiation field inside the ISS.

14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

Code of Federal Regulations, 2013 CFR

2013-01-01

..., 50cc 1 Epinephrine 1:1000, single dose ampule or equivalent) 2 Diphenhydramine HC1 injection, single dose ampule or equivalent 2 Nitroglycerin tablets 10 Basic instructions for use of the drugs in the kit 1 protective nonpermeable gloves or equivalent 1 pair 2. As of April 12, 2004, at least one approved...

14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

Code of Federal Regulations, 2010 CFR

2010-01-01

..., 50cc 1 Epinephrine 1:1000, single dose ampule or equivalent) 2 Diphenhydramine HC1 injection, single dose ampule or equivalent 2 Nitroglycerin tablets 10 Basic instructions for use of the drugs in the kit 1 protective nonpermeable gloves or equivalent 1 pair 2. As of April 12, 2004, at least one approved...

14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

Code of Federal Regulations, 2014 CFR

2014-01-01

..., 50cc 1 Epinephrine 1:1000, single dose ampule or equivalent) 2 Diphenhydramine HC1 injection, single dose ampule or equivalent 2 Nitroglycerin tablets 10 Basic instructions for use of the drugs in the kit 1 protective nonpermeable gloves or equivalent 1 pair 2. As of April 12, 2004, at least one approved...

14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

Code of Federal Regulations, 2011 CFR

2011-01-01

..., 50cc 1 Epinephrine 1:1000, single dose ampule or equivalent) 2 Diphenhydramine HC1 injection, single dose ampule or equivalent 2 Nitroglycerin tablets 10 Basic instructions for use of the drugs in the kit 1 protective nonpermeable gloves or equivalent 1 pair 2. As of April 12, 2004, at least one approved...

14 CFR Appendix A to Part 121 - First Aid Kits and Emergency Medical Kits

Code of Federal Regulations, 2012 CFR

2012-01-01

..., 50cc 1 Epinephrine 1:1000, single dose ampule or equivalent) 2 Diphenhydramine HC1 injection, single dose ampule or equivalent 2 Nitroglycerin tablets 10 Basic instructions for use of the drugs in the kit 1 protective nonpermeable gloves or equivalent 1 pair 2. As of April 12, 2004, at least one approved...

Evaluation of the Coca-Cola company travel health kit.

PubMed

Harper, Lynne A; Bettinger, Julie; Dismukes, Roberta; Kozarsky, Phyllis E

2002-01-01

The Coca-Cola travel health kit has been used for about one decade for international travelers and required evaluation to see if the items contained were appropriate for the employees. Two hundred thirty-four travelers were sampled and filled out a voluntary survey including questions about demographic information, travel history, and usage and value of the contents of the travel health kit. One hundred eighty-one surveys were returned; 65% of the respondents were male, and the majority of travelers were between the ages of 36 and 45 years. The most useful items were analgesics and medications used for gastrointestinal problems. In general, the items identified as being the least useful were those requiring specialized use by a medical practitioner, such as needles and syringes. Suggestions of items to be added to the kit included vitamins, cough drops, sleep aids, and eye drops. A surprising result that Coca-Cola employees expressed the desire for brand name rather than generic items. Evaluation of the Coca-Cola Company travel health kit revealed it to be very useful to most corporate travelers. Suggestions that were made will be taken into consideration in designing a new kit, and consideration is being given to whether a basic travel health kit should be provided to which travelers can add other items depending on their personal needs.

Science on the International Space Station: Stepping Stones for Exploration

NASA Technical Reports Server (NTRS)

Robinson, Julie A.

2007-01-01

This viewgraph presentation reviews the state of science research on the International Space Station (ISS). The shuttle and other missions that have delivered science research facilities to the ISS are shown. The different research facilities provided by both NASA and partner organizations available for use and future facilities are reviewed. The science that has been already completed is discussed. The research facilitates the Vision for Space Exploration, in Human Life Sciences, Biological Sciences, Materials Science, Fluids Science, Combustion Science, and all other sciences. The ISS Focus for NASA involves: Astronaut health and countermeasure, development to protect crews from the space environment during long duration voyages, Testing research and technology developments for future exploration missions, Developing and validating operational procedures for long-duration space missions. The ISS Medical Project (ISSMP) address both space systems and human systems. ISSMP has been developed to maximize the utilization of ISS to obtain solutions to the human health and performance problems and the associated mission risks of exploration class missions. Including complete programmatic review with medical operations (space medicine/flight surgeons) to identify: (1) evidence base on risks (2) gap analysis.

Validity of Soccer Injury Data from the National Collegiate Athletic Association's Injury Surveillance System

PubMed Central

Kucera, Kristen L.; Marshall, Stephen W.; Bell, David R.; DiStefano, Michael J.; Goerger, Candice P.; Oyama, Sakiko

2011-01-01

Context: Few validation studies of sport injury-surveillance systems are available. Objective: To determine the validity of a Web-based system for surveillance of collegiate sport injuries, the Injury Surveillance System (ISS) of the National Collegiate Athletic Association's (NCAA). Design: Validation study comparing NCAA ISS data from 2 fall collegiate sports (men's and women's soccer) with other types of clinical records maintained by certified athletic trainers. Setting: A purposive sample of 15 NCAA colleges and universities that provided NCAA ISS data on both men's and women's soccer for at least 2 years during 2005–2007, stratified by playing division. Patients or Other Participants: A total of 737 men's and women's soccer athletes and 37 athletic trainers at these 15 institutions. Main Outcome Measure(s): The proportion of injuries captured by the NCAA ISS (capture rate) was estimated by comparing NCAA ISS data with the other clinical records on the same athletes maintained by the athletic trainers. We reviewed all athletic injury events resulting from participation in NCAA collegiate sports that resulted in 1 day or more of restricted activity in games or practices and necessitated medical care. A capture-recapture analysis estimated the proportion of injury events captured by the NCAA ISS. Agreement for key data fields was also measured. Results: We analyzed 664 injury events. The NCAA ISS captured 88.3% (95% confidence interval = 85.9%, 90.8%) of all time-lost medical-attention injury events. The proportion of injury events captured by the NCAA ISS was higher in Division I (93.8%) and Division II (89.6%) than in Division III (82.3%) schools. Agreement between the NCAA ISS data and the non–NCAA ISS data was good for the majority of data fields but low for date of full return and days lost from sport participation. Conclusions: The overall capture rate of the NCAA ISS was very good (88%) in men's and women's soccer for this period. PMID:22488136

ISS: A Science Classroom for America

NASA Astrophysics Data System (ADS)

McPherson, Alexander; Jenkins, Greg; Kenny, Nate

2002-01-01

Four years ago the scientific and engineering staff of our laboratory at the University of California Irvine initiated a student outreach program with the objective of teaching structural biology through involvement with scientific experiments on the International Space Station. That program is now active in 28 of the 50 United States, and has reached approximately 1100 middle and high school teachers, and 50,000 of their students. It will soon have a presence in every state through the support of NASA, The Space Grant Consortium, and a host of other private and public sector institutions. The program is based on a protein and virus crystallization experiment we are conducting at regular intervals of about 2-6 months on the International Space Station. The experiment utilizes a device called the Enhanced GN2 Dewar, and it has now been flown to Mir and the International Space Station more than ten times. The Enhanced GN2 Dewar is an extremely inexpensive, simple, high capacity system for the crystallization of macromolecules, including proteins, nucleic acids, and viruses, in a microgravity environment aboard the ISS (International Space Station). The samples, which are prepared by hand, are frozen by plunging them into liquid nitrogen and maintained in a common freezer until the time of mission launch. The Dewar keeps the samples frozen for periods up to twelve days, including that period during which they are placed on board the Space Shuttle, carried into space from Kennedy Space Center, and transferred to the ISS. We began the classroom experiments in November 1998 and the first workshop was given in January 1999. We have participated in four missions to the ISS. STS-106 on 9/8/2000, STS-98 on 2/7/2001, STS-104 on 7/12/2001, and STS-110 on 4/8/2002. To date we have conducted 28 teacher kit training workshops and 24-flight sample loading workshops. We have had 406 students and 266 teachers load actual flight samples. These participants selected through essay and project competitions were from AL, CA, GA, TN, FL, MI, TX, IN, IL, OH, and WV. We have had over 800 teachers from 35 different states participate in our kit training workshops. Our classroom experiment has been a huge success. Approximately 50,000 kids have done the classroom experiment with participants from AL, AZ, AR, CA, CO, GA, LA, FL, PA, MO, NM, MN, MS, TN, KY, NC, NY, NJ, OH, WV, PR,TX, WI, SC, MI, MA, IL, IN, VA, and MT. ISS will, therefore, serve, not only as a science laboratory for researchers, but as a science classroom for America.

[Correlation of Th17 Cells and IL-17 Level in Multiple Myeloma Patients with Pathogenesis of Multiple Myeloma].

PubMed

DU, Chao-Yang; Yang, Ru-Yu; Li, Chao; Duan, Li-Juan

2017-02-01

To explore the correlation of Th17 cell rate and IL-17 level with pathogenetis of multiple myeloma(MM). Forty-five cases of MM were enrolled in MM group, while 45 healthy volunteers were selected in control group. The rate of Th17 cells, levels of IL-17 and β2-microglobulin(β2-MG) in patients subgrouping according to ISS staging and treatment were detected by using flow cytometer and IL-17 assay kit. The correlation of Th17 cell rate and IL-17 level with MM was analyzed. The rate of Th17 cells and level of IL-17 in MM group were higher than those in control group(P<0.05), the rate of Th17 cells and level of IL-17 in ISS III stage patients were higher than those in ISS I and II stage patients(P<0.05); the rate of Th17 cells and level of IL-17 in ISS I and ISS II stage patients were not significant difference (P>0.05); the rate of Th17 cells and level of IL-17 in firstly treated, retreated/refractory patients were significantly higher than those in patients with effective treatment(P<0.05), while the rate of Th17 cells and level of IL-17 between firstly treated patients and retreated/refractory patients were not significant difference (P>0.05). The Th17 rate and IL-17 level in MM patients positively correlated with β2-MG level (r=0.422, r=0.416, P<0.05). The obvious increase of Th17 rate, IL-17 and β2-MG levels closely relates with pathogenesis of MM. The Th17 rate and IL-17 level may be used as important evidence for evaluation of ISS stage and therapeutic efficacy of MM.

The Problem of Untested Sexual Assault Kits: Why Are Some Kits Never Submitted to a Crime Laboratory?

ERIC Educational Resources Information Center

Patterson, Debra; Campbell, Rebecca

2012-01-01

Victims of sexual assault are often advised to seek postassault medical care to have a forensic exam, which includes evidence collection (termed a "sexual assault kit" [SAK]). After the exam, law enforcement personnel are supposed to submit the SAK to a crime laboratory for analysis. However, recent media reports suggest that in many communities…

15 CFR 742.2 - Proliferation of chemical and biological weapons.

Code of Federal Regulations, 2011 CFR

2011-01-01

... medical, analytical, diagnostic, and food testing kits that consist of pre-packaged materials of defined... health purposes: (1) Test kits containing no more than 300 grams of any chemical controlled by ECCN 1C350... part 745 of the EAR). Such test kits are controlled by ECCN 1C395 for CB and CW reasons, to States not...

15 CFR 742.2 - Proliferation of chemical and biological weapons.

Code of Federal Regulations, 2013 CFR

2013-01-01

... medical, analytical, diagnostic, and food testing kits that consist of pre-packaged materials of defined... health purposes: (1) Test kits containing no more than 300 grams of any chemical controlled by ECCN 1C350... part 745 of the EAR). Such test kits are controlled by ECCN 1C395 for CB and CW reasons, to States not...

In-flight medical incidents in the NASA-Mir program.

PubMed

Gontcharov, Igor B; Kovachevich, Irina V; Pool, Sam L; Navinkov, Oleg L; Barratt, Michael R; Bogomolov, Valery V; House, Nancy

2005-07-01

This paper summarizes medical experience during the six NASA-Mir flights from March 14, 1995, to June 4, 1998. There were 7 U.S. astronauts who were part of 6 Mir space crews and worked jointly with 12 Russian cosmonauts. Advances in space medicine have created a safer environment; however, experience shows that crewmembers experience traumatic injuries and illnesses of diverse etiologies during spaceflight. During these joint flights both Russian and U.S. medical kits were available to crewmembers who could access either medical kit as appropriate. The Russian medical team had primary responsibility for monitoring and care of all crewmembers and analyzing medical results. When medical incidents occurred, the appropriate Russian or U.S. medical team determined the plan for diagnosis and treatment. Each team kept the other informed regarding medical situations during the flights and strictly observed the principles of medical confidentiality. A summary of medical incidents by programmatic element is described as experienced by the crewmembers and the ground support medical teams. The most frequent medical cases were small traumatic injuries to the skin and mucous membranes and fluctuations in the cardiovascular system, manifesting primarily in the form of cardiac dysrhythmias. The ability to use both the Russian medical aids and the U.S. medical kit significantly increased the effectiveness and reliability of therapeutic and prophylactic care. The degree of medical care and cooperation established precedents for integrating these systems for the medical support of expeditions on the International Space Station.

Rapid Biochemical Analysis on the International Space Station (ISS): Preparing for Human Exploration of the Moon and Mars

NASA Technical Reports Server (NTRS)

Maule, J.; Morris, Heather; Monaco, L.; Steele, A.; Wainwright, N.

2008-01-01

The Lab-on-a-Chip Application Development - Portable Test System, known as LOCAD-PTS, was launched to the International Space Station (ISS) aboard Space Shuttle Discovery (STS-116) on December 9th,2006. Since that time, it has remained onboard ISS and has been operated by the crew on 10 separate occasions LOCAD-PTS is a handheld device for rapid biochemical analysis; it consists of a spectrophotometer, a series of interchangeable cartridges, a pipette and several clean/sterilized swabbing kits to obtain samples from ISS surfaces. Sampling, quantitative analysis and data retrieval is performed onboard, therefore reducing the need to return samples to Earth. Less than 20 minutes are required from sampling to data, significantly faster than existing culture-based methods on ISS, which require 3-5 days. Different cartridges are available for the detection of different target molecules (simply by changing the formulation within each cartridge), thereby maximizing the benefit and applications addressed by a single instrument. Initial tests on ISS have focused on the detection of the bact.erial macromolecule endotoxin, a component of bacterial cell walls. LOCAD-PTS detects endotoxin with a cartridge that contains a formulation known as Limulus Amebocyte Lysate (LAL) assay. LAL is derived from blood of the horseshoe crab, Limulus polyphemus, and detects enodotoxin with an enzyme cascade that triggers generation Of a yellow colored dye, p-nitroanaline. The more p-nitroanaline product, the more endotoxin is in the original sample. To enable quantitative analysis, the absorbance of this color is measured by LOCAD-PTS through a 395 nm filter and compared with an internal calibration curve, to provide a reading on the LED display that ranges from 0.05 Endotoxin Units (EU)/ml to 5 EU/ml. Several surface sites were analyzed within ISS between March 2007 and February 2008, including multiple locations in the US Laboratory Destiny, Node 1 Unity, AMock, and Service Module Zvezda. The goals of this initial study were to i) test the cleanliness of reagents/supplies on orbit, ii) test the crew's ability to collect and process a sample in microgravity without contamination, iii) demonstrate nominal function of the LOCAD-PTS, and iv) provide a general survey of endotoxin within the ISS. The surface sites varied greatly in terms of their frequency-of-use and material texture/composition; from relatively smooth aluminum, to fabric, to the room temperature vulcanizing (RTV) rubber of a Extravehicular Mobility Unit (EMU) spacesuit. Results showed that: i) the swabbing kits and reagents remained clean on orbit, ii) the crew could collect and process a sample without contamination, and iii) the LOCAD-PTS functioned nominally in > 99% of the 55 tests completed. We will present detailed results of the survey of endotoxin on ISS surfaces. These results and technology are important in the near-term - by providing an extra tool in the toolbox for ISS microbial monitoring. They are also important in the longer term as valuable preparation for human exploration of the Moon and Mars. One of the proposed science goals for the human exploration of Mars will be to detect and characterize any indigenous biological molecules that may exist on the Martian surface. To achieve that goal, the crew must have the technology available onboard to differentiate indigenous biology from any terrestrial biological material brought to Mars by the spacecraft and crew (termed 'forward contamination'). The LAL assay is already one of the official methods used by NASA's planetary protection program to certify cleanliness of interplanetary robotic spacecraft prior to launch; and therefore endotoxin is a good marker of forward contamination (as well as other microbial molecules detectable with LOCAD-PTS e.g. box-1, 3-glucan and lipoteichoic acid). Furthermore, the distribution and abundance of these molecules on the ISS provides a good indicator of what to expect on the Crew Exploratioehicle Orion, the lunar lander Antares, and future crewed spacecraft destined for Mars. In addition, technology such as LOCAD-PTS has been proposed to help evaluate forward contamination during lunar surface operations by the crew, as preparation for the human exploration of Mars.

Pediatric emergencies on a US-based commercial airline.

PubMed

Moore, Brian R; Ping, Jennifer M; Claypool, David W

2005-11-01

The purpose of this investigation was to determine the incidence and character of pediatric emergencies on a US-based commercial airline and to evaluate current in-flight medical kits. In-flight consultations to a major US airline by a member of our staff are recorded in an institutional database. In this observational retrospective review, the database was queried for consultations for all passengers up to 18 years old between January 1, 1995, and December 31, 2002. Consultations were reviewed for type of emergency, use of the medical kit, and unscheduled landings. Two hundred twenty-two pediatric consultations were identified, representing 1 pediatric call per 20,775 flights. The mean age of patients was 6.8 years. Fifty-three emergencies were preflight calls, and 169 were in-flight pediatric consultations. The most common in-flight consultations concerned infectious disease (45 calls, 27%), neurological (25 calls, 15%), and respiratory tract (22 calls, 13%) emergencies. The emergency medical kit was used for 60 emergencies. Nineteen consultations (11%) resulted in flight diversions (1/240,000 flights), most commonly because of in-flight neurological (9) and respiratory tract (5) emergencies. International flights had a higher incidence than domestic flights of consultations and diversions for pediatric emergencies. The most common in-flight pediatric emergencies involved infectious diseases and neurological and respiratory tract problems. Emergency medical kits should be expanded to include pediatric medications.

Microbiology and Crew Medical Events on the International Space Station

NASA Technical Reports Server (NTRS)

Oubre, Cherie M.; Charvat, Jacqueline M.; Kadwa, Biniafer; Taiym, Wafa; Ott, C. Mark; Pierson, Duane; Baalen, Mary Van

2014-01-01

The closed environment of the International Space Station (ISS) creates an ideal environment for microbial growth. Previous studies have identified the ubiquitous nature of microorganisms throughout the space station environment. To ensure safety of the crew, microbial monitoring of air and surface within ISS began in December 2000 and continues to be monitored on a quarterly basis. Water monitoring began in 2009 when the potable water dispenser was installed on ISS. However, it is unknown if high microbial counts are associated with inflight medical events. The microbial counts are determined for the air, surface, and water samples collected during flight operations and samples are returned to the Microbiology laboratory at the Johnson Space Center for identification. Instances of microbial counts above the established microbial limit requirements were noted and compared inflight medical events (any non-injury event such as illness, rashes, etc.) that were reported during the same calendar-quarter. Data were analyzed using repeated measures logistic regression for the forty-one US astronauts flew on ISS between 2000 and 2012. In that time frame, instances of microbial counts being above established limits were found for 10 times for air samples, 22 times for surface samples and twice for water. Seventy-eight inflight medical events were reported among the astronauts. A three times greater risk of a medical event was found when microbial samples were found to be high (OR = 3.01; p =.007). Engineering controls, crew training, and strict microbial limits have been established to mitigate the crew medical events and environmental risks. Due to the timing issues of sampling and the samples return to earth, identification of particular microorganisms causing a particular inflight medical event is difficult. Further analyses are underway.

Microbiological Contamination of Spacecraft

NASA Technical Reports Server (NTRS)

Pierson, D. L.; Bruce, R. J.; Groves, T. O.; Novikova, N. D.; Viktorov, A. N.

2000-01-01

The International Space Station (ISS) Phase1 Program resulted in seven US astronauts residing aboard the Russian Space Station Mir between March 1995 and May 1998. Collaboration between U.S. and Russian scientists consisted of collection and analyses of samples from the crewmembers and the Mir and Shuttle environments before, during, and after missions that lasted from 75 to 209 days in duration. The effects of long-duration space flight on the microbial characteristics of closed life support systems and the interactions of microbes with the spacecraft environment and crewmembers were investigated. Air samples were collected using a Russian or U.S.-supplied sampler (SAS, RCS, or Burkard,) while surface samples were collected using contact slides (Hycon) or swabs. Mir recycled condensate and stored potable water sources were analyzed using the U.S.-supplied Water Experiment Kit. In-flight analysis consisted of enumeration of levels of bacteria and fungi. Amounts of microorganisms seen in the air and on surfaces were mostly within acceptability lin1its; observed temporal fluctuations in levels of microbes probably reflect changes in environmental conditions (e.g., humidity). All Mir galley hot water samples were within the standards set for Mir and the ISS. Microbial isolates were returned to Earth for identification of bacterial and fungal isolates. Crew samples (nose, throat, skin, urine, and feces) were analyzed using methods approved for the medical evaluations of Shuttle flight crews. No significant changes in crew microbiota were found during space flight or upon return relative to preflight results. Dissemination of microbes between the crew and environment was demonstrated by D A fingerprinting. Some biodegradation of spacecraft materials was observed. Accumulation of condensate allowed for the recovery of a wide range of bacteria and fungi as well as some protozoa and dust mites.

Aeromedical Disposition and Waiver Consideration for ISS Crewmembers

NASA Technical Reports Server (NTRS)

Taddeo, Terrance

2012-01-01

Aeromedical certification of astronauts and cosmonauts traveling to the International Space Station is a multi?-tiered process that involv es standards agreed to by the partner agencies, and participation by the individual agency aeromedical boards and a multilateral space medi cine board. Medical standards are updated continually by a multilater al working group. The boards operate by consensus and strive to achie ve effective decision making through experience, medical judgment, medical evidence and risk modeling. The aim of the certification process is to minimize the risk to the ISS program of loss of mission object ives due to human health issues.

Chemical Potency and Degradation Products of Medications Stored Over 550 Earth Days at the International Space Station.

PubMed

Wotring, Virginia E

2016-01-01

Medications degrade over time, and degradation is hastened by extreme storage conditions. Current procedures ensure that medications aboard the International Space Station (ISS) are restocked before their expiration dates, but resupply may not be possible on future long-duration exploration missions. For this reason, medications stored on the ISS were returned to Earth for analysis. This was an opportunistic, observational pilot-scale investigation to test the hypothesis that ISS-aging does not cause unusual degradation. Nine medications were analyzed for active pharmaceutical ingredient (API) content and degradant amounts; results were compared to 2012 United States Pharmacopeia (USP) requirements. The medications were two sleep aids, two antihistamines/decongestants, three pain relievers, an antidiarrheal, and an alertness medication. Because the samples were obtained opportunistically from unused medical supplies, each medication was available at only 1 time point and no control samples (samples aged for a similar period on Earth) were available. One medication met USP requirements 5 months after its expiration date. Four of the nine (44% of those tested) medications tested met USP requirements 8 months post expiration. Another three medications (33%) met USP guidelines 2-3 months before expiration. One compound, a dietary supplement used as a sleep aid, failed to meet USP requirements at 11 months post expiration. No unusual degradation products were identified. Limited, evidence-based extension of medication shelf-lives may be possible and would be useful in preparation for lengthy exploration missions. Only analysis of flight-aged samples compared to appropriately matched ground controls will permit determination of the spaceflight environment on medication stability.

[Retrospective computation of the ISS in multiple trauma patients: Potential pitfalls and limitations of findings in full body CT scans].

PubMed

Bogner, V; Brumann, M; Kusmenkov, T; Kanz, K G; Wierer, M; Berger, F; Mutschler, W

2016-03-01

The Injury Severity Score (ISS) is a well-established anatomical scoring system for polytraumatized patients. However, any inaccuracy in the Abbreviated Injury Score (AIS) directly increases the ISS impreciseness. Using the full body computed tomography (CT) scan report, ISS computation can be associated with certain pitfalls. This study evaluates interpretation variations depending on radiological reports and indicates requirements to reliably determine the ISS. The ISS of 81 polytraumatized patients was calculated based on the full body CT scan report. If an injury could not be attributed to a precise AIS cipher, the minimal and maximal ISS was computed. Real ISS included all conducted investigations, intraoperative findings, and final medical reports. The differences in ISS min, ISS max, and ISS real were evaluated using the Kruskal-Wallis test (p<0.05) and plotted in a linear regression analysis. Mean ISS min was 24.0 (± 0.7 SEM) points, mean ISS real 38.6 (±1.3 SEM) and mean ISS max was 48.3 (±1.4 SEM) points. All means were significantly different compared to one another (p<0.001). The difference between possible and real ISS showed a distinctive variation. Mean deviation was 9.7 (±0.9 SEM) points downward and 14.5 (±1.1 SEM) points upward. The difference between deviation to ISS min and ISS max was highly significant (p<0.001). Objectification of injury severity in polytraumatized patients using the ISS is an internationally well-established method in clinical and scientific settings. The full body CT scan report must meet distinct criteria and has to be written in acquaintance to the AIS scale if intended to be used for correct ISS computation.

78 FR 28631 - Cardinal Health 200, LLC, a Wholly Owned Subsidiary of Cardinal Health, Inc., Medical-Presource...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-15

... surgical kits. New information shows that some workers separated from employment at Cardinal Health 200... sterile surgical kits. Accordingly, the Department is amending this certification to properly reflect this...

77 FR 66181 - Procurement List; Proposed Deletions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-02

...: 6545-00-911-1300--Blanket Set, Bed NSN: 6545-01-168-6893--First Aid Kit, Small Craft NSN: 6545-00-920-7125--First Aid Kit, Gun Crew NSN: 6545-01-141-9476--Medical Equipment Set, Ground Ambulance NSN: 6545...

Adult Competency Education Kit. Basic Skills in Speaking, Math, and Reading for Employment. Part D. ACE Competency Based Job Descriptions: #2--Child Care Attendent; #4--Guard; #8--Medical Assistant.

ERIC Educational Resources Information Center

San Mateo County Office of Education, Redwood City, CA. Career Preparation Centers.

This first of fifteen sets of Adult Competency Education (ACE) Based Job Descriptions in the ACE kit contains job descriptions for Child Care Attendent, Guard, and Medical Assistant. Each begins with a fact sheet that includes this information: occupational title, D.O.T. code, ACE number, career ladder, D.O.T. general educational developmental…

Medical Support for ISS Crewmember Training in Star City, Russia

NASA Technical Reports Server (NTRS)

Chough, Natacha; Pattarini, James; Cole, Richard; Patlach, Robert; Menon, Anil

2017-01-01

Medical support of spaceflight training operations across international lines is a unique circumstance with potential applications to other aerospace medicine support scenarios. KBRwyle's Star City Medical Support Group (SCMSG) has fulfilled this role since the Mir-Shuttle era, with extensive experience and updates to share with the greater AsMA community. OVERVIEW: The current Soyuz training flow for assigned ISS crewmembers takes place in Star City, Russia. Soyuz training flow involves numerous activities that pose potential physical and occupational risks to crewmembers, including centrifuge runs and pressurized suit simulations at ambient and hypobaric pressures. In addition, Star City is a relatively remote location in a host nation with variable access to reliable, Western-standard medical care. For these reasons, NASA's Human Health & Performance contract allocates full-time physician support to assigned ISS crewmembers training in Star City. The Star City physician also treats minor injuries and illnesses as needed for both long- and short-term NASA support personnel traveling in the area, while working to develop and maintain relationships with local health care resources in the event of more serious medical issues that cannot be treated on-site. The specifics of this unique scope of practice will be discussed. SIGNIFICANCE: ISS crewmembers training in Star City are at potential physical and occupational risk of trauma or dysbarism during nominal Soyuz training flow, requiring medical support from an on-duty aerospace medicine specialist. This support maintains human health and performance by preserving crewmember safety and well-being for mission success; sharing information regarding this operational model may contribute to advances in other areas of international, military, and civilian operational aerospace medicine.

Integrated Medical Model Project - Overview and Summary of Historical Application

NASA Technical Reports Server (NTRS)

Myers, J.; Boley, L.; Butler, D.; Foy, M.; Goodenow, D.; Griffin, D.; Keenan, A.; Kerstman, E.; Melton, S.; McGuire, K.;

First aid kits for recreational dive boats, what should they contain?

PubMed

Pye, Jacqueline; Greenhalgh, Trisha

2010-09-01

Well-equipped first-aid kits are necessary but not always provided on recreational dive boats. We aimed to review the types of illness and injury likely to be encountered on such boats and inform a content list for such kits. We conducted a 3-round Delphi study by email using a volunteer panel of 18 experts drawn from diving, dive medicine and nursing. In round 1, panellists shared examples of illnesses and injuries they had come across personally. These scenarios were circulated along with findings from a literature review, including existing recommendations. In rounds 2 and 3, the list of kit for dive boats in different settings was iteratively refined through online discussion and feedback. Passengers and crew on recreational dive boats may encounter a range of medical problems from minor injuries to serious accidents and non-dive-related illnesses. Recommended kit varied depending on context and setting (e.g. distance from land, qualifications and experience of crew). Consensus was quickly reached on key first-aid items but experts' views on emergency medicines differed. The study highlights the diversity of medical problems encountered on recreational dive boats. We offer preliminary guidance on the content of suitable first-aid kits and suggest areas for further research. Copyright © 2010 Elsevier Ltd. All rights reserved.

In-flight medical events and aircraft diversions: one airline's experience.

PubMed

Delaune, Eugene F; Lucas, Raymond H; Illig, Petra

2003-01-01

An aging population combined with the increasing mobility of people with acute and chronic illnesses could make an increase in the frequency of in-flight medical events aboard commercial aircraft likely. To determine the incidence of each type of in-flight medical complaint, the appropriateness of medical kit contents, which factors lead to aircraft diversion, and which factors effect the appropriateness of the decision to divert. Medical complaints reported aboard a sample airline from July 1, 1999 through June 30, 2000 were studied. The frequency of aircraft diversion was related to complaint and medical assistance provided. The appropriateness of the decision to divert was determined as a function of hospital admission rates. There was an incidence of 22.6 medical complaints per million passengers and 0.1 deaths per million passengers. There were 210 diversions per million flights with one of every 12.6 incidents resulting in a diversion. When a passenger volunteer was used, they opened the medical kit 62% of the time. When a physician participated in the decision to divert the hospital admission rate was 49% versus 15% with no physician input. Variations in incidence of medical complaints cited in previous studies demonstrate the need for an industry-wide standardized reporting method of in-flight medical events. All in-flight medical complaints could likely have been adequately treated with the contents of the FM's newly mandated medical kits. Physician participation in decisions to divert aircraft should be sought as it is associated with more appropriate divert decisions.

JSC Pharmacy Services for Remote Operations

NASA Technical Reports Server (NTRS)

Stoner, Paul S.; Bayuse, Tina

2005-01-01

The Johnson Space Center Pharmacy began operating in March of 2003. The pharmacy serves in two main capacities: to directly provide medications and services in support of the medical clinics at the Johnson Space Center, physician travel kits for NASA flight surgeon staff, and remote operations, such as the clinics in Devon Island, Star City and Moscow; and indirectly provide medications and services for the International Space Station and Space Shuttle medical kits. Process changes that occurred and continued to evolve in the advent of the installation of the new JSC Pharmacy, and the process of stocking medications for each of these aforementioned areas will be discussed. Methods: The incorporation of pharmacy involvement to provide services for remote operations and supplying medical kits was evaluated. The first step was to review the current processes and work the JSC Pharmacy into the existing system. The second step was to provide medications to these areas. Considerations for the timeline of expiring medications for shipment are reviewed with each request. The third step was the development of a process to provide accountability for the medications. Results: The JSC Pharmacy utilizes a pharmacy management system to document all medications leaving the pharmacy. Challenges inherent to providing medications to remote areas were encountered. A process has been designed to incorporate usage into the electronic medical record upon return of the information from these remote areas. This is an evolving program and several areas have been identified for further improvement.

Transvaginal retropubic sling systems: efficacy and patient acceptability

PubMed Central

Moldovan, Christina P; Marinone, Michelle E; Staack, Andrea

2015-01-01

Stress urinary incontinence is a common, disabling, and costly medical problem that affects approximately 50% of women with urinary incontinence. Suburethral retropubic slings have been developed as a minimally invasive and effective surgical option, and they have been used as a first-line treatment for stress urinary incontinence since 1995. However, complications including vaginal extrusion, erosion, pain, bleeding, infections, lower urinary tract symptoms, urinary retention, and incontinence have been reported with use of the slings. Several companies manufacture sling kits, and the sling kits vary with regard to the composition of the mesh and introducer needle. The aim of this review was to determine which sling kit was most effective for patients, had minimal reported side effects, and was best accepted by patients and surgeons. In a review of the literature, it was found that a total of 38 studies were published between 1995 and 2014 that reported on eight tension-free retropubic sling kits: SPARC, RetroArc, Align, Advantage, Lynx, Desara, Supris, and Gynecare TVT. The Gynecare TVT was the most cited sling kit; the second most cited was the SPARC. This review provides a summary of the studies that have examined positive and negative outcomes of the retropubic tension-free suburethral sling procedure using various sling kits. Overall, the results of the literature review indicated that data from comparisons of the available sling kits are insufficient to make an evidenced-based recommendation. Therefore, the decision regarding which sling kit is appropriate to use in surgery is determined by the medical provider’s preference, training, and past experience, and not by the patient. PMID:25733928

Direct Signal-to-Noise Quality Comparison between an Electronic and Conventional Stethoscope aboard the International Space Station

NASA Technical Reports Server (NTRS)

Marshburn, Thomas; Cole, Richard; Ebert, Doug; Bauer, Pete

2014-01-01

Introduction: Evaluation of heart, lung, and bowel sounds is routinely performed with the use of a stethoscope to help detect a broad range of medical conditions. Stethoscope acquired information is even more valuable in a resource limited environments such as the International Space Station (ISS) where additional testing is not available. The high ambient noise level aboard the ISS poses a specific challenge to auscultation by stethoscope. An electronic stethoscope's ambient noise-reduction, greater sound amplification, recording capabilities, and sound visualization software may be an advantage to a conventional stethoscope in this environment. Methods: A single operator rated signal-to-noise quality from a conventional stethoscope (Littman 2218BE) and an electronic stethoscope (Litmann 3200). Borborygmi, pulmonic, and cardiac sound quality was ranked with both stethoscopes. Signal-to-noise rankings were preformed on a 1 to 10 subjective scale with 1 being inaudible, 6 the expected quality in an emergency department, 8 the expected quality in a clinic, and 10 the clearest possible quality. Testing took place in the Japanese Pressurized Module (JPM), Unity (Node 2), Destiny (US Lab), Tranquility (Node 3), and the Cupola of the International Space Station. All examinations were conducted at a single point in time. Results: The electronic stethoscope's performance ranked higher than the conventional stethoscope for each body sound in all modules tested. The electronic stethoscope's sound quality was rated between 7 and 10 in all modules tested. In comparison, the traditional stethoscope's sound quality was rated between 4 and 7. The signal to noise ratio of borborygmi showed the biggest difference between stethoscopes. In the modules tested, the auscultation of borborygmi was rated between 5 and 7 by the conventional stethoscope and consistently 10 by the electronic stethoscope. Discussion: This stethoscope comparison was limited to a single operator. However, we believe the results are noteworthy. The electronic stethoscope out preformed the traditional stethoscope in each direct comparison. Consideration should be made to incorporate an electronic stethoscope into current and future space vehicle medical kits.

International Space Station Medical Project

NASA Technical Reports Server (NTRS)

Starkey, Blythe A.

2008-01-01

The goals and objectives of the ISS Medical Project (ISSMP) are to: 1) Maximize the utilization the ISS and other spaceflight platforms to assess the effects of longduration spaceflight on human systems; 2) Devise and verify strategies to ensure optimal crew performance; 3) Enable development and validation of a suite of integrated physical (e.g., exercise), pharmacologic and/or nutritional countermeasures against deleterious effects of space flight that may impact mission success or crew health. The ISSMP provides planning, integration, and implementation services for Human Research Program research tasks and evaluation activities requiring access to space or related flight resources on the ISS, Shuttle, Soyuz, Progress, or other spaceflight vehicles and platforms. This includes pre- and postflight activities; 2) ISSMP services include operations and sustaining engineering for HRP flight hardware; experiment integration and operation, including individual research tasks and on-orbit validation of next generation on-orbit equipment; medical operations; procedures development and validation; and crew training tools and processes, as well as operation and sustaining engineering for the Telescience Support Center; and 3) The ISSMP integrates the HRP approved flight activity complement and interfaces with external implementing organizations, such as the ISS Payloads Office and International Partners, to accomplish the HRP's objectives. This effort is led by JSC with Baseline Data Collection support from KSC.

78 FR 54731 - Update to the List of Basic Medical Supplies

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-05

... Suture removal kits Syringes Thermometers, mercury for measuring human body temperature Tongue depressors... equipment Orthopedic traction devices and tables Human body positioners including pads, wedges, cradles... staples; and removal kits Tourniquets Thermometers for measuring human body temperature Clinical basins...

ISS Crew Transportation and Services Requirements Document

NASA Technical Reports Server (NTRS)

Bayt, Robert L. (Compiler); Lueders, Kathryn L. (Compiler)

2016-01-01

The ISS Crew Transportation and Services Requirements Document (CCT-REQ-1130) contains all technical, safety, and crew health medical requirements that are mandatory for achieving a Crew Transportation System Certification that will allow for International Space Station delivery and return of NASA crew and limited cargo. Previously approved on TN23183.

“Back on Track”: A Mobile App Observational Study Using Apple’s ResearchKit Framework

PubMed Central

Woias, Peter; Suedkamp, Norbert P; Niemeyer, Philipp

2017-01-01

Background In March 2015, Apple Inc announced ResearchKit, a novel open-source framework intended to help medical researchers to easily create apps for medical studies. With the announcement of this framework, Apple presented 5 apps built in a beta phase based on this framework. Objective The objective of this study was to better understand decision making in patients with acute anterior cruciate ligament (ACL) ruptures. Here, we describe the development of a ResearchKit app for this study. Methods A multilanguage observatory study was conducted. At first a suitable research topic, target groups, participating territories, and programming method were carefully identified. The ResearchKit framework was used to program the app. A secure server connection was realized via Secure Sockets Layer. A data storage and security concept separating personal information and study data was proposed. Furthermore, an efficient method to allow multilanguage support and distribute the app in many territories was presented. Ethical implications were considered and taken into account regarding privacy policies. Results An app study based on ResearchKit was developed without comprehensive iPhone Operating System (iOS) development experience. The Apple App Store is a major distribution channel causing significant download rates (>1.200/y) without active recruitment. Preliminary data analysis showed moderate dropout rates and a good quality of data. A total of 180 participants were currently enrolled with 107 actively participating and producing 424 completed surveys in 9 out of 24 months. Conclusions ResearchKit is an easy-to-use framework and powerful tool to create medical studies. Advantages are the modular built, the extensive reach of iOS devices, and the convenient programming environment. PMID:28246069

"Back on Track": A Mobile App Observational Study Using Apple's ResearchKit Framework.

PubMed

Zens, Martin; Woias, Peter; Suedkamp, Norbert P; Niemeyer, Philipp

2017-02-28

In March 2015, Apple Inc announced ResearchKit, a novel open-source framework intended to help medical researchers to easily create apps for medical studies. With the announcement of this framework, Apple presented 5 apps built in a beta phase based on this framework. The objective of this study was to better understand decision making in patients with acute anterior cruciate ligament (ACL) ruptures. Here, we describe the development of a ResearchKit app for this study. A multilanguage observatory study was conducted. At first a suitable research topic, target groups, participating territories, and programming method were carefully identified. The ResearchKit framework was used to program the app. A secure server connection was realized via Secure Sockets Layer. A data storage and security concept separating personal information and study data was proposed. Furthermore, an efficient method to allow multilanguage support and distribute the app in many territories was presented. Ethical implications were considered and taken into account regarding privacy policies. An app study based on ResearchKit was developed without comprehensive iPhone Operating System (iOS) development experience. The Apple App Store is a major distribution channel causing significant download rates (>1.200/y) without active recruitment. Preliminary data analysis showed moderate dropout rates and a good quality of data. A total of 180 participants were currently enrolled with 107 actively participating and producing 424 completed surveys in 9 out of 24 months. ResearchKit is an easy-to-use framework and powerful tool to create medical studies. Advantages are the modular built, the extensive reach of iOS devices, and the convenient programming environment. ©Martin Zens, Peter Woias, Norbert P Suedkamp, Philipp Niemeyer. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 28.02.2017.

Clinical risk management approach for long-duration space missions.

PubMed

Gray, Gary W; Sargsyan, Ashot E; Davis, Jeffrey R

2010-12-01

In the process of crewmember evaluation and certification for long-duration orbital missions, the International Space Station (ISS) Multilateral Space Medicine Board (MSMB) encounters a surprisingly wide spectrum of clinical problems. Some of these conditions are identified within the ISS Medical Standards as requiring special consideration, or as falling outside the consensus Medical Standards promulgated for the ISS program. To assess the suitability for long-duration missions on ISS for individuals with medical problems that fall outside of standards or are otherwise of significant concern, the MSMB has developed a risk matrix approach to assess the risks to the individual, the mission, and the program. The goal of this risk assessment is to provide a more objective, evidence- and risk-based approach for aeromedical disposition. Using a 4 x 4 risk matrix, the probability of an event is plotted against the potential impact. Event probability is derived from a detailed review of clinical and aerospace literature, and based on the best available evidence. The event impact (consequences) is assessed and assigned within the matrix. The result has been a refinement of MSMB case assessment based on evidence-based data incorporated into a risk stratification process. This has encouraged an objective assessment of risk and, in some cases, has resulted in recertification of crewmembers with medical conditions which hitherto would likely have been disqualifying. This paper describes a risk matrix approach developed for MSMB disposition decisions. Such an approach promotes objective, evidence-based decision-making and is broadly applicable within the aerospace medicine community.

Adult Competency Education Kit. Basic Skills in Speaking, Math, and Reading for Employment. Part I. ACE Competency Based Job Descriptions: #30--Roofer Apprentice; #31--Pipefitter; #32--Medical Supply Clerk; #33--Stock Clerk; #35--Warehouseman (Laborer, Stores).

ERIC Educational Resources Information Center

San Mateo County Office of Education, Redwood City, CA. Career Preparation Centers.

This sixth of fifteen sets of Adult Competency Education (ACE) Based Job Descriptions in the ACE kit contains job descriptions for Roofer Apprentice, Pipefitter, Medical Supply Clerk, Stock Clerk, and Warehouseperson. Each begins with a fact sheet that includes this information: occupational title, D.O.T. code, ACE number, career ladder, D.O.T.…

How the discovery of ISS-N1 led to the first medical therapy for spinal muscular atrophy

PubMed Central

Singh, Natalia N.; Howell, Matthew D.; Androphy, Elliot J.; Singh, Ravindra N.

2017-01-01

Spinal muscular atrophy (SMA), a prominent genetic disease of infant mortality, is caused by low levels of survival motor neuron (SMN) protein owing to deletions or mutations of the SMN1 gene. SMN2, a nearly identical copy of SMN1 present in humans, cannot compensate for the loss of SMN1 due to predominant skipping of exon 7 during pre-mRNA splicing. With the recent FDA approval of nusinersen (Spinraza™), the potential for correction of SMN2 exon 7 splicing as a SMA therapy has been affirmed. Nusinersen is an antisense oligonucleotide that targets intronic splicing silencer N1 (ISS-N1) discovered in 2004 at the University of Massachusetts Medical School. ISS-N1 has emerged as the model target for testing the therapeutic efficacy of antisense oligonucleotides using different chemistries as well as different mouse models of SMA. Here we provide a historical account of events that led to the discovery of ISS-N1 and describe the impact of independent validations that raised the profile of ISS-N1 as one of the most potent antisense targets for the treatment of a genetic disease. Recent approval of nusinersen provides a much-needed boost for antisense technology that is just beginning to realize its potential. Beyond treating SMA, the ISS-N1 target offers myriad potentials for perfecting various aspects of the nucleic-acid-based technology for the amelioration of the countless number of pathological conditions. PMID:28485722

How the discovery of ISS-N1 led to the first medical therapy for spinal muscular atrophy.

PubMed

Singh, N N; Howell, M D; Androphy, E J; Singh, R N

2017-09-01

Spinal muscular atrophy (SMA), a prominent genetic disease of infant mortality, is caused by low levels of survival motor neuron (SMN) protein owing to deletions or mutations of the SMN1 gene. SMN2, a nearly identical copy of SMN1 present in humans, cannot compensate for the loss of SMN1 because of predominant skipping of exon 7 during pre-mRNA splicing. With the recent US Food and Drug Administration approval of nusinersen (Spinraza), the potential for correction of SMN2 exon 7 splicing as an SMA therapy has been affirmed. Nusinersen is an antisense oligonucleotide that targets intronic splicing silencer N1 (ISS-N1) discovered in 2004 at the University of Massachusetts Medical School. ISS-N1 has emerged as the model target for testing the therapeutic efficacy of antisense oligonucleotides using different chemistries as well as different mouse models of SMA. Here, we provide a historical account of events that led to the discovery of ISS-N1 and describe the impact of independent validations that raised the profile of ISS-N1 as one of the most potent antisense targets for the treatment of a genetic disease. Recent approval of nusinersen provides a much-needed boost for antisense technology that is just beginning to realize its potential. Beyond treating SMA, the ISS-N1 target offers myriad potentials for perfecting various aspects of the nucleic-acid-based technology for the amelioration of the countless number of pathological conditions.

21 CFR 870.1350 - Catheter balloon repair kit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Catheter balloon repair kit. 870.1350 Section 870.1350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1350 Catheter balloon...

21 CFR 870.1350 - Catheter balloon repair kit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Catheter balloon repair kit. 870.1350 Section 870.1350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1350 Catheter balloon...

21 CFR 864.1860 - Immunohistochemistry reagents and kits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Immunohistochemistry reagents and kits. 864.1860 Section 864.1860 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Biological Stains § 864.1860...

21 CFR 864.1860 - Immunohistochemistry reagents and kits.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Immunohistochemistry reagents and kits. 864.1860 Section 864.1860 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Biological Stains § 864.1860...

21 CFR 864.1860 - Immunohistochemistry reagents and kits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Immunohistochemistry reagents and kits. 864.1860 Section 864.1860 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Biological Stains § 864.1860...

Ariane transfer vehicle in service of man in orbit

NASA Astrophysics Data System (ADS)

Deutscher, N.; Schefold, K.; Cougnet, C.

The Ariane transfer vehicle (ATV), an Ariane 5 borne, unmanned propulsion vehicle, is designed to transport the logistics needed to resupply the International Space Station (ISS) and the man tended free flyer (MTFF) step 2 with pressurized and unpressurized cargo and to dispose the waste. The ATV is an expendable vehicle and is disposed of by a safe atmospheric burn up. In accordance with the AR5 schedule it should be operational in 1996 for missions toward ISS and beyond the year 2000 for MTFF 2 missions. The main constituents of the proposed ATV are the modified AR5 third stage L5, an upgraded VEB steering the launcher as well as the ATV and the P/L-adaptor providing mechanical and umbilical links to the payload. The mechanical part of the RVD-kit will be placed on the payload-module, the main RVD sensors are located on the adaptor and the needed computer intelligence will be integrated on the VEB. To minimize the development, and recurring costs, the ATV concept fully complies to the idea of maximum use of existing hardware and software, mainly from the AR5, Hermes and Columbus programs thus minimizing development and recurring costs. The ATV is compatible to ISS, MTFF and OMV and is able to transport logistic modules compatible with NSTS and U.S.-expendable launchers.

Human Factors in Training - Space Medicine Proficiency Training

NASA Technical Reports Server (NTRS)

Connell, Erin; Arsintescu, Lucia

2009-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction ratings were captured.

21 CFR 866.2480 - Quality control kit for culture media.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Quality control kit for culture media. 866.2480 Section 866.2480 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2480 Quality...

21 CFR 866.2480 - Quality control kit for culture media.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Quality control kit for culture media. 866.2480 Section 866.2480 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2480 Quality...

21 CFR 866.2480 - Quality control kit for culture media.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Quality control kit for culture media. 866.2480 Section 866.2480 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2480 Quality...

21 CFR 866.2480 - Quality control kit for culture media.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Quality control kit for culture media. 866.2480 Section 866.2480 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2480 Quality...

21 CFR 866.2480 - Quality control kit for culture media.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Quality control kit for culture media. 866.2480 Section 866.2480 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Microbiology Devices § 866.2480 Quality...

21 CFR 864.2260 - Chromosome culture kit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Chromosome culture kit. 864.2260 Section 864.2260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2260 Chromosome...

National High Blood Pressure 12-Month Kit. May 1988.

ERIC Educational Resources Information Center

National Heart and Lung Inst. (DHHS/NIH), Bethesda, MD. National High Blood Pressure Education Program.

Part I of this kit provides information for program planners and health professionals on ways to overcome barriers to health care among the medically underserved, promote high blood pressure control through the media and other community channels, and improve adherence to treatment among hypertensive patients. It lists additional resources for…

21 CFR 864.2260 - Chromosome culture kit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Chromosome culture kit. 864.2260 Section 864.2260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2260 Chromosome...

21 CFR 864.2260 - Chromosome culture kit.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Chromosome culture kit. 864.2260 Section 864.2260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2260 Chromosome...

21 CFR 864.2260 - Chromosome culture kit.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Chromosome culture kit. 864.2260 Section 864.2260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2260 Chromosome...

21 CFR 864.2260 - Chromosome culture kit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Chromosome culture kit. 864.2260 Section 864.2260 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Cell And Tissue Culture Products § 864.2260 Chromosome...

Civic Action Guide for Vietnam

DTIC Science & Technology

1966-03-01

ideally suited for medical patrols. (2) CASE. CAKE distributes a midwifery kit. This kit can. be requested on the CARE request form; however, delivery...Salaries of 14 Cadres x (4,000$ x 12m) Training of 400 farmers x 4 days x 30$ 7 drug stations x 10,000$ Anti epidemic Demonstration of 2 centers x... Midwifery Replacement Kit, When ordering these items xe ’ * equest Form should include the name of the using mid-wife, the ■iterator It*6ft&on, and the

International Space Station (ISS) Gas Logistics Planning in the Post Shuttle Era

NASA Technical Reports Server (NTRS)

Leonard, Daniel J.; Cook, Anthony J.; Lehman, Daniel A.

2011-01-01

Over its life the International Space Station (ISS) has received gas (nitrogen, oxygen, and air) from various sources. Nitrogen and oxygen are used in the cabin to maintain total pressure and oxygen partial pressures within the cabin. Plumbed nitrogen is also required to support on-board experiments and medical equipment. Additionally, plumbed oxygen is required to support medical equipment as well as emergency masks and most importantly EVA support. Gas are supplied to ISS with various methods and vehicles. Vehicles like the Progress and ATV deliver nitrogen (both as a pure gas and as air) and oxygen via direct releases into the cabin. An additional source of nitrogen and oxygen is via tanks on the ISS Airlock. The Airlock nitrogen and oxygen tanks can deliver to various users via pressurized systems that run throughout the ISS except for the Russian segment. Metabolic oxygen is mainly supplied via cabin release from the Elektron and Oxygen Generator Assembly (OGA), which are water electrolyzers. As a backup system, oxygen candles (Solid Fuel Oxygen Generators-SFOGs) supply oxygen to the cabin as well. In the past, a major source of nitrogen and oxygen has come from the Shuttle via both direct delivery to the cabin as well as to recharge the ISS Airlock tanks. To replace the Shuttle capability to recharge the ISS Airlock tanks, a new system was developed called Nitrogen/Oxygen Recharge System (NORS). NIORS consists of high pressure (7000 psi) tanks which recharge the ISS Airlock tanks via a blowdown fill for both nitrogen and oxygen. NORS tanks can be brought up on most logistics vehicles such as the HTV, COTS, and ATV. A proper balance must be maintained to insure sufficient gas resources are available on-orbit so that all users have the required gases via the proper delivery method (cabin and/or plumbed).

ISS Payload Racks Automated Flow Control Calibration Method

NASA Technical Reports Server (NTRS)

Simmonds, Boris G.

2003-01-01

Payload Racks utilize MTL and/or LTL station water for cooling of payloads and avionics. Flow control range from valves of fully closed, to up to 300 Ibmhr. Instrument accuracies are as high as f 7.5 Ibm/hr for flow sensors and f 3 Ibm/hr for valve controller, for a total system accuracy of f 10.5 Ibm/hr. Improved methodology was developed, tested and proven that reduces accuracy of the commanded flows to less than f 1 Ibmhr. Uethodology could be packed in a "calibration kit" for on- orbit flow sensor checkout and recalibration, extending the rack operations before return to earth. -

Crew Medical Restraint System Inspection

NASA Image and Video Library

2013-05-22

ISS036-E-003301 (22 May 2013) --- In the Destiny lab aboard the International Space Station, NASA astronaut Chris Cassidy, Expedition 36 flight engineer, participates in a Crew Medical Restraint System (CMRS) checkout.

Emergency Physicians as Good Samaritans: Survey of Frequency, Locations, Supplies and Medications.

PubMed

Burkholder, Taylor W; King, Renee A

2016-01-01

Little is known about the frequency and locations in which emergency physicians (EPs) are bystanders to an accident or emergency; equally uncertain is which contents of an "emergency kit" may be useful during such events. The aim of this study was to describe the frequency and locations of Good Samaritan acts by EPs and also determine which emergency kit supplies and medications were most commonly used by Good Samaritans. We conducted an electronic survey among a convenience sample of EPs in Colorado. Respondents reported a median frequency of 2.0 Good Samaritan acts per five years of practice, with the most common locations being sports and entertainment events (25%), road traffic accidents (21%), and wilderness settings (19%). Of those who had acted as Good Samaritans, 86% reported that at least one supply would have been useful during the most recent event, and 66% reported at least one medication would have been useful. The most useful supplies were gloves (54%), dressings (34%), and a stethoscope (20%), while the most useful medications were oxygen (19%), intravenous fluids (17%), and epinephrine (14%). The majority of EPs can expect to provide Good Samaritan care during their careers and would be better prepared by carrying a kit with common supplies and medications where they are most likely to use them.

Portable radiography: a reality and necessity for ISS and explorer-class missions.

PubMed

Lerner, David J; Parmet, Allen J

2015-02-01

On ISS missions and explorer class missions, unexpected medical and surgical emergencies could be disastrous. Lack of ability to rapidly assess and make critical decisions affects mission capability. Current imaging modalities on ISS consist only of ultrasound. There are many acute diagnoses which ultrasound alone cannot diagnose. Portable X-Ray imaging (radiography) technology has advanced far enough to where it is now small enough, cheap enough, and accurate enough to give diagnostic quality images sent wirelessly to the onboard computer and on Earth for interpretation while fitting in something the size of a briefcase. Although further research is warranted, Portable Radiography is an important addition to have on ISS and future Explorer Class Missions while maintaining a very small footprint.

Atmosphere Kits: Hands-On Learning Activities with a Foundation in NASA Earth Science Missions.

NASA Astrophysics Data System (ADS)

Teige, V.; McCrea, S.; Damadeo, K.; Taylor, J.; Lewis, P. M., Jr.; Chambers, L. H.

2016-12-01

The Science Directorate (SD) at NASA Langley Research Center provides many opportunities to involve students, faculty, researchers, and the citizen science community in real world science. The SD Education Team collaborates with the education community to bring authentic Earth science practices and real-world data into the classroom, provide the public with unique NASA experiences, engaging activities, and advanced technology, and provide products developed and reviewed by science and education experts. Our goals include inspiring the next generation of Science, Technology, Engineering and Mathematics (STEM) professionals and improving STEM literacy by providing innovative participation pathways for educators, students, and the public. The SD Education Team has developed Atmosphere activity kits featuring cloud and aerosol learning activities with a foundation in NASA Earth Science Missions, the Next Generation Science Standards, and The GLOBE Program's Elementary Storybooks. Through cloud kit activities, students will learn how to make estimates from observations and how to categorize and classify specific cloud properties, including cloud height, cloud cover, and basic cloud types. The purpose of the aerosol kit is to introduce students to aerosols and how they can affect the colors we see in the sky. Students will engage in active observation and reporting, explore properties of light, and model the effects of changing amounts/sizes or aerosols on sky color and visibility. Learning activity extensions include participation in ground data collection of environmental conditions and comparison and analysis to related NASA data sets, including but not limited to CERES, CALIPSO, CloudSat, and SAGE III on ISS. This presentation will provide an overview of multiple K-6 NASA Earth Science hands-on activities and free resources will be available.

Medical evaluations on the KC-135 1991 flight report summary

NASA Technical Reports Server (NTRS)

Lloyd, Charles W.

1993-01-01

The medical investigations completed on the KC-135 during FY 1991 in support of the development of the Health Maintenance Facility and Medical Operations are presented. The experiments consisted of medical and engineering evaluations of medical hardware and procedures and were conducted by medical and engineering personnel. The hardware evaluated included prototypes of a crew medical restraint system and advanced life support pack, a shuttle orbiter medical system, an airway medical accessory kit, a supplementary extended duration orbiter medical kit, and a surgical overhead canopy. The evaluations will be used to design flight hardware and identify hardware-specific training requirements. The following procedures were evaluated: transport of an ill or injured crewmember at man-tended capability, surgical technique in microgravity, transfer of liquids in microgravity, advanced cardiac life support using man-tended capability Health Maintenance Facility hardware, medical transport using a model of the assured crew return vehicle, and evaluation of delivery mechanisms for aerosolized medications in microgravity. The results of these evaluation flights allow for a better understanding of the types of procedures that can be performed in a microgravity environment.

Cardiomed System for Medical Monitoring Onboard ISS

NASA Astrophysics Data System (ADS)

Lloret, J. C.; Aubry, P.; Nguyen, L.; Kozharinov, V.; Grachev, V.; Temnova, E.

2008-06-01

Cardiomed system was developed with two main objectives: (1) cardiovascular medical monitoring of cosmonauts onboard ISS together with LBNP countermeasure; (2) scientific study of the cardio-vascular system in micro-gravity. Cardiomed is an integrated end-to-end system, from the onboard segment operating different medical instruments, to the ground segment which provides real-time telemetry of on-board experiments and off-line analysis of physiological measurements. In the first part of the paper, Cardiomed is described from an architecture point of view together with some typical uses. In the second part, the most constraining requirements with respect to system design are introduced. Some requirements are generic; some are specific to medical follow-up, others to scientific objectives. In the last part, the main technical challenges which were addressed during the development and the qualification of Cardiomed and the lessons learnt are presented.

The First Decade of ISS Exercise: Lessons Learned on Expeditions 1-25.

PubMed

Hayes, Judith

2015-12-01

Long-duration spaceflight results in musculoskeletal, cardiorespiratory, and sensorimotor deconditioning. Historically, exercise has been used as a countermeasure to mitigate these deleterious effects that occur as a consequence of microgravity exposures. The International Space Station (ISS) exercise community describes their approaches, biomedical surveillance, and lessons learned in the development of exercise countermeasure modalities and prescriptions for maintaining health and performance among station crews. This report is focused on the first 10 yr of ISS defined as Expeditions 1-25 and includes only crewmembers with missions > 30 d on ISS for all 5 partner agencies (United States, Russia, Europe, Japan, and Canada). All 72 cosmonauts and astronauts participated in the ISS exercise countermeasures program. This Supplement presents a series of papers that provide an overview of the first decade of ISS exercise from a multidisciplinary, multinational perspective to evaluate the initial countermeasure program and record its operational limitations and challenges. In addition, we provide results from standardized medical evaluations before, during, and after each mission. Information presented in this context is intended to describe baseline conditions of the ISS exercise program. This paper offers an introduction to the subsequent series of manuscripts.

Interplanetary Transit Simulations Using the International Space Station

NASA Technical Reports Server (NTRS)

Charles, J. B.; Arya, Maneesh

2010-01-01

It has been suggested that the International Space Station (ISS) be utilized to simulate the transit portion of long-duration missions to Mars and near-Earth asteroids (NEA). The ISS offers a unique environment for such simulations, providing researchers with a high-fidelity platform to study, enhance, and validate technologies and countermeasures for these long-duration missions. From a space life sciences perspective, two major categories of human research activities have been identified that will harness the various capabilities of the ISS during the proposed simulations. The first category includes studies that require the use of the ISS, typically because of the need for prolonged weightlessness. The ISS is currently the only available platform capable of providing researchers with access to a weightless environment over an extended duration. In addition, the ISS offers high fidelity for other fundamental space environmental factors, such as isolation, distance, and accessibility. The second category includes studies that do not require use of the ISS in the strictest sense, but can exploit its use to maximize their scientific return more efficiently and productively than in ground-based simulations. In addition to conducting Mars and NEA simulations on the ISS, increasing the current increment duration on the ISS from 6 months to a longer duration will provide opportunities for enhanced and focused research relevant to long-duration Mars and NEA missions. Although it is currently believed that increasing the ISS crew increment duration to 9 or even 12 months will pose little additional risk to crewmembers, additional medical monitoring capabilities may be required beyond those currently used for the ISS operations. The use of the ISS to simulate aspects of Mars and NEA missions seems practical, and it is recommended that planning begin soon, in close consultation with all international partners.

Activities of the Korean Institute of Tuberculosis

PubMed Central

Ryoo, Sungweon; Kim, Hee Jin

2014-01-01

The Korean National Tuberculosis Association (KNTA) set up the Korean Institute of Tuberculosis (KIT) in 1970 to foster research and technical activities pertaining to tuberculosis (TB). The KNTA/KIT had successfully conducted a countrywide TB prevalence survey from 1965 to 1995 at 5-year intervals. The survey results (decline in TB rates) established Korea as a country that had successfully implemented national control programs for TB. The KIT developed the Korea Tuberculosis Surveillance System and the Laboratory Management Information System, both of which were transferred to the Korea Centers for Disease Control and Prevention after its establishment. The KIT functions as a central and supranational reference TB laboratory for microbiological and epidemiological research and provides training and education for health-care workers and medical practitioners. Recently, the KIT has expanded its activities to countries such as Ethiopia, Laos, and Timor-Leste to support TB control and prevention. The KIT will continue to support research activities and provide technical assistance in diagnosing the infection until it is completely eliminated in Korea. PMID:25861580

Medical Scenarios Relevant to Spaceflight

NASA Technical Reports Server (NTRS)

Bacal, Kira; Hurs, Victor; Doerr, Harold

2004-01-01

The Medical Operational Support Team (MOST) was tasked by the JSC Space Medicine and Life Sciences Directorate (SLSD) to incorporate medical simulation into 1) medical training for astronaut-crew medical officers (CMO) and medical flight control teams and 2) evaluations of procedures and resources required for medical care aboard the International Space Station (ISS). Development of evidence-based medical scenarios that mimic the physiology observed during spaceflight will be needed for the MOST to complete these two tasks. The MOST used a human patient simulator, the ISS-like resources in the Medical Simulation Laboratory (MSL), and evidence from space operations, military operations and medical literature to develop space relevant medical scenarios. These scenarios include conditions concerning airway management, Advanced Cardiac Life Support (ACLS) and mitigating anaphylactic symptoms. The MOST has used these space relevant medical scenarios to develop a preliminary space medical training regimen for NASA flight surgeons, Biomedical Flight Controllers (Biomedical Engineers; BME) and CMO-analogs. This regimen is conducted by the MOST in the MSL. The MOST has the capability to develop evidence-based space-relevant medical scenarios that can help SLSD I) demonstrate the proficiency of medical flight control teams to mitigate space-relevant medical events and 2) validate nextgeneration medical equipment and procedures for space medicine applications.

Teaching Medical Students About "The Conversation": An Interactive Value-Based Advance Care Planning Session.

PubMed

Lum, Hillary D; Dukes, Joanna; Church, Skotti; Abbott, Jean; Youngwerth, Jean M

2018-02-01

Advance care planning (ACP) promotes care consistent with patient wishes. Medical education should teach how to initiate value-based ACP conversations. To develop and evaluate an ACP educational session to teach medical students a value-based ACP process and to encourage students to take personal ACP action steps. Groups of third-year medical students participated in a 75-minute session using personal reflection and discussion framed by The Conversation Starter Kit. The Conversation Project is a free resource designed to help individuals and families express their wishes for end-of-life care. One hundred twenty-seven US third-year medical students participated in the session. Student evaluations immediately after the session and 1 month later via electronic survey. More than 90% of students positively evaluated the educational value of the session, including rating highly the opportunities to reflect on their own ACP and to use The Conversation Starter Kit. Many students (65%) reported prior ACP conversations. After the session, 73% reported plans to discuss ACP, 91% had thought about preferences for future medical care, and 39% had chosen a medical decision maker. Only a minority had completed an advance directive (14%) or talked with their health-care provider (1%). One month later, there was no evidence that the session increased students' actions regarding these same ACP action steps. A value-based ACP educational session using The Conversation Starter Kit successfully engaged medical students in learning about ACP conversations, both professionally and personally. This session may help students initiate conversations for themselves and their patients.

Overview of Pre-Flight Physical Training, In-Flight Exercise Countermeasures and the Post-Flight Reconditioning Program for International Space Station Astronauts

NASA Technical Reports Server (NTRS)

Kerstman, Eric

2011-01-01

International Space Station (ISS) astronauts receive supervised physical training pre-flight, utilize exercise countermeasures in-flight, and participate in a structured reconditioning program post-flight. Despite recent advances in exercise hardware and prescribed exercise countermeasures, ISS crewmembers are still found to have variable levels of deconditioning post-flight. This presentation provides an overview of the astronaut medical certification requirements, pre-flight physical training, in-flight exercise countermeasures, and the post-flight reconditioning program. Astronauts must meet medical certification requirements on selection, annually, and prior to ISS missions. In addition, extensive physical fitness testing and standardized medical assessments are performed on long duration crewmembers pre-flight. Limited physical fitness assessments and medical examinations are performed in-flight to develop exercise countermeasure prescriptions, ensure that the crewmembers are physically capable of performing mission tasks, and monitor astronaut health. Upon mission completion, long duration astronauts must re-adapt to the 1 G environment, and be certified as fit to return to space flight training and active duty. A structured, supervised postflight reconditioning program has been developed to prevent injuries, facilitate re-adaptation to the 1 G environment, and subsequently return astronauts to training and space flight. The NASA reconditioning program is implemented by the Astronaut Strength, Conditioning, and Rehabilitation (ASCR) team and supervised by NASA flight surgeons. This program has evolved over the past 10 years of the International Space Station (ISS) program and has been successful in ensuring that long duration astronauts safely re-adapt to the 1 g environment and return to active duty. Lessons learned from this approach to managing deconditioning can be applied to terrestrial medicine and future exploration space flight missions.

Benefits for Professional Staff in ARL Libraries. SPEC Kit 197.

ERIC Educational Resources Information Center

Switzer, Teri R., Comp.

The kit and flyer explore employee benefits offered to professional staff by member institutions of the Association of Research Libraries (ARL). To find out about these benefits, ARL surveyed its 119 members in 1993, and received 71 replies. Of responding libraries, 100% provide health care insurance, 69% have a major medical plan, while 86.4%…

Sleep Disruption Medical Intervention Forecasting (SDMIF) Module for the Integrated Medical Model

NASA Technical Reports Server (NTRS)

Lewandowski, Beth; Brooker, John; Mallis, Melissa; Hursh, Steve; Caldwell, Lynn; Myers, Jerry

2011-01-01

The NASA Integrated Medical Model (IMM) assesses the risk, including likelihood and impact of occurrence, of all credible in-flight medical conditions. Fatigue due to sleep disruption is a condition that could lead to operational errors, potentially resulting in loss of mission or crew. Pharmacological consumables are mitigation strategies used to manage the risks associated with sleep deficits. The likelihood of medical intervention due to sleep disruption was estimated with a well validated sleep model and a Monte Carlo computer simulation in an effort to optimize the quantity of consumables. METHODS: The key components of the model are the mission parameter program, the calculation of sleep intensity and the diagnosis and decision module. The mission parameter program was used to create simulated daily sleep/wake schedules for an ISS increment. The hypothetical schedules included critical events such as dockings and extravehicular activities and included actual sleep time and sleep quality. The schedules were used as inputs to the Sleep, Activity, Fatigue and Task Effectiveness (SAFTE) Model (IBR Inc., Baltimore MD), which calculated sleep intensity. Sleep data from an ISS study was used to relate calculated sleep intensity to the probability of sleep medication use, using a generalized linear model for binomial regression. A human yes/no decision process using a binomial random number was also factored into sleep medication use probability. RESULTS: These probability calculations were repeated 5000 times resulting in an estimate of the most likely amount of sleep aids used during an ISS mission and a 95% confidence interval. CONCLUSIONS: These results were transferred to the parent IMM for further weighting and integration with other medical conditions, to help inform operational decisions. This model is a potential planning tool for ensuring adequate sleep during sleep disrupted periods of a mission.

Evaluating Bone Loss in ISS Astronauts.

PubMed

Sibonga, Jean D; Spector, Elisabeth R; Johnston, Smith L; Tarver, William J

2015-12-01

The measurement of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) is the Medical Assessment Test used at the NASA Johnson Space Center to evaluate whether prolonged exposure to spaceflight increases the risk for premature osteoporosis in International Space Station (ISS) astronauts. The DXA scans of crewmembers' BMD during the first decade of the ISS existence showed precipitous declines in BMD for the hip and spine after the typical 6-mo missions. However, a concern exists that skeletal integrity cannot be sufficiently assessed solely by DXA measurement of BMD. Consequently, use of relatively new research technologies is being proposed to NASA for risk surveillance and to enhance long-term management of skeletal health in long-duration astronauts. Sibonga JD, Spector ER, Johnston SL, Tarver WJ. Evaluating bone loss in ISS astronauts.

Thirsk during CHeCS medical emergency training

NASA Image and Video Library

2009-07-02

ISS020-E-016866 (2 July 2009) --- Canadian Space Agency astronaut Robert Thirsk, Expedition 20 flight engineer, participates in Crew Health Care Systems (CHeCS) medical emergency training in the Destiny laboratory of the International Space Station.

Estimated Probabililty of Chest Injury During an International Space Station Mission

NASA Technical Reports Server (NTRS)

Lewandowski, Beth E.; Milo, Eric A.; Brooker, John E.; Weaver, Aaron S.; Myers, Jerry G., Jr.

2013-01-01

The Integrated Medical Model (IMM) is a decision support tool that is useful to spaceflight mission planners and medical system designers when assessing risks and optimizing medical systems. The IMM project maintains a database of medical conditions that could occur during a spaceflight. The IMM project is in the process of assigning an incidence rate, the associated functional impairment, and a best and a worst case end state for each condition. The purpose of this work was to develop the IMM Chest Injury Module (CIM). The CIM calculates the incidence rate of chest injury per person-year of spaceflight on the International Space Station (ISS). The CIM was built so that the probability of chest injury during one year on ISS could be predicted. These results will be incorporated into the IMM Chest Injury Clinical Finding Form and used within the parent IMM model.

Estimated Probability of Traumatic Abdominal Injury During an International Space Station Mission

NASA Technical Reports Server (NTRS)

Lewandowski, Beth E.; Brooker, John E.; Weavr, Aaron S.; Myers, Jerry G., Jr.; McRae, Michael P.

2013-01-01

The Integrated Medical Model (IMM) is a decision support tool that is useful to spaceflight mission planners and medical system designers when assessing risks and optimizing medical systems. The IMM project maintains a database of medical conditions that could occur during a spaceflight. The IMM project is in the process of assigning an incidence rate, the associated functional impairment, and a best and a worst case end state for each condition. The purpose of this work was to develop the IMM Abdominal Injury Module (AIM). The AIM calculates an incidence rate of traumatic abdominal injury per person-year of spaceflight on the International Space Station (ISS). The AIM was built so that the probability of traumatic abdominal injury during one year on ISS could be predicted. This result will be incorporated into the IMM Abdominal Injury Clinical Finding Form and used within the parent IMM model.

Emergency medical equipment on board German airliners.

PubMed

Hinkelbein, Jochen; Neuhaus, Christopher; Wetsch, Wolfgang A; Spelten, Oliver; Picker, Susanne; Böttiger, Bernd W; Gathof, Birgit S

2014-01-01

Medical emergencies often occur on commercial airline flights, but valid data on their causes and consequences are rare. Therefore, it is unclear what emergency medical equipment is necessary. Although a minimum standard for medical equipment is defined in regulations, additional material is not standardized and may vary significantly between different airlines. German airlines operating aircrafts with more than 30 seats were selected and interviewed with a 5-page written questionnaire between August 2011 and January 2012. Besides pre-packed and required emergency medical material, drugs, medical devices, and equipment lists were queried. If no reply was received, airlines were contacted another three times by e-mail and/or phone. Descriptive analysis was used for data presentation and interpretation. From a total of 73 German airlines, 58 were excluded from analysis (eg, those not providing passenger transport). Fifteen airlines were contacted and data of 13 airlines were available for analysis (two airlines did not participate). A first aid kit was available on all airlines. Seven airlines reported having a doctor's kit, and another four provided an "emergency medical kit." Four airlines provided an automated external defibrillator (AED)/electrocardiogram (ECG). While six airlines reported providing anesthesia drugs, a laryngoscope, and endotracheal tubes, another four airlines did not provide even a resuscitator bag. One airline did not provide any material for cardiopulmonary resuscitation (CPR). Although the minimal material required according to European aviation regulations is provided by all airlines for medical emergencies, there are significant differences in the provision of additional material. The equipment on most airlines is not sufficient for the treatment of specific emergencies according to published medical guidelines (eg, for CPR or acute myocardial infarction). © 2014 International Society of Travel Medicine.

Evaluating ACLS Algorithms for the International Space Station (ISS) - A Paradigm Revisited

NASA Technical Reports Server (NTRS)

Alexander, Dave; Brandt, Keith; Locke, James; Hurst, Victor, IV; Mack, Michael D.; Pettys, Marianne; Smart, Kieran

2007-01-01

The ISS may have communication gaps of up to 45 minutes during each orbit and therefore it is imperative to have medical protocols, including an effective ACLS algorithm, that can be reliably autonomously executed during flight. The aim of this project was to compare the effectiveness of the current ACLS algorithm with an improved algorithm having a new navigation format.

Service on demand for ISS users

NASA Astrophysics Data System (ADS)

Hüser, Detlev; Berg, Marco; Körtge, Nicole; Mildner, Wolfgang; Salmen, Frank; Strauch, Karsten

2002-07-01

Since the ISS started its operational phase, the need of logistics scenarios and solutions, supporting the utilisation of the station and its facilities, becomes increasingly important. Our contribution to this challenge is a SERVICE On DEMAND for ISS users, which offers a business friendly engineering and logistics support for the resupply of the station. Especially the utilisation by commercial and industrial users is supported and simplified by this service. Our industrial team, consisting of OHB-System and BEOS, provides experience and development support for space dedicated hard- and software elements, their transportation and operation. Furthermore, we operate as the interface between customer and the envisaged space authorities. Due to a variety of tailored service elements and the ongoing servicing, customers can concentrate on their payload content or mission objectives and don't have to deal with space-specific techniques and regulations. The SERVICE On DEMAND includes the following elements: ITR is our in-orbit platform service. ITR is a transport rack, used in the SPACEHAB logistics double module, for active and passive payloads on subrack- and drawer level of different standards. Due to its unique late access and early retrieval capability, ITR increases the flexibility concerning transport capabilities to and from the ISS. RIST is our multi-functional test facility for ISPR-based experiment drawer and locker payloads. The test program concentrates on physical and functional interface and performance testing at the payload developers site prior to the shipment to the integration and launch. The RIST service program comprises consulting, planning and engineering as well. The RIST test suitcase is planned to be available for lease or rent to users, too. AMTSS is an advanced multimedia terminal consulting service for communication with the space station scientific facilities, as part of the user home-base. This unique ISS multimedia kit combines communication technologies, software tools and hardware to provide a simple and cost-efficient access to data from the station, using the interconnection ground subnetwork. BEOLOG is our efficient ground logistics service for the transportation of payload hardware and support equipment from the user location to the launch/landing sites for the ISS service flights and back home. The main function of this service is the planning and organisation of all packaging, handling, storage & transportation tasks according to international rules. In conclusion, we offer novel service elements for logistics ground- and flight-infrastructure, dedicated for ISS users. These services can be easily adapted to the needs of users and are suitable for other μg- platforms as well.

Contamination Detection and Mitigation Strategies for Unsymmetric Dimethylhydrazine/Nitrogen Tetroxide Non-Combustion Product Residues

NASA Technical Reports Server (NTRS)

Greene, Benjamin; Buchanan, Vanessa D.; Baker, David L.

2006-01-01

Dimethylamine and nitrite, which are non-combustion reaction products of unsymmetrical dimethylhydrazine (UDMH) and nitrogen tetroxide (NTO) propellants, can contaminate spacesuits during extra-vehicular activity (EVA) operations. They can react with water in the International Space Station (ISS) airlock to form N-nitrosodimethylamine (NDMA), a carcinogen. Detection methods for assessing nitrite and dimethylamine contamination were investigated. The methods are based on color-forming reactions in which intensity of color is proportional to concentration. A concept color detection kit using a commercially available presumptive field test for methamphetamine coupled with nitrite test strips was developed and used to detect dimethylamine and nitrite. Contamination mitigation strategies were also developed.

International Space Station United States Laboratory Module Water Recovery Management Subsystem Verification from Flight 5A to Stage ULF2

NASA Technical Reports Server (NTRS)

Williams, David E.; Labuda, Laura

2009-01-01

The International Space Station (ISS) Environmental Control and Life Support (ECLS) system comprises of seven subsystems: Atmosphere Control and Supply (ACS), Atmosphere Revitalization (AR), Fire Detection and Suppression (FDS), Temperature and Humidity Control (THC), Vacuum System (VS), Water Recovery and Management (WRM), and Waste Management (WM). This paper provides a summary of the nominal operation of the United States (U.S.) Laboratory Module WRM design and detailed element methodologies utilized during the Qualification phase of the U.S. Laboratory Module prior to launch and the Qualification of all of the modification kits added to it from Flight 5A up and including Stage ULF2.

Installation of Radioskaf 11.2 Kit and batteries for Radioskaf (Suitsat-1) on Expedition 12

NASA Image and Video Library

2006-01-24

ISS012-E-15655 (24 Jan. 2006) --- In the Unity node of the International Space Station, cosmonaut Valery I. Tokarev, Expedition 12 flight engineer representing Russia's Federal Space Agency, puts finishing touches on an old Russian Orlan spacesuit that will be released by hand from the space station during a spacewalk Feb. 3, 2006. Outfitted with a special radio transmitter and other gear, the spacesuit comprises a Russian experiment called SuitSat. It will fly free from the station as a satellite in orbit for several weeks of scientific research and radio tracking, including communications by amateur radio operators. Eventually, it will enter the atmosphere and be destroyed.

Analysis of the Ability of United States and Russian Trace Contaminant Control Systems to Meet U.S. 180-Day and Russian 360-Day Spacecraft Maximum Allowable Concentrations

NASA Technical Reports Server (NTRS)

Perry, J. L.

2016-01-01

As the Space Station Freedom program transitioned to become the International Space Station (ISS), uncertainty existed concerning the performance capabilities for U.S.- and Russian-provided trace contaminant control (TCC) equipment. In preparation for the first dialogue between NASA and Russian Space Agency personnel in Moscow, Russia, in late April 1994, an engineering analysis was conducted to serve as a basis for discussing TCC equipment engineering assumptions as well as relevant assumptions on equipment offgassing and cabin air quality standards. The analysis presented was conducted as part of the efforts to integrate Russia into the ISS program via the early ISS Multilateral Medical Operations Panel's Air Quality Subgroup deliberations. This analysis, served as a basis for technical deliberations that established a framework for TCC system design and operations among the ISS program's international partners that has been instrumental in successfully managing the ISS common cabin environment.

Teaching Medical Students About “The Conversation”: An Interactive Value-Based Advance Care Planning Session

PubMed Central

Lum, Hillary D.; Dukes, Joanna; Church, Skotti; Abbott, Jean; Youngwerth, Jean M.

2017-01-01

Background Advance care planning (ACP) promotes care consistent with patient wishes. Medical education should teach how to initiate value-based ACP conversations. Objective To develop and evaluate an ACP educational session to teach medical students a value-based ACP process and to encourage students to take personal ACP action steps. Design Groups of third-year medical students participated in a 75-minute session using personal reflection and discussion framed by The Conversation Starter Kit. The Conversation Project is a free resource designed to help individuals and families express their wishes for end-of-life care. Setting and Participants One hundred twenty-seven US third-year medical students participated in the session. Measurements Student evaluations immediately after the session and 1 month later via electronic survey. Results More than 90% of students positively evaluated the educational value of the session, including rating highly the opportunities to reflect on their own ACP and to use The Conversation Starter Kit. Many students (65%) reported prior ACP conversations. After the session, 73% reported plans to discuss ACP, 91% had thought about preferences for future medical care, and 39% had chosen a medical decision maker. Only a minority had completed an advance directive (14%) or talked with their health-care provider (1%). One month later, there was no evidence that the session increased students’ actions regarding these same ACP action steps. Conclusion A value-based ACP educational session using The Conversation Starter Kit successfully engaged medical students in learning about ACP conversations, both professionally and personally. This session may help students initiate conversations for themselves and their patients. PMID:28273761

Code Blue on Orbit: Treating Cardiac Arrest on the ISS

NASA Technical Reports Server (NTRS)

Bacal, Kira; Redmond, Melissa

2004-01-01

As a result of the Columbia tragedy on February 1,2003, the International Space Station (ISS) crew size has been temporarily reduced from three to two. This change forces adaptations in many operational procedures used by the crew, including medical protocols which were designed for scenarios involving one casualty and two caregivers. The Office of Space Medicine directed that the procedure for the resuscitation of a crewmember in cardiac arrest be rewritten for use by a single care provider. Methods: Adaptation of this procedure made use of current American Heart Association Advanced Cardiac Life Support (ACLS) procedures and reflects necessary compromises between the realities of the operational environment and prompt provision of medical care. Results: Numerous changes were incorporated due to the diminution in available personnel, including substitution of endotracheal rather than intravenous delivery of drugs, more rapid defibrillation, addition of a precordial thump, removal of transcutaneous pacing, streamlining of procedural steps, and clarification of termination criteria. Discussion: The on-orbit care available to the ISS crewmembers is constrained by numerous factors, including crew medical training, minimal medical assets, limited air/ground communication , and a single caregiver for the foreseeable future. All of these combine to make a successful resuscitation unlikely, however, this procedure must ultimately deal with not only the patient's welfare, but also that of the caregiver, the mission, and the program.

Utilization of emergency medical kits by air carriers.

DOT National Transportation Integrated Search

1991-03-01

The Department of Transportation Emergency Medical Equipment Requirements Rule of January 9, 1986, mandated a period of 24 months (August 1986 - July 1988) during which all air carriers flying under Federal Aviation Regulation, Part 121, would monito...

ISS Utilization for Exploration-Class Missions

NASA Technical Reports Server (NTRS)

FIncke, R.; Davis-Street, J.; Korth, D.

2006-01-01

Exercise countermeasures are the most commonly utilized approach for maintaining the health and performance of astronauts during spaceflight missions. However, International Space Station (ISS) exercise countermeasure hardware reliability and prescriptions are not at a point of departure to support exploration-class missions. The JSC Exercise Countermeasures Project (ECP) plans to use ISS as a research and hardware evaluation platform to define and validate improved exercise hardware, prescriptions, and monitoring strategies to support crewmember operations on the Moon and Mars. The ECP will partner with JSC's Space Medicine Division to standardize elements of ISS exercise prescriptions to better understand their efficacy and to propose modified prescriptions for implementation that may be used in the crew exploration vehicle and/or lunar habitat. In addition, evaluations of the ISS treadmill harness will be conducted to define and improve fit and function, and assess the next generation medical monitoring devices such as the portable unit for metabolic analysis and the muscle atrophy research and exercise system for completion of periodic fitness evaluations during lunar and Mars travel. Finally, biomechanical data from ISS crew exercise sessions will be obtained to better understand loading and restraint systems, and identify the physiologic requirements during ISS extravehicular activities that may be analogous to extended excursions from the lunar habitat. It is essential to optimize exercise prescriptions, hardware, and monitoring strategies for exploration initiatives using ISS as a platform before the planned retirement of the Shuttle in 2010 and the declining NASA emphasis on ISS to maximize knowledge before embarking on travel to the Moon and Mars.

Squat Biomechanical Modeling Results from Exercising on the Hybrid Ultimate Lifting Kit

NASA Technical Reports Server (NTRS)

Gallo, Christopher A.; Thompson, William K.; Lewandowski, Beth E.; Jagodnik, Kathleen M.

2016-01-01

Long duration space travel will expose astronauts to extended periods of reduced gravity. Since gravity is not present to aid loading, astronauts will use resistive and aerobic exercise regimes for the duration of the space flight to minimize loss of bone density, muscle mass and aerobic capacity that occurs during exposure to a reduced gravity environment. Unlike the International Space Station (ISS), the area available for an exercise device in the next generation of spacecraft is limited and therefore compact resistance exercise device prototypes are being developed. The Advanced Resistive Exercise Device (ARED) currently on the ISS is being used as a benchmark for the functional performance of these new devices. Biomechanical data collection and computational modeling aid the device design process by quantifying the joint torques and the musculoskeletal forces that occur during exercises performed on the prototype devices. The computational models currently under development utilize the OpenSim software, an open source code for musculoskeletal modeling, with biomechanical input data from test subjects for estimation of muscle and joint loads. The subjects are instrumented with reflective markers for motion capture data collection while exercising on the Hybrid Ultimate Lifting Kit (HULK) prototype device. Ground reaction force data is collected with force plates under the feet and device loading is recorded through load cells internal to the HULK. Test variables include applied device load, narrow or wide foot stance, slow or fast cadence and the harness or long bar interface between the test subject and the device. Data is also obtained using free weights for a comparison to the resistively loaded exercise device. This data is input into the OpenSim biomechanical model, which has been scaled to match the anthropometrics of the test subject, to calculate the body loads. The focus of this presentation is to summarize the results from the full squat exercises across the different test variables.

The Effects of Long-Term Feeding of Rodent Food Bars on Lipid Peroxidation And Antioxidant Enzyme Levels In Fisher Rats

NASA Technical Reports Server (NTRS)

Ramirez, Joel; Zirkle-Yoshida, M.; Piert, S.; Barrett, J.; Yul, D.; Dalton, B.; Girten, B.

2001-01-01

A specialized rodent food bar diet has been developed and utilized successfully for short-duration shuttle missions. Recent tests conducted in preparation for experiments aboard the International Space Station (ISS) indicated that long-term food bar feeding for three months induced hyperlipidemia in rats. This study examined oxidative stress status in livers of these same animals. Spectrophotometric analysis of 79 Fischer rat livers (40 female and 39 male) for lipid peroxidation (LPO) and superoxide dismutase (SOD) was conducted using Bioxytech LPO-587(TM) assay kit and SOD-525(Tm) assay kit, respectively. The treatment groups consisted of 20 male CHOW and 19 male FOOD BAR rats and 20 female CHOW and 20 female FOOD BAR rats. Statistical analysis to compare differences between groups was performed by standard analysis of variance procedures. The male FOOD BAR group LPO mean (3.6 +/- 0.2 mmol/g) was significantly (p less than or equal to 0.05) greater than that of the male CHOW group (2.1 +/-0.1 mmol/g). Moreover the female FOOD BAR group LPO mean (2.9 +/-0.1 mmol/g) was also significantly greater than the female CHOW group mean (2.2 +/-0.1 mmol/g). The mean values for SOD in both male and female groups showed no significant differences between CHOW and FOOD BAR groups. These results show that LPO levels were significantly higher in both the male and female FOOD BAR groups compared to CHOW groups and that there was no concomitant increase in SOD levels across the group. In addition, males showed a greater difference than females in terms of LPO levels. These findings suggest a need for further investigation into the use of the current food bar formulation for long-term experiments such as those planned for the ISS.

International Space Station Research for the Next Decade: International Coordination and Research Accomplishments

NASA Technical Reports Server (NTRS)

Thumm, Tracy L.; Robinson, Julie A.; Johnson-Green, Perry; Buckley, Nicole; Karabadzhak, George; Nakamura, Tai; Sorokin, Igor V.; Zell, Martin; Sabbagh, Jean

2011-01-01

During 2011, the International Space Station reached an important milestone in the completion of assembly and the shift to the focus on a full and continuous utilization mission in space. The ISS partnership itself has also met a milestone in the coordination and cooperation of utilization activities including research, technology development and education. We plan and track all ISS utilization activities jointly and have structures in place to cooperate on common goals by sharing ISS assets and resources, and extend the impacts and efficiency of utilization activities. The basic utilization areas on the ISS include research, technology development and testing, and education/outreach. Research can be categorized as applied research for future exploration, basic research taking advantage of the microgravity and open space environment, and Industrial R&D / commercial research focused at industrial product development and improvement. Technology development activities range from testing of new spacecraft systems and materials to the use of ISS as an analogue for future exploration missions to destinations beyond Earth orbit. This presentation, made jointly by all ISS international partners, will highlight the ways that international cooperation in all of these areas is achieved, and the overall accomplishments that have come as well as future perspectives from the cooperation. Recently, the partnership has made special efforts to increase the coordination and impact of ISS utilization that has humanitarian benefits. In this context the paper will highlight tentative ISS utilization developments in the areas of Earth remote sensing, medical technology transfer, and education/outreach.

Effect of using a Planecta™ port with a three-way stopcock on the natural frequency of blood pressure transducer kits.

PubMed

Fujiwara, Shigeki; Tachihara, Keiichi; Mori, Satoshi; Ouchi, Kentaro; Yokoe, Chizuko; Imaizumi, Uno; Morimoto, Yoshinari; Miki, Yoichiro; Toyoguchi, Izumi; Yoshida, Kazu-Ichi; Yokoyama, Takeshi

2016-12-01

Blood pressure transducer kits are equipped with two types of Planecta™ ports-the flat-type Planecta™ port (FTP) and the Planecta™ port with a three-way stopcock (PTS). We reported that FTP application decreased the natural frequency of the kits. However, Planecta™ is an invaluable tool as it prevents infection, ensures technical simplicity, and excludes air. Hence, an ideal Planecta™ port that does not decrease the frequency characteristics is required. As a first step in this direction, we aimed to assess the influence of PTSs on the natural frequency of blood transducer kits. A DTXplus transducer kit (DT4812J; Argon Medical Devices, TX, USA) was used along with ≥1 PTSs (JMS, Hiroshima, Japan), and the frequency characteristics were assessed. The natural frequency and damping coefficient of each kit were obtained by using frequency characteristics analysis software, and these parameters were evaluated by plotting them on Gardner's chart. Regardless of whether one or two PTSs were inserted, the natural frequency of the kits only slightly decreased (from 42.5 to 41.1 Hz, when 2 PTSs were used). Thus, the frequency characteristics of the kits with PTSs were adequate for pressure monitoring. The insertion of ≥2 FTPs in pressure transducer kits should be avoided, as they markedly decrease the natural frequency and lead to underdamping. However, the effect of PTS insertion in pressure transducer kits on the frequency characteristics is minimal. Thus, we found that the use of PTS markedly improved the frequency characteristics as compared to the use of FTP.

Medics as a channel for worksite health promotion in remote global locations.

PubMed

Bisits Bullen, Piroska A

2012-01-01

In the energy and mining sectors, it is common for employees to work in geographically remote locations, often with a medic for emergency response. This study evaluated an intervention to increase the number of medics conducting health promotion in remote worksites. Interviews were conducted to gather data for informing intervention and survey development. The intervention was evaluated in a quasiexperimental posttest-only comparison group design using survey data collected at baseline and again after 12 months. The intervention was implemented in remote worksites (N  =  201). There were 96 worksites in the intervention condition and 105 sites in the control condition. The target population was medics, including nurses, doctors, and paramedics, operating in remote worksites in 44 countries. The intervention was a series of campaign tool kits. The tool kits were adapted to the remote environment and could be customized for culture, language, and education level. The survey assessed frequency of health promotion activities, satisfaction with the intervention, and barriers to implementation. Survey data were analyzed using descriptive statistics and χ(2) tests. Interview results were coded to identify themes. Most medics (88%) in the intervention group reported running "tool box talks" (short education sessions) on at least a monthly basis, compared with 78% in the comparison group (p  =  .056). The trend was similar for displaying posters (71% vs. 55%; p  =  .021) and advocating for policy changes (84% vs. 71%; p  =  .027). Medic satisfaction was high. Difficulty distributing tool kits was the main barrier to implementation. When provided with appropriate tools, medics may be an ideal channel for health promotion in remote worksites.

Cardiac-Biology-In-Space

NASA Image and Video Library

2017-08-21

Astronauts experience structural changes to their heart during long-duration spaceflight, but the biological basis of that is not clearly understood. Jonathon Baio, a doctoral student at Loma Linda University’s School of Medicine, details an investigation of cardiovascular stem cells that hopes to better understand their role in cardiac biology and tissue regeneration, which could advance ways to maintain cardiac health of astronauts during extended missions as well inform future treatments to reverse heart muscle loss upon return to Earth, and may help the medical community combat cardiovascular disease, one of the world’s leading causes of death. For more on space station science, please visit: Twitter: https://twitter.com/ISS_Research or @ISS_research Website: https://www.nasa.gov/mission_pages/station/research/index.html _______________________________________ FOLLOW THE SPACE STATION! Twitter: https://twitter.com/Space_Station Facebook: https://www.facebook.com/ISS Instagram: https://instagram.com/iss/

The Abbreviated Injury Scale and its correlation with preventable traumatic accidental deaths: a study from South Delhi.

PubMed

Rautji, R; Bhardwaj, D N; Dogra, T D

2006-04-01

Anatomic trauma scoring systems are fundamental to trauma research. The Abbreviated Injury Scale (AIS) and its derivative, the Injury Severity Score (ISS), are the most frequently used scales. In a prospective study, 400 autopsies of road traffic accident victims performed between January 2002 and December 2003 were coded according to the AIS and ISS methods. All the cases were classified into different injury groups according to the Injury Severity Scale. Fifty-eight cases (14.5%) were assigned an ISS value of <25; 244 (61%) cases were valued between 25-49; 38 cases (9.5%) were valued between 50-74 and 60 (15%) cases had a value of 75. On analysis of medical care, in cases with ISS<50, about 96% of the victims did not receive optimal care quickly enough with a lack of pre-hospital resuscitation measures and lengthy transportation time to hospital being of major importance.

Performance Evaluation of the Operational Air Quality Monitor for Water Testing Aboard the International Space Station

NASA Technical Reports Server (NTRS)

Wallace, William T.; Limero, Thomas F.; Gazda, Daniel B.; Macatangay, Ariel V.; Dwivedi, Prabha; Fernandez, Facundo M.

2014-01-01

In the history of manned spaceflight, environmental monitoring has relied heavily on archival sampling. For short missions, this type of sample collection was sufficient; returned samples provided a snapshot of the presence of chemical and biological contaminants in the spacecraft air and water. However, with the construction of the International Space Station (ISS) and the subsequent extension of mission durations, soon to be up to one year, the need for enhanced, real-time environmental monitoring became more pressing. The past several years have seen the implementation of several real-time monitors aboard the ISS, complemented with reduced archival sampling. The station air is currently monitored for volatile organic compounds (VOCs) using gas chromatography-differential mobility spectrometry (Air Quality Monitor [AQM]). The water on ISS is analyzed to measure total organic carbon and biocide concentrations using the Total Organic Carbon Analyzer (TOCA) and the Colorimetric Water Quality Monitoring Kit (CWQMK), respectively. The current air and water monitors provide important data, but the number and size of the different instruments makes them impractical for future exploration missions. It is apparent that there is still a need for improvements in environmental monitoring capabilities. One such improvement could be realized by modifying a single instrument to analyze both air and water. As the AQM currently provides quantitative, compound-specific information for target compounds present in air samples, and many of the compounds are also targets for water quality monitoring, this instrument provides a logical starting point to evaluate the feasibility of this approach. In this presentation, we will discuss our recent studies aimed at determining an appropriate method for introducing VOCs from water samples into the gas phase and our current work, in which an electro-thermal vaporization unit has been interfaced with the AQM to analyze target analytes at the relevant concentrations at which they are routinely detected in archival water samples from the ISS.

Reversal of overdose on fentanyl being illicitly sold as heroin with naloxone nasal spray: A case report.

PubMed

Fareed, Ayman; Buchanan-Cummings, Ann Marie; Crampton, Kelli; Grant, Angela; Drexler, Karen

2015-08-01

This is a case report describing a reversal of fentanyl overdose with naloxone nasal spray. The patient was not aware that he overdosed on fentanyl being sold as heroin. The Veterans Health Administration (VHA) has implemented an initiative to provide education for veterans, their families, friends and significant others about opioid overdose and use of naloxone reversal kits. The Atlanta VA Medical Center adopted this program to reduce the risk of opioid overdose in high risk patients. Over the past year, we provided educational sessions for 63 veterans and their families. We also prescribed 41 naloxone kits. We have received three reports of opioid overdose reversal with use of naloxone kits prescribed by the Atlanta VA Medical Center. The authors recommend that public health administrators and policy makers advocate for the implementation of these programs to reduce the rising number of overdose death in the United States and worldwide. © American Academy of Addiction Psychiatry.

Operational and Research Musculoskeletal Summit: Summit Recommendations

NASA Technical Reports Server (NTRS)

Scheuring, Richard A.; Walton, Marlei; Davis-Street, Janis; Smaka, Todd J.; Griffin, DeVon

2006-01-01

The Medical Informatics and Health Care Systems group in the Office of Space Medicine at NASA Johnson Space Center (JSC) has been tasked by NASA with improving overall medical care on the International Space Station (ISS) and providing insights for medical care for future exploration missions. To accomplish this task, a three day Operational and Research Musculoskeletal Summit was held on August 23-25th, 2005 at Space Center Houston. The purpose of the summit was to review NASA#s a) current strategy for preflight health maintenance and injury screening, b) current treatment methods in-flight, and c) risk mitigation strategy for musculoskeletal injuries or syndromes that could occur or impact the mission. Additionally, summit participants provided a list of research topics NASA should consider to mitigate risks to astronaut health. Prior to the summit, participants participated in a web-based pre-summit forum to review the NASA Space Medical Conditions List (SMCL) of musculoskeletal conditions that may occur on ISS as well as the resources currently available to treat them. Data from the participants were compiled and integrated with the summit proceedings. Summit participants included experts from the extramural physician and researcher communities, and representatives from NASA Headquarters, the astronaut corps, JSC Medical Operations and Human Adaptations and Countermeasures Offices, Glenn Research Center Human Research Office, and the Astronaut Strength, Conditioning, and Reconditioning (ASCR) group. The recommendations in this document are based on a summary of summit discussions and the best possible evidence-based recommendations for musculoskeletal care for astronauts while on the ISS, and include recommendati ons for exploration class missions.

Analysis of Advanced Respiratory Support Onboard ISS and CCV

NASA Technical Reports Server (NTRS)

Shah, Ronak V.; Kertsman, Eric L.; Alexander, David J.; Duchesne, Ted; Law, Jennifer; Roden, Sean K.

2014-01-01

NASA is collaborating with private entities for the development of commercial space vehicles. The Space and Clinical Operations Division was tasked to review the oxygen and respiratory support system and recommend what capabilities, if any, the vehicle should have to support the return of an ill or injured crewmember. The Integrated Medical Model (IMM) was utilized as a data source for the development of these recommendations. The Integrated Medical Model (IMM) was used to simulate a six month, six crew, International Space Station (ISS) mission. Three medical system scenarios were considered based on the availability of (1) oxygen only, (2) oxygen and a ventilator, or (3) neither oxygen nor ventilator. The IMM analysis provided probability estimates of medical events that would require either oxygen or ventilator support. It also provided estimates of crew health, the probability of evacuation, and the probability of loss of crew life secondary to medical events for each of the three medical system scenarios. These IMM outputs were used as objective data to enable evidence-based decisions regarding oxygen and respiratory support system requirements for commercial crew vehicles. The IMM provides data that may be utilized to support informed decisions regarding the development of medical systems for commercial crew vehicles.

Recent Pharmacology Studies on the International Space Station

NASA Technical Reports Server (NTRS)

Wotring, Virginia

2014-01-01

The environment on the International Space Station (ISS) includes a variety of potential stressors including the absence of Earth's gravity, elevated exposure to radiation, confined living and working quarters, a heavy workload, and high public visibility. The effects of this extreme environment on pharmacokinetics, pharmacodynamics, and even on stored medication doses, are not yet understood. Dr. Wotring will discuss recent analyses of medication doses that experienced long duration storage on the ISS and a recent retrospective examination of medication use during long-duration spaceflights. She will also describe new pharmacology experiments that are scheduled for upcoming ISS missions. Dr. Virginia E. Wotring is a Senior Scientist in the Division of Space Life Sciences in the Universities Space Research Association, and Pharmacology Discipline Lead at NASA's Johnson Space Center, Human Heath and Countermeasures Division. She received her doctorate in Pharmacological and Physiological Science from Saint Louis University after earning a B.S. in Chemistry at Florida State University. She has published multiple studies on ligand gated ion channels in the brain and spinal cord. Her research experience includes drug mechanisms of action, drug receptor structure/function relationships and gene & protein expression. She joined USRA (and spaceflight research) in 2009. In 2012, her book reviewing pharmacology in spaceflight was published by Springer: Space Pharmacology, Space Development Series.

The injury severity score or the new injury severity score for predicting mortality, intensive care unit admission and length of hospital stay: experience from a university hospital in a developing country.

PubMed

Tamim, Hala; Al Hazzouri, Adina Zeki; Mahfoud, Ziad; Atoui, Maria; El-Chemaly, Souheil

2008-01-01

Limited research has been performed to compare the predictive abilities of the injury severity score (ISS) and the new ISS (NISS) in the developing world. From January 2001 until January 2003 all trauma patients admitted to the American University of Beirut Medical Centre were enrolled. The statistical performance of the ISS/NISS in predicting mortality, admission to the intensive care unit (ICU) and length of hospital stay (LOS dichotomised as <10 or > or =10 days) was evaluated using receiver operating characteristic and the Hosmer-Lemeshow calibration statistic. A total of 891 consecutive patients were enrolled. The ISS and NISS were equivalent in predicting survival, and both performed better in patients younger than 65 years of age. However, the ISS predicted ICU admission and LOS better than the NISS. However, these predictive abilities were lower for the geriatric trauma patients aged 65 years and above compared to the other age groups. There are conflicting results in the literature about the abilities of ISS and NISS to predict mortality. However, this is the first study to report that ISS has a superior ability in predicting both LOS and ICU admission. The scoring of trauma severity may need to be individualised to different countries and trauma systems.

Food and medical sample freezer kit concept for Shuttle

NASA Technical Reports Server (NTRS)

Copeland, R. J.; Jaax, J. R.; Proctor, B. W.

1977-01-01

A variety of food and storage of samples can be provided by a Space Shuttle Orbiter Freezer Kit. The proposed concept is an integrated package consisting of four -23 C (-10 F) storage compartments and a Stirling cycle refrigeration unit. The Stirling cycle mechanical refrigeration was selected over alternative systems for superior efficiency and safety. The trade-offs and a conceptual design of the system are presented.

Changing to AIS 2005 and agreement of injury severity scores in a trauma registry with scores based on manual chart review.

PubMed

Stewart, Kenneth E; Cowan, Linda D; Thompson, David M

2011-09-01

The Abbreviated Injury Scale (AIS) recently underwent a major revision from AIS 98 to AIS 05. AIS injury codes form the basis of widely used injury severity scores such as the injury severity score (ISS). ISS thresholds are often used in trauma case definitions and ISS is widely used in injury research to adjust for injury severity. This study evaluated changes from AIS 98 to AIS 05, the changes' effect on ISS distributions, and presents an application of the results. Injury descriptions from medical records of 137 randomly selected patients in the Oklahoma Trauma Registry (OTR) were obtained. A single trained coder used AIS 98 and AIS 05 to code each injury. ISS values were calculated and grouped into 4 categories: 1-8, 9-14, 16-24, >24. Paired ISS was compared using Kappa statistics and tests of symmetry. We identified common injury diagnoses for which AIS severity changed between versions. Estimates of the proportion of patients changing ISS groups were applied to the entire OTR to assess the impact on reporting and on a model for reimbursement. OTR AIS 98 and manual AIS 98-based ISS values had a weighted Kappa of 0.71. OTR AIS 98 and manual AIS 05-based ISS values had a Kappa of 0.58. Manual AIS 98 and manual AIS 05 ISS had the highest Kappa of 0.81, however, though the scores differed by only 1 ISS category, there were 30 discordant pairs. The distribution of these discordant pairs was not symmetrical (Bowker's S=30; df=6; p<0.0001) with AIS 05-based ISS values consistently shifted to a lower ISS category. Reductions in AIS severity and ISS values using AIS 05 were common for extremity fractures and thorax injuries. The results suggest fewer patients would be reported to the OTR or be eligible for reimbursement. Changing from AIS 98 to AIS 05 injury coding resulted in systematic changes in AIS codes and ISS. Specific injuries and body regions were differentially affected. Trauma registries and injury researchers that use AIS based injury coding can use this information to evaluate the potential impact of changes in AIS 2005. Copyright © 2010 Elsevier Ltd. All rights reserved.

Efforts to Reduce International Space Station Crew Maintenance Time in the Management of the Extravehicular Mobility Unit Transport Loop Water Quality

NASA Technical Reports Server (NTRS)

Etter,David; Rector, Tony; Boyle, robert; Zande, Chris Vande

2012-01-01

The EMU (Extravehicular Mobility Unit) contains a semi-closed-loop re-circulating water circuit (Transport Loop) to absorb heat into a LCVG (Liquid Coolant and Ventilation Garment) worn by the astronaut. A second, single-pass water circuit (Feed-water Loop) provides water to a cooling device (Sublimator) containing porous plates, and that water sublimates through the porous plates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. The quality of the EMU Transport Loop water is maintained through the use of a water processing kit (ALCLR - Airlock Cooling Loop Remediation) that is used to periodically clean and disinfect the water circuit. Opportunities to reduce crew time associated with ALCLR operations include a detailed review of the historical water quality data for evidence to support an extension to the implementation cycle. Furthermore, an EMU returned after 2-years of use on the ISS (International Space Station) is being used as a test bed to evaluate the results of extended and repeated ALCLR implementation cycles. Finally, design, use and on-orbit location enhancements to the ALCLR kit components are being considered to allow the implementation cycle to occur in parallel with other EMU maintenance and check-out activities, and to extend the life of the ALCLR kit components. These efforts are undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post- Shuttle 6-year service life.

Efforts to Reduce International Space Station Crew Maintenance for the Management of the Extravehicular Mobility Unit Transport Loop Water Quality

NASA Technical Reports Server (NTRS)

Steele, John W.; Etter, David; Rector, Tony; Boyle, Robert; Vandezande, Christopher

2013-01-01

The EMU (Extravehicular Mobility Unit) contains a semi-closed-loop re-circulating water circuit (Transport Loop) to absorb heat into a LCVG (Liquid Coolant and Ventilation Garment) worn by the astronaut. A second, single-pass water circuit (Feed-water Loop) provides water to a cooling device (Sublimator) containing porous plates, and that water sublimates through the porous plates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. The quality of the EMU Transport Loop water is maintained through the use of a water processing kit (ALCLR Airlock Cooling Loop Remediation) that is used to periodically clean and disinfect the water circuit. Opportunities to reduce crew time associated with on-orbit ALCLR operations include a detailed review of the historical water quality data for evidence to support an extension to the implementation cycle. Furthermore, an EMU returned after 2-years of use on the ISS (International Space Station) is being used as a test bed to evaluate the results of extended and repeated ALCLR implementation cycles. Finally, design, use and on-orbit location enhancements to the ALCLR kit components are being considered to allow the implementation cycle to occur in parallel with other EMU maintenance and check-out activities, and to extend the life of the ALCLR kit components. These efforts are undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post-Shuttle 6-year service life.

Orthostatic Intolerance After ISS and Space Shuttle Missions.

PubMed

Lee, Stuart M C; Feiveson, Alan H; Stein, Sydney; Stenger, Michael B; Platts, Steven H

2015-12-01

Cardiovascular deconditioning apparently progresses with flight duration, resulting in a greater incidence of orthostatic intolerance following long-duration missions. Therefore, we anticipated that the proportion of astronauts who could not complete an orthostatic tilt test (OTT) would be higher on landing day and the number of days to recover greater after International Space Station (ISS) than after Space Shuttle missions. There were 20 ISS and 65 Shuttle astronauts who participated in 10-min 80° head-up tilt tests 10 d before launch, on landing day (R+0), and 3 d after landing (R+3). Fisher's Exact Test was used to compare the ability of ISS and Shuttle astronauts to complete the OTT. Cox regression was used to identify cardiovascular parameters associated with OTT completion and mixed model analysis was used to compare the change and recovery rates between groups. The proportion of astronauts who completed the OTT on R+0 (2 of 6) was less in ISS than in Shuttle astronauts (52 of 65). On R+3, 13 of 15 and 19 of 19 of the ISS and Shuttle astronauts, respectively, completed the OTT. An index comprised of stroke volume and diastolic blood pressure provided a good prediction of OTT completion and was altered by spaceflight similarly for both astronaut groups, but recovery was slower in ISS than in Shuttle astronauts. The proportion of ISS astronauts who could not complete the OTT on R+0 was greater and the recovery rate slower after ISS compared to Shuttle missions. Thus, mission planners and crew surgeons should anticipate the need to tailor scheduled activities and level of medical support to accommodate protracted recovery after long-duration microgravity exposures.

Health Maintenance System (HMS) Hardware Research, Design, and Collaboration

NASA Technical Reports Server (NTRS)

Gonzalez, Stefanie M.

2010-01-01

The Space Life Sciences division (SLSD) concentrates on optimizing a crew member's health. Developments are translated into innovative engineering solutions, research growth, and community awareness. This internship incorporates all those areas by targeting various projects. The main project focuses on integrating clinical and biomedical engineering principles to design, develop, and test new medical kits scheduled for launch in the Spring of 2011. Additionally, items will be tagged with Radio Frequency Interference Devices (RFID) to keep track of the inventory. The tags will then be tested to optimize Radio Frequency feed and feed placement. Research growth will occur with ground based experiments designed to measure calcium encrusted deposits in the International Space Station (ISS). The tests will assess the urine calcium levels with Portable Clinical Blood Analyzer (PCBA) technology. If effective then a model for urine calcium will be developed and expanded to microgravity environments. To support collaboration amongst the subdivisions of SLSD the architecture of the Crew Healthcare Systems (CHeCS) SharePoint site has been redesigned for maximum efficiency. Community collaboration has also been established with the University of Southern California, Dept. of Aeronautical Engineering and the Food and Drug Administration (FDA). Hardware disbursements will transpire within these communities to support planetary surface exploration and to serve as an educational tool demonstrating how ground based medicine influenced the technological development of space hardware.

The National Problem of Untested Sexual Assault Kits (SAKs): Scope, Causes, and Future Directions for Research, Policy, and Practice.

PubMed

Campbell, Rebecca; Feeney, Hannah; Fehler-Cabral, Giannina; Shaw, Jessica; Horsford, Sheena

2015-12-23

Victims of sexual assault are often advised to have a medical forensic exam and sexual assault kit (SAK; also termed a "rape kit") to preserve physical evidence (e.g., semen, blood, and/or saliva samples) to aid in the investigation and prosecution of the crime. Law enforcement are tasked with submitting the rape kit to a forensic laboratory for DNA (deoxyribonucleic acid) analysis, which can be instrumental in identifying offenders in previously unsolved crimes, confirming identify in known-offender assaults, discovering serial rapists, and exonerating individuals wrongly accused. However, a growing number of media stories, investigative advocacy projects, and social science studies indicate that police are not routinely submitting SAKs for forensic testing, and instead rape kits are placed in evidence storage, sometimes for decades. This review article examines the growing national problem of untested rape kits by summarizing current research on the number of untested SAKs in the United States and exploring the underlying reasons why police do not submit this evidence for DNA testing. Recommendations for future research that can guide policy and practice are discussed. © The Author(s) 2015.

Novel Advancements in Internet-Based Real Time Data Technologies

NASA Technical Reports Server (NTRS)

Myers, Gerry; Welch, Clara L. (Technical Monitor)

2002-01-01

AZ Technology has been working with MSFC Ground Systems Department to find ways to make it easier for remote experimenters (RPI's) to monitor their International Space Station (ISS) payloads in real-time from anywhere using standard/familiar devices. AZ Technology was awarded an SBIR Phase I grant to research the technologies behind and advancements of distributing live ISS data across the Internet. That research resulted in a product called "EZStream" which is in use on several ISS-related projects. Although the initial implementation is geared toward ISS, the architecture and lessons learned are applicable to other space-related programs. This paper presents the high-level architecture and components that make up EZStream. A combination of commercial-off-the-shelf (COTS) and custom components were used and their interaction will be discussed. The server is powered by Apache's Jakarta-Tomcat web server/servlet engine. User accounts are maintained in a My SQL database. Both Tomcat and MySQL are Open Source products. When used for ISS, EZStream pulls the live data directly from NASA's Telescience Resource Kit (TReK) API. TReK parses the ISS data stream into individual measurement parameters and performs on-the- fly engineering unit conversion and range checking before passing the data to EZStream for distribution. TReK is provided by NASA at no charge to ISS experimenters. By using a combination of well established Open Source, NASA-supplied. and AZ Technology-developed components, operations using EZStream are robust and economical. Security over the Internet is a major concern on most space programs. This paper describes how EZStream provides for secure connection to and transmission of space- related data over the public Internet. Display pages that show sensitive data can be placed under access control by EZStream. Users are required to login before being allowed to pull up those web pages. To enhance security, the EZStream client/server data transmissions can be encrypted to preclude interception. EZStream was developed to make use of a host of standard platforms and protocols. Each are discussed in detail in this paper. The I3ZStream server is written as Java Servlets. This allows different platforms (i.e. Windows, Unix, Linux . Mac) to host the server portion. The EZStream client component is written in two different flavors: JavaBean and ActiveX. The JavaBean component is used to develop Java Applet displays. The ActiveX component is used for developing ActiveX-based displays. Remote user devices will be covered including web browsers on PC#s and scaled-down displays for PDA's and smart cell phones. As mentioned. the interaction between EZStream (web/data server) and TReK (data source) will be covered as related to ISS. EZStream is being enhanced to receive and parse binary data stream directly. This makes EZStream beneficial to both the ISS International Partners and non-NASA applications (i.e. factory floor monitoring). The options for developing client-side display web pages will be addressed along with the development of tools to allow creation of display web pages by non-programmers.

KIT amplification and gene mutations in acral/mucosal melanoma in Korea.

PubMed

Yun, Jina; Lee, Jeeyun; Jang, Jiryeon; Lee, Eui Jin; Jang, Kee Taek; Kim, Jung Han; Kim, Kyoung-Mee

2011-06-01

Mucosal and acral melanomas have demonstrated different genetic alterations and biological behavior compared with more common cutaneous melanomas. It was recently reported that gain-of-function KIT mutations and/or copy number increases are more common in mucosal and acral melanomas. Thus, we studied the frequency and pattern of KIT aberrations in mucosal and acral melanomas in Korea. We analyzed 97 patients who were pathologically confirmed with mucosal or acral melanoma between 1997 and 2010 at Samsung Medical Center. Of the 97 melanoma patients, 92 were screened for mutations in KIT exons 11, 13, 17, and 18, BRAF and NRAS genes. KIT copy number was assessed by quantitative, real-time PCR. Of the 97 patients, 55 (56.7%) were mucosal, 40 (41.2%) were acral melanoma, and two were of unknown primary origin. Among seven cases with KIT mutation, five (60.0%) occurred in exon 11, one (20.0%) in exon 17, and one (20.0%) in exon 13. Point mutations were the most common, resulting in substitutions in exon 11 (K558R, T574A, L576P, and V559A), exon 13 (N655K), and exon 17 (N822K). A novel Thr574Ala (c.1720A>G) KIT mutation, which has not been reported in melanoma or other tumor types, was identified in one genital melanoma case. Of the 97 mucosal or acral melanoma specimens, 49 were tested for KIT gene copy number changes using quantitative PCR. Increased KIT copy number was identified in 15 patients: seven (40%) of 20 acral melanomas and eight (31%) of 26 mucosal melanomas. Our study implicates that a significant proportion of acral and mucosal melanomas have KIT mutations in Asian population. © 2011 The Authors. APMIS © 2011 APMIS.

Creating Simulated Microgravity Patient Models

NASA Technical Reports Server (NTRS)

Hurst, Victor; Doerr, Harold K.; Bacal, Kira

2004-01-01

The Medical Operational Support Team (MOST) has been tasked by the Space and Life Sciences Directorate (SLSD) at the NASA Johnson Space Center (JSC) to integrate medical simulation into 1) medical training for ground and flight crews and into 2) evaluations of medical procedures and equipment for the International Space Station (ISS). To do this, the MOST requires patient models that represent the physiological changes observed during spaceflight. Despite the presence of physiological data collected during spaceflight, there is no defined set of parameters that illustrate or mimic a 'space normal' patient. Methods: The MOST culled space-relevant medical literature and data from clinical studies performed in microgravity environments. The areas of focus for data collection were in the fields of cardiovascular, respiratory and renal physiology. Results: The MOST developed evidence-based patient models that mimic the physiology believed to be induced by human exposure to a microgravity environment. These models have been integrated into space-relevant scenarios using a human patient simulator and ISS medical resources. Discussion: Despite the lack of a set of physiological parameters representing 'space normal,' the MOST developed space-relevant patient models that mimic microgravity-induced changes in terrestrial physiology. These models are used in clinical scenarios that will medically train flight surgeons, biomedical flight controllers (biomedical engineers; BME) and, eventually, astronaut-crew medical officers (CMO).

STK Integrated Message Production List Editor (SIMPLE) for CEO Operations

NASA Technical Reports Server (NTRS)

Trenchard, Mike; Heydorn, James

2014-01-01

Late in fiscal year 2011, the Crew Earth Observations (CEO) team was tasked to upgrade and replace its mission planning and mission operations software systems, which were developed in the Space Shuttle era of the 1980s and 1990s. The impetuses for this change were the planned transition of all workstations to the Windows 7 64-bit operating system and the desire for more efficient and effective use of Satellite Tool Kit (STK) software required for reliable International Space Station (ISS) Earth location tracking. An additional requirement of this new system was the use of the same SQL database of CEO science sites from the SMMS, which was also being developed. STK Integrated Message Production List Editor (SIMPLE) is the essential, all-in-one tool now used by CEO staff to perform daily ISS mission planning to meet its requirement to acquire astronaut photography of specific sites on Earth. The sites are part of a managed, long-term database that has been defined and developed for scientific, educational, and public interest. SIMPLE's end product is a set of basic time and location data computed for an operator-selected set of targets that the ISS crew will be asked to photograph (photography is typically planned 12 to 36 hours out). The CEO operator uses SIMPLE to (a) specify a payload operations planning period; (b) acquire and validate the best available ephemeris data (vectors) for the ISS during the planning period; (c) ingest and display mission-specific site information from the CEO database; (d) identify and display potential current dynamic event targets as map features; (e) compute and display time and location information for each target; (f) screen and select targets based on known crew availability constraints, obliquity constraints, and real-time evaluated constraints to target visibility due to illumination (sun elevation) and atmospheric conditions (weather); and finally (g) incorporate basic, computed time and location information for each selected target into the daily CEO Target List product (message) for submission to ISS payload planning and integration teams for their review and approval prior to uplink. SIMPLE requires and uses the following resources: an ISS mission planning period Greenwich Mean Time start date/time and end date/time), the best available ISS mission ephemeris data (vectors) for that planning period, the STK software package configured for the ISS, and an ISS mission-specific subset of the CEO sites database. The primary advantages realized by the development and implementation of SIMPLE into the CEO payload operations support activity are a smooth transition to the Windows 7 operating system upon scheduled workstation refresh; streamlining of the input and verification of the current ISS ephemeris (vector data); seamless incorporation of selected contents of the SQL database of science sites; the ability to tag and display potential dynamic event opportunities on orbit track maps; simplification of the display and selection of encountered sites based on crew availability, illumination, obliquity, and weather constraints; the incorporation of high-quality mapping of the Earth with various satellite-based datasets for use in describing targets; and the ability to encapsulate and export the essential selected target elements in XML format for use by onboard Earth-location systems, such as Worldmap. SIMPLE is a carefully designed and crafted in-house software package that includes detailed help files for the user and meticulous internal documentation for future modifications. It was delivered in February 2012 for test and evaluation. Following acceptance, it was implemented for CEO mission operations support in May 2012.

Medical Grade Water Generation for Intravenous Fluid Production on Exploration Missions

NASA Technical Reports Server (NTRS)

Niederhaus, Charles E.; Barlow, Karen L.; Griffin, DeVon W.; Miller, Fletcher J.

2008-01-01

This document describes the intravenous (IV) fluids requirements for medical care during NASA s future Exploration class missions. It further discusses potential methods for generating such fluids and the challenges associated with different fluid generation technologies. The current Exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. Conclusions on the fluid volume requirements are presented, and the feasibility of various fluid generation options are discussed. A separate report will document a more complete trade study on the options to provide the required fluids.At the time this document was developed, NASA had not yet determined requirements for medical care during Exploration missions. As a result, this study was based on the current requirements for care onboard the International Space Station (ISS). While we expect that medical requirements will be different for Exploration missions, this document will provide a useful baseline for not only developing hardware to generate medical water for injection (WFI), but as a foundation for meeting future requirements. As a final note, we expect WFI requirements for Exploration will be higher than for ISS care, and system capacity may well need to be higher than currently specified.

Health and Fitness Evaluations for Long Duration Microgravity Exposure

NASA Technical Reports Server (NTRS)

Roden, Sean Kevin; Ewert, Patricia

2006-01-01

The current health maintenance program for ISS is adequate; however the future of medical care and research in space requires a change where crew time efficiency and autonomy are emphasized. NASA s medical personnel are currently refining their ability to monitor and provide remote health care in such a manner. The proposed plan would evaluate health and fitness of the on orbit crew to; perform on orbit operations, and readiness to return to a terrestrial environment. A two tiered approach will utilize exercise and medical equipment, as well as periodic medical conferences with the flight surgeon, to provide a quantitative and clinical picture of the crew s health and fitness. Any off nominal health and fitness issues that could arise will be evaluated by providing an "armamentarium" of devices both medical and exercise specific to the on orbit crew to use. The ability for the crew to provide autonomous health care, with decreasing earth support, will become increasingly more important for exploration missions. This new plan of health care and maintenance will allow us to, development such efforts while continuing to monitor and provide the best possible health, care and medical research through the microgravity environment on board ISS.

[Bone metabolism in human space flight and bed rest study].

PubMed

Ohshima, Hiroshi; Mukai, Chiaki

2008-09-01

Japanese Experiment Module "KIBO" is Japan's first manned space facility and will be operated as part of the international space station (ISS) . KIBO operations will be monitored and controlled from Tsukuba Space Center. In Japan, after the KIBO element components are fully assembled and activated aboard the ISS, Japanese astronauts will stay on the ISS for three or more months, and full-scale experiment operations will begin. Bone loss and renal stone are significant medical concerns for long duration human space flight. This paper will summarize the results of bone loss, calcium balance obtained from the American and Russian space programs, and ground-base analog bedrest studies. Current in-flight training program, nutritional recommendations and future countermeasure plans for station astronauts are also described.

Space Medicine Issues and Healthcare Systems for Space Exploration Medicine

NASA Technical Reports Server (NTRS)

Scheuring, Richard A.; Jones, Jeff

2007-01-01

This viewgraph presentation reviews issues of health care in space. Some of the issues reviewed are: (1) Physiological adaptation to microgravity, partial gravity, (2) Medical events during spaceflight, (3) Space Vehicle and Environmental and Surface Health Risks, (4) Medical Concept of Operations (CONOPS), (4a) Current CONOPS & Medical Hardware for Shuttle (STS) and ISS, (4b) Planned Exploration Medical CONOPS & Hardware needs, (5) Exploration Plans for Lunar Return Mission & Mars, and (6) Developing Medical Support Systems.

Interplanetary Transit Simulations Using the International Space Station

NASA Technical Reports Server (NTRS)

Charles, John B.; Arya, M.; Kundrot, C. E.

2010-01-01

We evaluated the space life sciences utility of the International Space Station (ISS) to simulate the outbound transit portion of missions to Mars and Near Earth Asteroids (NEA) to investigate biomedical and psychological aspects of such transits, to develop and test space operation procedures compatible with communication delays and outages, and to demonstrate and validate technologies and countermeasures. Two major categories of space life sciences activities can capitalize on ISS capabilities. The first includes studies that require ISS (or a comparable facility), typically for access to prolonged weightlessness. The second includes studies that do not strictly require ISS but can exploit it to maximize their scientific return more efficiently and productively than in ground-based simulations. For these studies, ISS offers a high fidelity analog for fundamental factors on future missions, such as crew composition, mission control personnel, operational tasks and workload, real-world risk, and isolation, and can mimic the effects of distance and limited accessibility. In addition to conducting Mars- and NEA-transit simulations on 6-month ISS increments, extending the current ISS increment duration from 6 months to 9 or even 12 months will provide opportunities for enhanced and focused research relevant to long duration Mars and NEA missions. Increasing the crew duration may pose little additional risk to crewmembers beyond that currently accepted on 6-month increments, but additional medical monitoring capabilities will be required beyond those currently used for ISS operations. Finally, while presenting major logistical challenges, such a simulation followed by a post-landing simulation of Mars exploration could provide quantitative evidence of capabilities in an actual mission. Thus, the use of ISS to simulate aspects of Mars and NEA missions seems practical. If it were to be implemented without major disruption of on-going ISS activities, then planning should begin soon, in close consultation with all international partners.

Preparedness of government owned dental clinics for the management of medical emergencies: a survey of government dental clinics in Lagos.

PubMed

Gbotolorun, O M; Babatunde, L B; Osisanya, O; Omokhuale, E

2012-01-01

An emergency is a medical condition demanding immediate treatments. The aim of the study was to determine the knowledge and ability of dental surgeons in the management of medical emergencies and the availability of emergency drugs and equipment in government dental clinics and hospitals in Lagos State. The study was a descriptive cross-sectional study of knowledge and ability of Dental Surgeons in the management of medical emergencies, prevalence of medical emergencies in dental practice and availability of emergency drugs and equipment in dental practice in government dental clinics and hospitals in Lagos State. The study covered 22 government dental clinics and hospitals in Lagos State. Data obtained was entered into a computerand analyzed using Statistical Package for Social Science (SPSS) Version-16 data analysis software. Chi Square and cross-tabulations were used for the analysis. A 95% Confidence Level was used and a p-value of less than or equal to 0.05 was considered statistically significant. Of a population of 255 Dental Surgeons on the nominal rolls of all the health institutions, 224 (87%)responded.Of the total respondents, 204 (91.1%) stated they had no emergency kit in their dental clinics (p < 0.05) while 158 respondents (70.5%) stated they had no emergency drugs in their dental practice to manage medical emergencies (p < 0.05). The commonest emergencies reported was syncope 104 respondents (33.8%). 161 respondents (71.9%) claimed they are able to manage medical emergencies encountered in their dental practice if kits and drugs are available. The findings of the study show that government dental clinics/hospital in Lagos seem not to be adequately prepared to manage medical emergency. Although 71.9% of the dentist claimed they could mange such emergencies should they arise 91.1% and 70% of the respondent claimed they and no emergency kits and drugs to manage such emergencies in their hospital respectively should they arise.

Tutoring Trainees to Suture: An Alternative Method for Learning How to Suture and a Way to Compensate for a Lack of Suturing Cases.

PubMed

Wongkietkachorn, Apinut; Rhunsiri, Peera; Boonyawong, Pangpoom; Lawanprasert, Attaporn; Tantiphlachiva, Kasaya

2016-01-01

Tutoring in suturing was developed to compensate for a shortage of suturing cases. The objective of this study was to compare ideal suturing score (ISS; 9 points), suturing time (min:sec), and suture placement error (mm) between medical students completing the suturing tutoring program and medical students attending ordinary medical school training program. Participants consisted of 2 groups of medical students who had never performed suturing. The study group had the role of suturing tutor to teach interested high school students. The control group consisted of volunteers from the ordinary medical school program. Skills measurement was performed by having students from both the groups perform 3 vertical mattress sutures on a model. The study group was tested at weeks 1, 9, and 10 to assess improvement. Both the groups were tested at week 10 to compare final learning outcome. There were 41 and 40 participants in the study group and the control group, respectively. ISS was significantly improved in the study group from week 1-week 10 (7.0 ± 1.3 vs. 8.2 ± 0.9, p = 0.01). At week 10, the study group had a higher mean ISS than the control group (8.2 ± 0.9 vs. 7.8 ± 1.1, p = 0.68). Mean suturing time and mean placement error were also lower in the study group at the end of suturing training (5:1 ± 1:0 vs. 5:2 ± 1:2, p = 0.13; 7.4 ± 7.4 vs. 8.0 ± 10.8, p = 0.44). Tutoring trainees to suture can improve a student's ability to learn how to suture. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Padalka collects medical data for the Cardiocog experiment onboard the SM during Expedition 9

NASA Image and Video Library

2004-07-05

ISS009-E-13739 (5 July 2004) --- Cosmonaut Gennady I. Padalka, Expedition 9 commander representing Russia’s Federal Space Agency, works with the Cardiocog experiment in the Zvezda Service Module of the International Space Station (ISS). Originally part of Pedro Duque's VC5 "Cervantes" science program, Cardiocog studies changes in the human cardiovascular system in micro-G, expressed in the peripheral arteries, and the vegetative regulation of arterial blood pressure and heart rate.

Optimising the diagnostic strategy for onychomycosis from sample collection to FUNGAL identification evaluation of a diagnostic kit for real-time PCR.

PubMed

Petinataud, Dimitri; Berger, Sibel; Ferdynus, Cyril; Debourgogne, Anne; Contet-Audonneau, Nelly; Machouart, Marie

2016-05-01

Onychomycosis is a common nail disorder mainly due to dermatophytes for which the conventional diagnosis requires direct microscopic observation and culture of a biological sample. Nevertheless, antifungal treatments are commonly prescribed without a mycological examination having been performed, partly because of the slow growth of dermatophytes. Therefore, molecular biology has been applied to this pathology, to support a quick and accurate distinction between onychomycosis and other nail damage. Commercial kits are now available from several companies for improving traditional microbiological diagnosis. In this paper, we present the first evaluation of the real-time PCR kit marketed by Bio Evolution for the diagnosis of dermatophytosis. Secondly, we compare the efficacy of the kit on optimal and non-optimal samples. This study was conducted on 180 nails samples, processed by conventional methods and retrospectively analysed using this kit. According to our results, this molecular kit has shown high specificity and sensitivity in detecting dermatophytes, regardless of sample quality. On the other hand, and as expected, optimal samples allowed the identification of a higher number of dermatophytes by conventional mycological diagnosis, compared to non-optimal samples. Finally, we have suggested several strategies for the practical use of such a kit in a medical laboratory for quick pathogen detection. © 2016 Blackwell Verlag GmbH.

The role of small molecule Kit protein-tyrosine kinase inhibitors in the treatment of neoplastic disorders.

PubMed

Roskoski, Robert

2018-04-25

The Kit proto-oncogene was found as a consequence of the discovery of the feline v-kit sarcoma oncogene. Stem cell factor (SCF) is the Kit ligand and it mediates Kit dimerization and activation. The Kit receptor contains an extracellular segment that is made up of five immunoglobulin-like domains (D1/2/3/4/5), a transmembrane segment, a juxtamembrane segment, a protein-tyrosine kinase domain that contains an insert of 77 amino acid residues, and a carboxyterminal tail. Activating somatic mutations in Kit have been documented in various neoplasms including gastrointestinal stromal tumors (GIST), mast cell overexpression (systemic mastocytosis), core-binding factor acute myeloid leukemias (AML), melanomas, and seminomas. In the case of gastrointestinal stromal tumors, most activating mutations occur in the juxtamembrane segment and these mutants are initially sensitive to imatinib. As with many targeted anticancer drugs, resistance to Kit antagonists occurs in about two years and is the result of secondary KIT mutations. An activation segment exon 17 D816V mutation is one of the more common resistance mutations in Kit and this mutant is resistant to imatinib and sorafenib. Type I protein kinase inhibitors interact with the active enzyme form with DFG-D of the proximal activation segment directed inward toward the active site (DFG-D in ). In contrast, type II inhibitors bind to their target with the DFG-D pointing away from the active site (DFG-D out ). Based upon the X-ray crystallographic structures, imatinib, sunitinib, and ponatinib are Type II Kit inhibitors. We used the Schrödinger induced fit docking protocol to model the interaction of midostaurin with Kit and the result indicates that it binds to the DFG-D in conformation of the receptor and is thus classified as type I inhibitor. This medication inhibits the notoriously resistant Kit D816V mutant and is approved for the treatment of systemic mastocytosis and is effective against tumors bearing the D816V activation/resistance mutation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Severity of traumatic injuries predicting psychological outcomes: A surprising lack of empirical evidence.

PubMed

Boals, Adriel; Trost, Zina; Rainey, Evan; Foreman, Michael L; Warren, Ann Marie

2017-08-01

Despite widespread beliefs that trauma severity is related to levels of posttraumatic stress symptoms (PTSS), the empirical evidence to support such beliefs is lacking. In the current study we examined Injury Severity Score (ISS), a medical measure of event severity for physical injuries, in a sample of 460 patients admitted to a Level 1 Trauma Center. Results revealed no significant relationship between ISS and PTSS, depression, pain, and general physical and mental health at baseline, three months, and six months post-injury. However, at 12 months post-injury, ISS significantly predicted depression, pain, and physical health, but was unrelated to PTSS. The effect sizes of these relationships were small and would not remain significant if any adjustments for multiple comparisons were employed. We conclude that the relationship between ISS and PTSS is, at best, weak and inconsistent. The results are discussed in the broader picture of event severity and psychological outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Novitskiy participates in a CHeCS medical contingency drill in the U.S. Laboratory

NASA Image and Video Library

2012-11-26

ISS034-E-005260 (26 Nov. 2012) --- Russian cosmonaut Oleg Novitskiy, Expedition 34 flight engineer, participates in a Crew Health Care System (CHeCS) medical contingency drill in the Destiny laboratory of the International Space Station. This drill gives crew members the opportunity to work as a team in resolving a simulated medical emergency onboard the space station.

Shkaplerov participates in a CHeCS Medical Contingency Drill in the U.S. Laboratory

NASA Image and Video Library

2011-12-16

ISS030-E-012600 (16 Dec. 2011) --- Russian cosmonaut Anton Shkaplerov, Expedition 30 flight engineer, participates in a Crew Health Care System (CHeCS) medical contingency drill in the Destiny laboratory of the International Space Station. This drill gives crew members the opportunity to work as a team in resolving a simulated medical emergency onboard the space station.

Novitskiy participates in a CHeCS medical contingency drill in the U.S. Laboratory

NASA Image and Video Library

2012-11-26

ISS034-E-005266 (26 Nov. 2012) --- Russian cosmonaut Oleg Novitskiy, Expedition 34 flight engineer, participates in a Crew Health Care System (CHeCS) medical contingency drill in the Destiny laboratory of the International Space Station. This drill gives crew members the opportunity to work as a team in resolving a simulated medical emergency onboard the space station.

One hundred US EVAs: a perspective on spacewalks.

PubMed

Wilde, Richard C; McBarron, James W; Manatt, Scott A; McMann, Harold J; Fullerton, Richard K

2002-01-01

In the 36 years between June 1965 and February 2001, the US human space flight program has conducted 100 spacewalks, or extravehicular activities (EVAs), as NASA officially calls them. EVA occurs when astronauts wearing spacesuits travel outside their protective spacecraft to perform tasks in the space vacuum environment. US EVA started with pioneering feasibility tests during the Gemini Program. The Apollo Program required sending astronauts to the moon and performing EVA to explore the lunar surface. EVA supported scientific mission objectives of the Skylab program, but may be best remembered for repairing launch damage to the vehicle and thus saving the program. EVA capability on Shuttle was initially planned to be a kit that could be flown at will, and was primarily intended for coping with vehicle return emergencies. The Skylab emergency and the pivotal role of EVA in salvaging that program quickly promoted Shuttle EVA to an essential element for achieving mission objectives, including retrieving satellites and developing techniques to assemble and maintain the International Space Station (ISS). Now, EVA is supporting assembly of ISS. This paper highlights development of US EVA capability within the context of the overarching mission objectives of the US human space flight program. c2002 International Astronautical Federation. Published by Elsevier Science Ltd. All rights reserved.

Humans on the International Space Station-How Research, Operations, and International Collaboration are Leading to New Understanding of Human Physiology and Performance in Microgravity

NASA Technical Reports Server (NTRS)

Ronbinson, Julie A.; Harm, Deborah L.

2009-01-01

As the International Space Station (ISS) nears completion, and full international utilization is achieved, we are at a scientific crossroads. ISS is the premier location for research aimed at understanding the effects of microgravity on the human body. For applications to future human exploration, it is key for validation, quantification, and mitigation of a wide variety of spaceflight risks to health and human performance. Understanding and mitigating these risks is the focus of NASA s Human Research Program. However, NASA s approach to defining human research objectives is only one of many approaches within the ISS international partnership (including Roscosmos, the European Space Agency, the Canadian Space Agency, and the Japan Aerospace Exploration Agency). Each of these agencies selects and implements their own ISS research, with independent but related objectives for human and life sciences research. Because the science itself is also international and collaborative, investigations that are led by one ISS partner also often include cooperative scientists from around the world. The operation of the ISS generates significant additional data that is not directly linked to specific investigations. Such data comes from medical monitoring of crew members, life support and radiation monitoring, and from the systems that have been implemented to protect the health of the crew (such as exercise hardware). We provide examples of these international synergies in human research on ISS and highlight key early accomplishments that derive from these broad interfaces. Taken as a whole, the combination of diverse research objectives, operational data, international sharing of research resources on ISS, and scientific collaboration provide a robust research approach and capability that no one partner could achieve alone.

Telescience Resource Kit Software Lifecycle

NASA Technical Reports Server (NTRS)

Griner, Carolyn S.; Schneider, Michelle

1998-01-01

The challenge of a global operations capability led to the Telescience Resource Kit (TReK) project, an in-house software development project of the Mission Operations Laboratory (MOL) at NASA's Marshall Space Flight Center (MSFC). The TReK system is being developed as an inexpensive comprehensive personal computer- (PC-) based ground support system that can be used by payload users from their home sites to interact with their payloads on board the International Space Station (ISS). The TReK project is currently using a combination of the spiral lifecycle model and the incremental lifecycle model. As with any software development project, there are four activities that can be very time consuming: Software design and development, project documentation, testing, and umbrella activities, such as quality assurance and configuration management. In order to produce a quality product, it is critical that each of these activities receive the appropriate amount of attention. For TReK, the challenge was to lay out a lifecycle and project plan that provides full support for these activities, is flexible, provides a way to deal with changing risks, can accommodate unknowns, and can respond to changes in the environment quickly. This paper will provide an overview of the TReK lifecycle, a description of the project's environment, and a general overview of project activities.

RME 1327 - Crew Medical Restraint System (CMRS)

NASA Image and Video Library

1997-02-18

STS081-318-031 (12-22 Jan. 1997) --- Astronauts Brent W. Jett, Jr. (left), STS-81 pilot, and John E. Blaha in the Spacehab Double Module (DM) evaluate the Crew Medical Restraint System (CMRS) carrier, onboard the Space Shuttle Atlantis. The device is an emergency aid forerunner for hardware on the International Space Station (ISS).

A WOUND CARE AND INTRAVENOUS ACCESS SUMMIT FOR ON-ORBIT CARE

NASA Technical Reports Server (NTRS)

Scheuring, R.; Paul, B.; Gillis, D.; Bacal, K.; McCulley, P.; Polk, J.; Johnson-Throop, K.

2005-01-01

Wound care issues and the ability to establish intravenous (IV) access among injured or ill crew members are a source of concern for NASA flight surgeons. Indeed, the microgravity environment and the remote nature of the International Space Station (ISS) pose unique challenges in diagnosing and treating an injured astronaut. Therefore, it is necessary to identify and adapt the best evidence based terrestrial practices regarding wound care, hemostasis, and IV access for use on the ISS. Methods: A panel of consultants was convened to evaluate the adequacy of the current ISS in-flight medical system for diagnosis and treatment of wounds and establishing IV access by a nonclinician crew medical officer. Participants were acknowledged experts in terrestrial wound care and/or operational medicine. Prior to the meeting, each panelist was encouraged to participate in a pre-summit online forum. Results: Eight external experts participated in a face-to-face meeting held at NASA-Johnson Space Center. Recommendations were made to augment the space station pharmacopoeia, as well as current wound care diagnostic, therapeutic, and deorbit criteria protocols. Additionally, suggestions were offered regarding IV access techniques and devices for use in the microgravity environment. Discussion: The results of the expert panel provide an evidence-based approach to the diagnosis and care of wounds in an injured astronaut on aboard the ISS. The results of the panel underscored the need for further research in wound therapy and IV access devices.

Incidence of clinical symptoms during long-duration orbital spaceflight.

PubMed

Crucian, Brian; Babiak-Vazquez, Adriana; Johnston, Smith; Pierson, Duane L; Ott, C Mark; Sams, Clarence

2016-01-01

The environment of spaceflight may elevate an astronaut's clinical risk for specific diseases. The purpose of this study was to derive, as accurately as currently possible, an assessment of in-flight clinical "incidence" data, based on observed clinical symptoms in astronauts on board the International Space Station (ISS). Electronic medical records were examined from 46 long-duration ISS crew members, each serving approximately a 6-month mission on board the ISS, constituting 20.57 total flight years. Incidence for immunological-related adverse health events or relevant clinical symptoms was tabulated in a non-identifiable fashion. Event categories included infectious diseases, allergies, and rashes/hypersensitivities. A subsequent re-evaluation of more notable events, either of prolonged duration or unresponsive to treatment, was performed. For the disease/symptom categories used in this evaluation, the ISS incidence rate was 3.40 events per flight year. Skin rashes were the most reported event (1.12/flight year) followed by upper respiratory symptoms (0.97/flight year) and various other (non-respiratory) infectious processes. During flight, 46% of crew members reported an event deemed "notable". Among the notable events, 40% were classified as rashes/hypersensitivities. Characterization of on-orbit rashes manifested as redness with irritation, and could present on a variety of body locations. Based on reported symptoms, astronauts experience adverse medical events of varying severity during long-duration spaceflights. The data suggests caution, from both a vehicle design and biomedical countermeasures perspective, as space agencies plan for prolonged deep space exploration missions.

Inflight Emergencies During Eurasian Flights.

PubMed

Kesapli, Mustafa; Akyol, Can; Gungor, Faruk; Akyol, Angelika Janitzky; Guven, Dilek Soydam; Kaya, Gokhan

2015-01-01

This study evaluated the incidence and status of urgent medical conditions, the attitudes of health professionals who encounter such conditions, the adequacy of medical kits and training of cabin crew in data-received-company aircrafts suggested by Aerospace Medical Association, and the demographic data of patients. Data were collected from medical records of a major flight company from 2011 through 2013. All patients with complete records were included in the study. Numerical variables were defined as median and interquartiles (IQR) for median, while categorical variables were defined as numbers and percentage. During the study period, 10,100,000 passengers were carried by the company flights, with 1,312 (0.013%) demands for urgent medical support (UMS). The median age of the passengers who requested UMS was 45 years (IQR: 29-62). Females constituted 698 (53.2%) among the patients, and 721 (55%) patients were evaluated by medical professionals found among passengers. The most common nontraumatic complaints resulting in requests for UMS were flight anxiety (311 patients, 23.7%) and dyspnea (145 patients, 11%). The most common traumatic complaint was burns (221 patients, 16.8%) resulting from trauma during flight. A total of 22 (1.67%) emergency landings occurred for which the most frequent reasons were epilepsy (22.7%) and death (18.2%). Deaths during flights were recorded in 13 patients, whose median age was 77 years (IQR: 69-82), which was significantly higher compared to the age of patients requiring UMS (p < 0.0001). A total of 592 (45%) patients did not require any treatment for UMS. Medical kits and training were found to be sufficient according to the symptomatic treatments. Most of the urgent cases encountered during flights can be facilitated with basic medical support. "Traumatic emergency procedures inflight medical care" would be useful for additional training. Medical professionals as passengers are significantly involved in encountered emergency situations. Adding automated external defibrillator and pulse oximetry to recommended kits and training can help facilitate staff decisions such as emergency landings and tele-assistance. © 2015 International Society of Travel Medicine.

Bismuth, Metronidazole, and Tetracycline

MedlinePlus

Helidac® (as a kit containing Bismuth Subsalicylate, Metronidazole, Tetracycline) ... Bismuth, metronidazole, and tetracycline is used along with other ulcer medications to treat duodenal ulcers. It is in a ...

Medication use by U.S. crewmembers on the International Space Station.

PubMed

Wotring, Virginia E

2015-11-01

The environment on the International Space Station (ISS) includes a variety of potential physiologic stressors, including low gravity, elevated exposure to radiation, confined living and working quarters, a heavy workload, and high public visibility. This retrospective study examined medication use during long-duration spaceflights (>30 d). Medication records from 24 crewmembers on 20 missions longer than 30 d over a 10 yr period were examined for trends in usage rates, efficacy, and indication, as well as adverse event quality, frequency, and severity. Results were compared with those from crewmembers on shorter space shuttle missions (>16 d) and other reports of medication use by healthy adults. The most frequently used medications on the ISS were for sleep problems, pain, congestion, or allergy. Medication use during spaceflight missions was similar to that noted on the Space Shuttle and in adult ambulatory medicine, except that usage of sleep aids was about 10 times higher during spaceflight missions. There were also 2 apparent treatment failures in cases of skin rash, raising questions about the efficacy or suitability of the treatments used. Many spaceflight-related medication uses (at least 10%) were linked to extravehicular activities, exercise protocols, or equipment and operationally driven schedule changes. It seems likely that alterations in spaceflight mission operations (schedule-shifting and lighting) or hardware (extravehicular activity suits and exercise equipment) could reduce the need for a sizable fraction of medication uses. © FASEB.

Quantitative Validation of the Integrated Medical Model (IMM) for ISS Missions

NASA Technical Reports Server (NTRS)

Young, Millennia; Arellano, J.; Boley, L.; Garcia, Y.; Saile, L.; Walton, M.; Kerstman, E.; Reyes, D.; Goodenow, D. A.; Myers, J. G.

2016-01-01

Lifetime Surveillance of Astronaut Health (LSAH) provided observed medical event data on 33 ISS and 111 STS person-missions for use in further improving and validating the Integrated Medical Model (IMM). Using only the crew characteristics from these observed missions, the newest development version, IMM v4.0, will simulate these missions to predict medical events and outcomes. Comparing IMM predictions to the actual observed medical event counts will provide external validation and identify areas of possible improvement. In an effort to improve the power of detecting differences in this validation study, the total over each program ISS and STS will serve as the main quantitative comparison objective, specifically the following parameters: total medical events (TME), probability of loss of crew life (LOCL), and probability of evacuation (EVAC). Scatter plots of observed versus median predicted TMEs (with error bars reflecting the simulation intervals) will graphically display comparisons while linear regression will serve as the statistical test of agreement. Two scatter plots will be analyzed 1) where each point reflects a mission and 2) where each point reflects a condition-specific total number of occurrences. The coefficient of determination (R2) resulting from a linear regression with no intercept bias (intercept fixed at zero) will serve as an overall metric of agreement between IMM and the real world system (RWS). In an effort to identify as many possible discrepancies as possible for further inspection, the -level for all statistical tests comparing IMM predictions to observed data will be set to 0.1. This less stringent criterion, along with the multiple testing being conducted, should detect all perceived differences including many false positive signals resulting from random variation. The results of these analyses will reveal areas of the model requiring adjustment to improve overall IMM output, which will thereby provide better decision support for mission critical applications.

The International Space Station: A Low-Earth Orbit (LEO) Test Bed for Advancements in Space and Environmental Medicine

NASA Technical Reports Server (NTRS)

Ruttley, Tara M.; Robinson, Julie A.

2010-01-01

Ground-based space analog projects such as the NASA Extreme Environment Mission Operations (NEEMO) can be valuable test beds for evaluation of experimental design and hardware feasibility before actually being implemented on orbit. The International Space Station (ISS) is an closed-system laboratory that orbits 240 miles above the Earth, and is the ultimate extreme environment. Its inhabitants spend hours performing research that spans from fluid physics to human physiology, yielding results that have implications for Earth-based improvements in medicine and health, as well as those that will help facilitate the mitigation of risks to the human body associated with exploration-class space missions. ISS health and medical experiments focus on pre-flight and in-flight prevention, in-flight treatment, and postflight recovery of health problems associated with space flight. Such experiments include those on enhanced medical monitoring, bone and muscle loss prevention, cardiovascular health, immunology, radiation and behavior. Lessons learned from ISS experiments may not only be applicable to other extreme environments that face similar capability limitations, but also serve to enhance standards of care for everyday use on Earth.

Euthanasia: a "kit" sold in Belgian pharmacies.

PubMed

2005-10-01

(1) In France, legislation adopted in 2005 recognises the right of dying patients to refuse further treatment, and the right of physicians to ease their suffering with treatments that, due to adverse effects, may shorten their life. Measures deliberately aimed at hastening death are forbidden. (2) In Belgium, medical euthanasia was decriminalised in 2002, and can now be carried out either in hospital or at home. Nearly 20 cases of euthanasia are reported per month in Belgium. (3) A Belgian pharmacy chain now markets a "euthanasia kit".

A comparison of "life threatening injury" concept in the Turkish Penal Code and trauma scoring systems.

PubMed

Fedakar, Recep; Aydiner, Ahmet Hüsamettin; Ercan, Ilker

2007-07-01

To compare accuracy and to check the suitability of the Glasgow Coma Scale (GCS), the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the New Injury Severity Score (NISS) and the Trauma and Injury Severity Score (TRISS), the scoring systems widely used in international trauma studies, in the evaluation of the "life threatening injury" concept established by the Turkish Penal Code. The age, sex, type of trauma, type and localizations of wounds, GCS, RTS, ISS, NISS and TRISS values, the decision of life threatening injury of 627 trauma patients admitted to Emergency Department of the Uludag University Medical School Hospital in year 2003 were examined. A life-threatening injury was present in 35.2% of the cases examined. GCS, RTS, ISS, NISS and TRISS confirmed the decision of life threatening injury with percentages of 74.8%, 76.9%, 88.7%, 86.6% and 68.6%, respectively. The best cut-off point 14 was determined in the ISS system with 79.6% sensitivity and 93.6% specificity. All of the cases with sole linear skull fracture officially decided as life threatening injury had an ISS of 5, a NISS of 6 and the best scores of GCS (15), RTS (7.8408) and TRISS (100%). ISS and NISS appeared to be the best trauma scoring systems that can be used for the decision of life threatening injury, compared with GCS, RTS and TRISS. Thus, ISS and NISS can be acceptable for using the evaluation of the life threatening injury concept established by the Turkish Penal Code.

Medical Operations Console Procedure Evaluation: BME Response to Crew Call Down for an Emergency

NASA Technical Reports Server (NTRS)

Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis

2006-01-01

International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task completion and/or navigation, in particular the execution of the Surgeon call sequence. Debrief comments were used to analyze unclear procedural steps and to discern any discrepancies between the procedure and generally accepted BME actions. The sequence followed by BME participants differed considerably from the sequence intended by the procedure. Common deviations included the call sequence used to contact Surgeon, the content of BME and crew interaction and the gathering of pertinent console resources. Differing perceptions of task priority and imprecise language seem to have caused multiple deviations from the procedure s intended sequence. The study generated 40 recommendations for the procedure, of which 34 are being implemented. These recommendations address improving the clarity of the instructions, identifying training considerations, expediting Surgeon contact, improving cues for anticipated flight control team communication and identifying missing console tools.

Medical Operations Support for ISS Operations - The Role of the BME Operations Team Leads

NASA Technical Reports Server (NTRS)

Janney, Rob; Sabatier, Veronica

2010-01-01

This slide presentation reviews the role of the biomedical flight controllers (BMEs), and BME Operations Team Leads (OTLs) in providing medical support for personnel on the International Space Station. This presentation will concentrate on role of the BME OTLs, who provide the integration function across the integration function across all Crew Health Care System (CHeCS) disciplines for operational products and medical procedures.

Burbank participates in a CHeCS Medical Contingency Drill in the U.S. Laboratory

NASA Image and Video Library

2011-12-16

ISS030-E-012613 (16 Dec. 2011) --- NASA astronaut Dan Burbank (foreground), Expedition 30 commander, and Russian cosmonaut Anton Shkaplerov, flight engineer, participate in a Crew Health Care System (CHeCS) medical contingency drill in the Destiny laboratory of the International Space Station. This drill gives crew members the opportunity to work as a team in resolving a simulated medical emergency onboard the space station.

Burbank participates in a CHeCS Medical Contingency Drill in the U.S. Laboratory

NASA Image and Video Library

2011-12-16

ISS030-E-012609 (16 Dec. 2011) --- NASA astronaut Dan Burbank (foreground), Expedition 30 commander, and Russian cosmonaut Anton Shkaplerov, flight engineer, participate in a Crew Health Care System (CHeCS) medical contingency drill in the Destiny laboratory of the International Space Station. This drill gives crew members the opportunity to work as a team in resolving a simulated medical emergency onboard the space station.

Ivanishin participates in a CHeCS Medical Contingency Drill in the U.S. Laboratory

NASA Image and Video Library

2011-12-16

ISS030-E-012604 (16 Dec. 2011) --- Russian cosmonauts Anatoly Ivanishin (foreground) and Anton Shkaplerov, both Expedition 30 flight engineers, participate in a Crew Health Care System (CHeCS) medical contingency drill in the Destiny laboratory of the International Space Station. This drill gives crew members the opportunity to work as a team in resolving a simulated medical emergency onboard the space station.

Expanding NASA and Roscosmos Scientific Collaboration on the International Space Station

NASA Technical Reports Server (NTRS)

Hasbrook, Pete

2016-01-01

The International Space Station (ISS) is a world-class laboratory orbiting in space. NASA and Roscosmos have developed a strong relationship through the ISS Program Partnership, working together and with the other ISS Partners for more than twenty years. Since 2013, based on a framework agreement between the Program Managers, NASA and Roscosmos are building a joint program of collaborative research on ISS. This international collaboration is developed and implemented in phases. Initially, members of the ISS Program Science Forum from NASA and TsNIIMash (representing Roscosmos) identified the first set of NASA experiments that could be implemented in the "near term". The experiments represented the research categories of Technology Demonstration, Microbiology, and Education. Through these experiments, the teams from the "program" and "operations" communities learned to work together to identify collaboration opportunities, establish agreements, and jointly plan and execute the experiments. The first joint scientific activity on ISS occurred in January 2014, and implementation of these joint experiments continues through present ISS operations. NASA and TsNIIMash have proceeded to develop "medium term" collaborations, where scientists join together to improve already-proposed experiments. A major success is the joint One-Year Mission on ISS, with astronaut Scott Kelly and cosmonaut Mikhail Kornienko, who returned from ISS in March, 2016. The teams from the NASA Human Research Program and the RAS Institute for Biomedical Problems built on their considerable experience to design joint experiments, learn to work with each other's protocols and processes, and share medical and research data. New collaborations are being developed between American and Russian scientists in complex fluids, robotics, rodent research and space biology, and additional human research. Collaborations are also being developed in Earth Remote Sensing, where scientists will share data from imaging systems mounted on ISS as well as other orbiting spacecraft to improve our understanding of the Earth and its climate. NASA and Roscosmos continue to encourage international scientific cooperation and expanded use of the ISS Laboratory. "Long-term", larger collaborations will achieve scientific objectives that no single national science team or agency can achieve on its own. The joint accomplishments achieved so far have paved the way for a stronger international scientific community and improved results and benefits from ISS.

STS-1 medical report

NASA Technical Reports Server (NTRS)

Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

1981-01-01

The report includes a review of the health of the crew before, during and immediately after the first Shuttle orbital flight (April 12-14, 1981). Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical kit carried inflight; tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results; hematology and immunology analyses; medical microbiology; food and nutrition; potable water; shuttle toxicology; radiological health; cabin acoustical noise. Also included is information on: environmental effects of Shuttle launch and landing, medical information management; and management, planning and implementation of the medical program.

Investigating Associations Between Proliferation Indices, C-kit, and Lymph Node Stage in Canine Mast Cell Tumors.

PubMed

Krick, Erika Lauren; Kiupel, Matti; Durham, Amy C; Thaiwong, Tuddow; Brown, Dorothy C; Sorenmo, Karin U

Previous studies have evaluated cellular proliferation indices, KIT expression, and c-kit mutations to predict the clinical behavior of canine mast cell tumors (MCTs). The study purpose was to retrospectively compare mitotic index, argyrophilic nucleolar organizer regions (AgNORs)/nucleus, Ki-67 index, KIT labeling pattern, and internal tandem duplication mutations in c-KIT between stage I and stage II grade II MCTs. Medical records and tumor biopsy samples from dogs with Grade II MCTs with cytological or histopathological regional lymph node evaluation were included. Signalment, tumor location and stage, and presence of a recurrent versus de novo tumor were recorded. Mitotic index, AgNORs/nucleus, Ki-67, KIT staining pattern, and internal tandem duplication mutations in exon 11 of c-KIT were evaluated. Sixty-six tumors (51 stage I; 15 stage II) were included. Only AgNORs/nucleus and recurrent tumors were significantly associated with stage (odds ratio 2.8, 95% confidence interval [CI] 1.0-8.0, P = .049; odds ratio 8.8, 95% CI 1.1-69.5; P = .039). Receiver-operator characteristic analysis showed that the sensitivity and specificity of AgNORs/cell ≥ 1.87 were 93.3% and 27.4%, respectively, (area under the curve: 0.65) for predicting stage. Recurrent tumors and higher AgNORs/nucleus are associated with stage II grade II MCTs; however, an AgNOR cutoff value that reliably predicts lymph node metastasis was not determined.

Mkit: A cell migration assay based on microfluidic device and smartphone.

PubMed

Yang, Ke; Wu, Jiandong; Peretz-Soroka, Hagit; Zhu, Ling; Li, Zhigang; Sang, Yaoshuo; Hipolito, Jolly; Zhang, Michael; Santos, Susy; Hillier, Craig; de Faria, Ricardo Lobato; Liu, Yong; Lin, Francis

2018-01-15

Mobile sensing based on the integration of microfluidic device and smartphone, so-called MS 2 technology, has enabled many applications over recent years, and continues to stimulate growing interest in both research communities and industries. In particular, it has been envisioned that MS 2 technology can be developed for various cell functional assays to enable basic research and clinical applications. Toward this direction, in this paper, we describe the development of a MS 2 -based cell functional assay for testing cell migration (the M kit ). The system is constructed as an integrated test kit, which includes microfluidic chips, a smartphone-based imaging platform, the phone apps for image capturing and data analysis, and a set of reagent and accessories for performing the cell migration assay. We demonstrated that the M kit can effectively measure purified neutrophil and cancer cell chemotaxis. Furthermore, neutrophil chemotaxis can be tested from a drop of whole blood using the M kit with red blood cell (RBC) lysis. The effects of chemoattractant dose and gradient profile on neutrophil chemotaxis were also tested using the M kit . In addition to research applications, we demonstrated the effective use of the M kit for on-site test at the hospital and for testing clinical samples from chronic obstructive pulmonary disease patient. Thus, this developed M kit provides an easy and integrated experimental platform for cell migration related research and potential medical diagnostic applications. Copyright © 2017 Elsevier B.V. All rights reserved.

X-38 TPS Seal Status

NASA Technical Reports Server (NTRS)

Curry, Donald M.

2000-01-01

This presentation discuss the x-38 crew return vehicle. As an element of the International Space Station (ISS), there are potential problems that are discussed. These include ISS catastrophe, emergency medical evacuation, and period of Space Shuttle unavailability. The x-38 program purpose was also discussed. The Reduction of the costs and schedule for the development of Crew Return Vehicles (CRV's) and Crew Transfer Vehicles (CTV's) through the use of the rapid development methodology associated with an X-project were also presented. With specific attention to ground testing, atmospheric testing, and space flight testing.

GeneLab: NASA's Open Access, Collaborative Platform for Systems Biology and Space Medicine

NASA Technical Reports Server (NTRS)

Berrios, Daniel C.; Thompson, Terri G.; Fogle, Homer W.; Rask, Jon C.; Coughlan, Joseph C.

2015-01-01

NASA is investing in GeneLab1 (http:genelab.nasa.gov), a multi-year effort to maximize utilization of the limited resources to conduct biological and medical research in space, principally aboard the International Space Station (ISS). High-throughput genomic, transcriptomic, proteomic or other omics analyses from experiments conducted on the ISS will be stored in the GeneLab Data Systems (GLDS), an open-science information system that will also include a biocomputation platform with collaborative science capabilities, to enable the discovery and validation of molecular networks.

Deployment of the DosiKit System Under Operational Conditions: Experience From a French Defense National Nuclear Exercise.

PubMed

Entine, F; Bensimon Etzol, J; Bettencourt, C; Dondey, M; Michel, X; Gagna, G; Gellie, G; Corre, Y; Ugolin, N; Chevillard, S; Amabile, J-C

2018-07-01

Estimation of the dose received by accidentally irradiated victims is based on a tripod: clinical, biological, and physical dosimetry. The DosiKit system is an operational and mobile biodosimetry device allowing the measurement of external irradiation directly on the site of a radiological accident. This tool is based on capillary blood sample and hair follicle collection. The aim is to obtain a whole-body and local-surface dose assessment. This paper is about the technical evaluation of the DosiKit; the analytical process and scientific validation are briefly described. The Toulon exercise scenario was based on a major accident involving the reactor of a nuclear attack submarine. The design of the scenario made it impossible for several players (firefighters, medical team) to leave the area for a long time, and they were potentially exposed to high dose rates. The DosiKit system was fully integrated into a deployable radiological emergency laboratory, and the response to operational needs was very satisfactory.

Home bowel cancer tests and informed choice--is current information sufficient?

PubMed

Howard, K; Salkeld, G

2003-10-01

To evaluate the type of information that is available to purchasers of home-based bowel cancer test kits. Manufacturers, pharmacies and independent testing programs were contacted to obtain faecal occult blood test (FOBT) kits. State cancer organisations were contacted for information on bowel cancer screening. Information on bowel cancer, the FOBT kit, the testing process and potential benefits and harms of the screening process were assessed using guidelines provided by the UK General Medical Council (GMC). FOBT kits and cancer organisation information provided adequate information on the purpose of screening, the screening process itself and potential benefits, but provided no information concerning uncertainties of screening or potential harms. On the basis of both the UK GMC criteria and patient desires for information, the information available at present falls short of being considered adequate for an informed decision to purchase a home-based FOBT. We must ensure adequate and balanced information is available to redress the present information asymmetry to facilitate informed participation in a potentially valuable public health initiative.

NASA Astronaut Urinary Conditions Associated with Spaceflight

NASA Technical Reports Server (NTRS)

Law, Jennifer; Cole, Richard; Young, Millennia H.; Mason, Sara

2016-01-01

INTRODUCTION: Spaceflight is associated with many factors which may promote kidney stone formation, urinary retention, and/or Urinary Tract Infection (UTI). According to ISS mission predictions supplied by NASA's Integrated Medical Model, kidney stone is the second and sepsis (urosepsis as primary driver) the third most likely reason for emergent medical evacuation from the International Space Station (ISS). METHODS: Inflight and postflight medical records of NASA astronauts were reviewed for urinary retention, UTI and kidney stones during Mercury, Gemini, Apollo, Mir, Shuttle, and ISS expeditions 1-38. RESULTS: NASA astronauts have had 7 cases of kidney stones in the 12 months after flight. Three of these cases occurred within 90 to 180 days after landing and one of the seven cases occurred in the first 90 days after flight. There have been a total of 16 cases (0.018 events per person-flights) of urinary retention during flight. The event rates per mission are nearly identical between Shuttle and ISS flights (0.019 vs 0.021 events per person-flights). In 12 of the 16 cases, astronauts had taken at least one space motion sickness medication. Upon further analysis, it was determined that the odds of developing urinary retention in spaceflight is 3 times higher among astronauts who took promethazine. The female to male odds ratio for inflight urinary retention is 11:14. An astronaut with urinary retention is 25 times more likely to have a UTI with a 17% infection rate per mission. There have been 9 reported UTIs during spaceflight. DISCUSSION: It is unclear if spaceflight carries an increased post-flight risk of kidney stones. Regarding urinary retention, the female to male odds ratio is higher during flight compared to the general population where older males comprise almost all cases due to prostatic hypertrophy. This female prevalence in spaceflight is even more concerning given the fact that there have been many more males in space than females. Terrestrial medications with a known side effect of urinary retention are also associated with urinary retention during flight. However, not all cases of urinary retention surrounded medication use inflight. It is also known that UTI is a terrestrial cause of urinary retention. Furthermore, the treatment of urinary retention with a urinary catheter may be more likely to initiate a UTI in space than on the ground, as aseptic techniques can be particularly challenging with an inexperienced provider in a free-floating environment. Inflight urinary retention and UTI have proven to be highly associated and urinary risks should be considered collectively when planning for space flight.

Medication Assisted Treatment for the 21st Century: Community Education Kit.

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

The need to support the success of individuals in methadone-assisted recovery, and the recent availability of new pharmacologic treatment options for opioid dependence, calls for an information tool that underscores the evidence-based benefits of medication assisted treatment for opioid dependence. The U.S. Department of Health and Human Services'…

Kit for providing a technetium medical radioimaging agent

DOEpatents

Wildung, Raymond E.; Garland, Thomas R.; Li, Shu-Mei W.

2000-01-01

The present invention is directed toward a kit for microbial reduction of a technetium compound to form other compounds of value in medical imaging. The technetium compound is combined in a mixture with non-growing microbial cells which contain a technetium-reducing enzyme system, a stabilizing agent and an electron donor in a saline solution under anaerobic conditions. The mixture is substantially free of an inorganic technetium reducing agent and its reduction products. The resulting product is Tc of lower oxidation states, the form of which can be partially controlled by the stabilizing agent. It has been discovered that the microorganisms Shewanella alga, strain Bry and Shewanella putrifacians, strain CN-32 contain the necessary enzyme systems for technetium reduction and can form both mono nuclear and polynuclear reduced Tc species depending on the stabilizing agent.

Biomechanical Modeling of Split-leg Squat and Heel Raise on the Hybrid Ultimate Lifting Kit (HULK)

NASA Technical Reports Server (NTRS)

Thompson, William K.; Gallo, Christopher A.; Lewandowski, Beth E.; Jagodnik, Kathleen M.; Humphreys, Brad; Funk, Justin; Funk, Nathan; Dewitt, John K.

2016-01-01

Long duration space travel will expose astronauts to extended periods of reduced gravity. Since gravity is not present to aid loading, astronauts will use resistive and aerobic exercise regimes for the duration of the space flight to minimize the loss of bone density, muscle mass and aerobic capacity that occurs during exposure to a reduced gravity environment. Unlike the International Space Station (ISS), the area available for an exercise device in the next generation of spacecraft is limited and therefore compact resistance exercise device prototypes are being developed. The Advanced Resistive Exercise Device (ARED) currently on the ISS is being used as a benchmark for the functional performance of these new devices. Biomechanical data collection and computational modeling aid the device design process by quantifying the joint torques and musculoskeletal forces that occur during exercises performed on the prototype devices. Computational models currently use OpenSim software, an open source code for musculoskeletal modeling, with biomechanical input data from subjects for estimation of muscle and joint loads. Subjects are instrumented with reflective markers for motion capture data collection while exercising on the Hybrid Ultimate Lifting Kit (HULK) prototype device. Ground reaction force data is collected with force plates under the feet and device loading is recorded through load cells internal to the HULK. This data is input into the OpenSim biomechanical model, which has been scaled to match the anthropometrics of the test subject, to calculate the loads on the body. Multiple exercises are performed and evaluated during a test session such as a full squat, single leg squat, heel raise and dead lift. Variables for these exercises include applied device load, narrow or wide foot stance, slow or fast cadence and the harness or long bar interface between the test subject and the device. Data from free weights are compared to the resistively loaded exercise device. The focus of this presentation is to summarize the results from the single-leg squat and heel raise exercises performed during three sessions occurring in 2015. Differences in loading configuration, cadence and stance produce differences in kinematics, joint toques and force and muscle forces.

Visual Impairment and Intracranial Hypertension: An Emerging Spaceflight Risk

NASA Technical Reports Server (NTRS)

Taddeo, Terrance A.

2010-01-01

During recent long duration missions to the International Space Station (ISS) crewmembers have reported changes in visual acuity or visual field defects. Exams in the postflight period revealed changes to the visual system and elevated intracranial pressures. As a result, NASA Space Medicine has added a number of tests to be performed in the preflight, inflight and postflight periods for ISS and shuttle missions with the goal of determining the processes at work and any potential mitigation strategies. This discussion will acquaint you with the changes that NASA has made to its medical requirements in order to address the microgravity induced intracranial hypertension and associated visual changes. Key personnel have been assembled to provide you information on this topic. Educational Objectives: Provide an overview of the current Medical Operations requirements and the mitigation steps taken to operationally address the issue.

Rapid Vision Correction by Special Operations Forces.

PubMed

Reynolds, Mark E

This report describes a rapid method of vision correction used by Special Operations Medics in multiple operational engagements. Between 2011 and 2015, Special Operations Medics used an algorithm- driven refraction technique. A standard block of instruction was provided to the medics, along with a packaged kit. The technique was used in multiple operational engagements with host nation military and civilians. Data collected for program evaluation were later analyzed to assess the utility of the technique. Glasses were distributed to 230 patients with complaints of either decreased distance or near (reading). Most patients (84%) with distance complaints achieved corrected binocular vision of 20/40 or better, and 97% of patients with near-vision complaints achieved corrected near-binocular vision of 20/40 or better. There was no statistically significant difference between the percentages of patients achieving 20/40 when medics used the technique under direct supervision versus independent use. A basic refraction technique using a designed kit allows for meaningful improvement in distance and/or near vision at austere locations. Special Operations Medics can leverage this approach after specific training with minimal time commitment. It can serve as a rapid, effective intervention with multiple applications in diverse operational environments. 2017.

Clinical Space Medicine Products as Developed by the Medical Operations Support Team (MOST)

NASA Technical Reports Server (NTRS)

Polk, James D.; Doerr, Harold K.; Hurst, Victor W., IV; Schmid, Josef

2007-01-01

Medical Operations Support Team (MOST) is introducing/integrating teaching practices associated with high fidelity human patient simulation into the NASA culture, in particular, into medical training sessions and medical procedure evaluations. Current/Future Products iclude: a) Development of Sub-optimal Airway Protocols for the International Space Station (ISS) using the ILMA; b) Clinical Core Competency Training for NASA Flight Surgeons (FS); c) Post-Soyuz Landing Clinical Training for NASA FS; d) Experimental Integrated Training for Astronaut Crew Medical Officers and NASA FS; and e) Private Clinical Refresher Training.

Macromolecular Crystallization in Microfluidics for the International Space Station

NASA Technical Reports Server (NTRS)

Monaco, Lisa A.; Spearing, Scott

2003-01-01

At NASA's Marshall Space Flight Center, the Iterative Biological Crystallization (IBC) project has begun development on scientific hardware for macromolecular crystallization on the International Space Station (ISS). Currently ISS crystallization research is limited to solution recipes that were prepared on the ground prior to launch. The proposed hardware will conduct solution mixing and dispensing on board the ISS, be fully automated, and have imaging functions via remote commanding from the ground. Utilizing microfluidic technology, IBC will allow for on orbit iterations. The microfluidics LabChip(R) devices that have been developed, along with Caliper Technologies, will greatly benefit researchers by allowing for precise fluid handling of nano/pico liter sized volumes. IBC will maximize the amount of science return by utilizing the microfluidic approach and be a valuable tool to structural biologists investigating medically relevant projects.

Ford and Novitskiy participate in a CHeCS Medical Contingency Drill in the U.S. Laboratory

NASA Image and Video Library

2012-11-26

ISS034-E-005268 (26 Nov. 2012) --- NASA astronaut Kevin Ford (background), Expedition 34 commander; and Russian cosmonaut Oleg Novitskiy, flight engineer, participate in a Crew Health Care System (CHeCS) medical contingency drill in the Destiny laboratory of the International Space Station. This drill gives crew members the opportunity to work as a team in resolving a simulated medical emergency onboard the space station.

Novitskiy and Tarelkin both participate in a CHeCS medical contingency drill in the U.S. Laboratory

NASA Image and Video Library

2012-11-26

ISS034-E-005261 (26 Nov. 2012) --- Russian cosmonauts Oleg Novitskiy (left) and Evgeny Tarelkin, both Expedition 34 flight engineers, participate in a Crew Health Care System (CHeCS) medical contingency drill in the Destiny laboratory of the International Space Station. This drill gives crew members the opportunity to work as a team in resolving a simulated medical emergency onboard the space station.

STS-3 medical report

NASA Technical Reports Server (NTRS)

Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

1982-01-01

The medical operations report for STS-3, which includes a review of the health of the crew before, during, and immediately after the third Shuttle orbital flight is presented. Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical 'kit' carried in flight, tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results, hematology and immunology analyses, medical microbiology, food and nutrition, potable water, shuttle toxicology, radiological health, and cabin acoustic noise. Environmental effects of shuttle launch and landing medical information management, and management, planning, and implementation of the medical program are also dicussed.

Autonomous Medical Care for Exploration Class Space Missions

NASA Technical Reports Server (NTRS)

Hamilton, Douglas; Smart, Kieran; Melton, Shannon; Polk, James D.; Johnson-Throop, Kathy

2007-01-01

The US-based health care system of the International Space Station (ISS) contains several subsystems, the Health Maintenance System, Environmental Health System and the Countermeasure System. These systems are designed to provide primary, secondary and tertiary medical prevention strategies. The medical system deployed in Low Earth Orbit (LEO) for the ISS is designed to enable a "stabilize and transport" concept of operations. In this paradigm, an ill or injured crewmember would be rapidly evacuated to a definitive medical care facility (DMCF) on Earth, rather than being treated for a protracted period on orbit. The medical requirements of the short (7 day) and long duration (up to 6 months) exploration class missions to the Moon are similar to LEO class missions with the additional 4 to 5 days needed to transport an ill or injured crewmember to a DCMF on Earth. Mars exploration class missions are quite different in that they will significantly delay or prevent the return of an ill or injured crewmember to a DMCF. In addition the limited mass, power and volume afforded to medical care will prevent the mission designers from manifesting the entire capability of terrestrial care. NASA has identified five Levels of Care as part of its approach to medical support of future missions including the Constellation program. In order to implement an effective medical risk mitigation strategy for exploration class missions, modifications to the current suite of space medical systems may be needed, including new Crew Medical Officer training methods, treatment guidelines, diagnostic and therapeutic resources, and improved medical informatics.

Response of the extremely halophilic Halococcus dombrowskii strain H4 to UV radiation and space conditions in the EXPOSE -ADAPT project on the International Space Station

NASA Astrophysics Data System (ADS)

Fendrihan, Sergiu; Grosbacher, Michael; Stan-Lotter, Helga

2010-05-01

The international project ADAPT focuses on the response of different microorganisms to outer space conditions. In 2007, the European Space Agency (ESA) has installed the Columbus laboratory and the exposure facility EXPOSE-E on the International Space Station (ISS). One of the microorganisms that were exposed for 18 months on the ISS is Halococcus dombrowskii strain H4, an extremely halophilic archaeon which was isolated from about 250 million years old alpine salt deposits (1). Ground experiments with Hcc. dombrowskii included irradiation with different wavelengths and doses of UV, using a Hg low pressure lamp, a solar simulator SOL2 (both at the DLR, Cologne) and a Mars UV simulation lamp (2). Cells were embedded in halite crystals which were formed on quartz discs by evaporation of high salt buffers. Methods for analyzing the effects of exposure on Hcc. dombrowskii include the estimation of colony forming units (CFUs), staining for viability with the BacLight LIVE/DEAD kit (2), establishing long term liquid cultures and determination of the formation of cyclobutane pyrimidine dimers (CPDs) with specific antibodies (3). Counting of viable (green) and dead (red) cells showed an apparent preservation of viability following exposure to about 21 kJ/m2 in ground experiments, but the calculated D37 (dose of 37 % survival) for Hcc. dombrowskii was about 400 kJ/m2 in salt crystals (2). CPDs were detected in about 6-8% of cells of Hcc. dombrowskii following exposure to a dose of 3000 kJ/m2 (200-400 nm). Preliminary results with the samples of Hcc. dombrowskii from the ISS suggested preservation of cellular morphology and stainability with the fluorescent dyes of the LIVE/DEAD kit, as well as formation of CPDs in about 2-3 % of the cells. The determination of the survival of cells by measuring proliferation requires months of incubation; data can be expected in May or June 2010. (1) Stan-Lotter H, Pfaffenhuemer M, Legat A, Busse H-J, Radax C, Gruber C (2002) Halococcus dombrowskii sp. nov., an archaeal isolate from a Permian alpine salt deposit. Int J Syst Evol Microbiol 52, 1807-1814. (2) Fendrihan S, Bérces A, Lammer H, Musso M, Rontó G, Polacsek TK, Holzinger A, Kolb C, Stan-Lotter H (2009) Investigating the effects of simulated Martian ultraviolet radiation on Halococcus dombrowskii and other extremely halophilic archaebacteria. Astrobiology 9, 104-112. (3) Peccia J, Hernandez M (2002) Rapid immunoassays for detection of UV-induced cyclobutane pyrimidine dimers in whole bacterial cells. Appl Environ Microbiol 68, 2542-2549.

Early Results and Spaceflight Implications of the SWAB Flight Experiment

NASA Technical Reports Server (NTRS)

Ott, C. Mark; Pierson, Duane L.

2007-01-01

Microbial monitoring of spacecraft environments provides key information in the assessment of infectious disease risk to the crew. Monitoring aboard the Mir space station and International Space Station (ISS) has provided a tremendous informational baseline to aid in determining the types and concentrations of microorganisms during a mission. Still, current microbial monitoring hardware utilizes culture-based methodology which may not detect many medically significant organisms, such as Legionella pneumophila. We hypothesize that evaluation of the ISS environment using non-culture-based technologies would reveal microorganisms not previously reported in spacecraft, allowing for a more complete health assessment. To achieve this goal, a spaceflight experiment, operationally designated as SWAB, was designed to evaluate the DNA from environmental samples collected from ISS and vehicles destined for ISS. Results from initial samples indicate that the sample collection and return procedures were successful. Analysis of these samples using denaturing gradient gel electrophoresis and targeted PCR primers for fungal contaminants is underway. The current results of SWAB and their implication for in-flight molecular analysis of environmental samples will be discussed.

Incidence of clinical symptoms during long-duration orbital spaceflight

PubMed Central

Crucian, Brian; Babiak-Vazquez, Adriana; Johnston, Smith; Pierson, Duane L; Ott, C Mark; Sams, Clarence

2016-01-01

Background The environment of spaceflight may elevate an astronaut’s clinical risk for specific diseases. The purpose of this study was to derive, as accurately as currently possible, an assessment of in-flight clinical “incidence” data, based on observed clinical symptoms in astronauts on board the International Space Station (ISS). Methods Electronic medical records were examined from 46 long-duration ISS crew members, each serving approximately a 6-month mission on board the ISS, constituting 20.57 total flight years. Incidence for immunological-related adverse health events or relevant clinical symptoms was tabulated in a non-identifiable fashion. Event categories included infectious diseases, allergies, and rashes/hypersensitivities. A subsequent re-evaluation of more notable events, either of prolonged duration or unresponsive to treatment, was performed. Results For the disease/symptom categories used in this evaluation, the ISS incidence rate was 3.40 events per flight year. Skin rashes were the most reported event (1.12/flight year) followed by upper respiratory symptoms (0.97/flight year) and various other (non-respiratory) infectious processes. During flight, 46% of crew members reported an event deemed “notable”. Among the notable events, 40% were classified as rashes/hypersensitivities. Characterization of on-orbit rashes manifested as redness with irritation, and could present on a variety of body locations. Conclusion Based on reported symptoms, astronauts experience adverse medical events of varying severity during long-duration spaceflights. The data suggests caution, from both a vehicle design and biomedical countermeasures perspective, as space agencies plan for prolonged deep space exploration missions. PMID:27843335

Innovative Imagery System for Enhanced Habitability Onboard ISS: Desired Features and Possible Hardware Applications

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Baggerman, Susan; Byrne, Vicky

2004-01-01

With the advent of the ISS and the experience of Russian, European, and US crewmembers on Mir, the importance of the psychological element in long duration missions is increasingly recognized. An integrated imagery system or Magic Window System could enhance the habitability, performance, and productivity for long term stays in space. Because this is type of system is a new concept for space, functional and technical requirements need to be determined. As part of a three-year project, the functional and technical requirements for an Imagery System onboard the International Space Station (ISS) have been explored. Valuable information was gathered from a survey completed by participants that had been in analog environments (remote/isolated) such as Antarctica, Aquarius, ISS crewmember debriefs, and crew support meetings to identify key functions desired for an integrated Magic Window System. Exercise and medical care activities were identified as areas that could benefit from such a system. It was determined that for exercise, it was worth exploring the concept of displaying a dynamic screen that changes as the crewmember's speed changes while showing physiological measures in a combined display. In terms of enhancing the interfaces for medical care activities, the Magic Window System could show video clips along side procedures for just-in-time training scenarios through a heads-up display. In addition, the portability, usability, and reliability were stressed as important considerations for an integrated system of technologies or Magic Window System. In addition, a review of state-of-the-art screens and other existing technologies such as tablet PCs and Personal Digital Assistants (PDAs) was conducted and contributed to defining technical requirements and feasibility of systems. Some heuristic evaluations of large displays and PDAs were conducted. Finally, feasibility for implementation onboard ISS has been considered. Currently, specific headset units are undergoing usability testing. The outcome of these activities will be valuable to determine the best candidates for an integrated system that could accommodate different needs depending on task.

Educating medical staff about responding to a radiological or nuclear emergency.

PubMed

McCurley, M Carol; Miller, Charles W; Tucker, Florie E; Guinn, Amy; Donnelly, Elizabeth; Ansari, Armin; Holcombe, Maire; Nemhauser, Jeffrey B; Whitcomb, Robert C

2009-05-01

A growing body of audience research reveals medical personnel in hospitals are unprepared for a large-scale radiological emergency such as a terrorist event involving radioactive or nuclear materials. Also, medical personnel in hospitals lack a basic understanding of radiation principles, as well as diagnostic and treatment guidelines for radiation exposure. Clinicians have indicated that they lack sufficient training on radiological emergency preparedness; they are potentially unwilling to treat patients if those patients are perceived to be radiologically contaminated; and they have major concerns about public panic and overloading of clinical systems. In response to these findings, the Centers for Disease Control and Prevention (CDC) has developed a tool kit for use by hospital medical personnel who may be called on to respond to unintentional or intentional mass-casualty radiological and nuclear events. This tool kit includes clinician fact sheets, a clinician pocket guide, a digital video disc (DVD) of just-in-time basic skills training, a CD-ROM training on mass-casualty management, and a satellite broadcast dealing with medical management of radiological events. CDC training information emphasizes the key role that medical health physicists can play in the education and support of emergency department activities following a radiological or nuclear mass-casualty event.

Home-Use Tests - Cholesterol

MedlinePlus

... Medical Procedures In Vitro Diagnostics Home Use Tests Cholesterol Share Tweet Linkedin Pin it More sharing options ... a home-use test kit to measure total cholesterol. What cholesterol is: Cholesterol is a fat (lipid) ...

Performance evaluation of the HepB Typer-Entecavir kit for detection of entecavir resistance mutations in chronic hepatitis B.

PubMed

Ahn, Sang Hoon; Chun, Ji-Yong; Shin, Soo-Kyung; Park, Jun Yong; Yoo, Wangdon; Hong, Sun Pyo; Kim, Soo-Ok; Han, Kwang-Hyub

2013-12-01

Molecular diagnostic methods have enabled the rapid diagnosis of drug-resistant mutations in hepatitis B virus (HBV) and have reduced both unnecessary therapeutic interventions and medical costs. In this study we evaluated the analytical and clinical performances of the HepB Typer-Entecavir kit (GeneMatrix, Korea) in detecting entecavir-resistance-associated mutations. The HepB Typer-Entecavir kit was evaluated for its limit of detection, interference, cross-reactivity, and precision using HBV reference standards made by diluting high-titer viral stocks in HBV-negative human serum. The performance of the HepB Typer-Entecavir kit for detecting mutations related to entecavir resistance was compared with direct sequencing for 396 clinical samples from 108 patients. Using the reference standards, the detection limit of the HepB Typer-Entecavir kit was found to be as low as 500 copies/mL. No cross-reactivity was observed, and elevated levels of various interfering substances did not adversely affect its analytical performance. The precision test conducted by repetitive analysis of 2,400 replicates with reference standards at various concentrations showed 99.9% agreement (2398/2400). The overall concordance rate between the HepB Typer-Entecavir kit and direct sequencing assays in 396 clinical samples was 99.5%. The HepB Typer-Entecavir kit showed high reliability and precision, and comparable sensitivity and specificity for detecting mutant virus populations in reference and clinical samples in comparison with direct sequencing. Therefore, this assay would be clinically useful in the diagnosis of entecavir-resistance-associated mutations in chronic hepatitis B.

Frostbite

MedlinePlus

... Preventing Frostbite To help prevent frostbite in cold weather: Stay updated on weather forecasts. If it's extremely cold, even brief exposure ... Medical History Cold, Ice, and Snow Safety Cold-Weather Sports and Your Family First-Aid Kit What ...

MEDICAL INJECTION

NASA Image and Video Library

1963-06-10

S62-08371 (1962) --- The automatic medical injectors carried on the Mercury-Atlas 9 flight. The injectors provide the astronaut with injection tubes of Tigan, for preventing motion sickness and Demerol, for relieving pain. The tubes encased in the block are stowed in the astronauts survival kit. The single injection tubes are placed in a pocket of the astronauts spacesuit. Photo credit: NASA

Challenges in Evaluating Relationships Between Quantitative Data (Carbon Dioxide) and Qualitative Data (Self-Reported Visual Changes)

NASA Technical Reports Server (NTRS)

Mendez, C. M.; Foy, M.; Mason, S.; Wear, M. L.; Meyers, V.; Law, J.; Alexander, D.; Van Baalen, M.

2014-01-01

Understanding the nuances in clinical data is critical in developing a successful data analysis plan. Carbon dioxide (CO2) data are collected on board the International Space Station (ISS) in a continuous stream. Clinical data on ISS are primarily collected via conversations between individual crewmembers and NASA Flight Surgeons during weekly Private Medical Conferences (PMC). Law, et.al, 20141 demonstrated a statistically significant association between weekly average CO2 levels on ISS and self-reported headaches over the reporting period from March 14, 2001 to May 31, 2012. The purpose of this analysis is to describe the evaluation of a possible association between visual changes and CO2 levels on ISS and to discuss challenges in developing an appropriate analysis plan. METHODS & PRELIMINARY RESULTS: A first analysis was conducted following the same study design as the published work on CO2 and self-reported headaches1; substituting self-reported changes in visual acuity in place of self-reported headaches. The analysis demonstrated no statistically significant association between visual impairment characterized by vision symptoms self-reported during PMCs and ISS average CO2 levels over ISS missions. Closer review of the PMC records showed that vision outcomes are not well-documented in terms of clinical severity, timing of onset, or timing of resolution, perhaps due to the incipient nature of vision changes. Vision has been monitored in ISS crewmembers, pre- and post-flight, using standard optometry evaluations. In-flight visual assessments were limited early in the ISS program, primarily consisting of self-perceived changes reported by crewmembers. Recently, on-orbit capabilities have greatly improved. Vision data ranges from self-reported post-flight changes in visual acuity, pre- to postflight changes identified during fundoscopic examination, and in-flight progression measured by advanced on-orbit clinical imaging capabilities at predetermined testing intervals. In contrast, CO2 data are recorded in a continuous stream over time; however, for the initial analysis this data was categorized into weekly averages.

[Objective assessment of trauma severity in patients with spleen injuries].

PubMed

Alekseev, V S; Ivanov, V A; Alekseev, S V; Vaniukov, V P

2013-01-01

The work presents an analysis of condition severity of 139 casualties with isolated and combined spleen injuries on admission to a surgical hospital. The assessment of condition severity was made using the traditional gradation and score scale VPH-SP. The degree of the severity of combined trauma of the spleen was determined by the scales ISS. The investigation showed that the scale ISS and VPH-SP allowed objective measurement of the condition severity of patients with spleen trauma. The score assessment facilitated early detection of the severe category of the patients, determined the diagnostic algorithm and the well-timed medical aid.

Space The New Medical Frontier / NASA Spinoffs Milestones in Space Research

MedlinePlus

... occasion. Photo courtesy of NIH Long-Term Space Research Until the advent of the ISS, research missions ... improving human health." NASA Spinoffs Milestones in Space Research Inspired by the space suits Apollo astronauts wore ...

Telescience Resource Kit Software Capabilities and Future Enhancements

NASA Technical Reports Server (NTRS)

Schneider, Michelle

2004-01-01

The Telescience Resource Kit (TReK) is a suite of PC-based software applications that can be used to monitor and control a payload on board the International Space Station (ISS). This software provides a way for payload users to operate their payloads from their home sites. It can be used by an individual or a team of people. TReK provides both local ground support system services and an interface to utilize remote services provided by the Payload Operations Integration Center (POIC). by the POIC and to perform local data functions such as processing the data, storing it in local files, and forwarding it to other computer systems. TReK can also be used to build, send, and track payload commands. In addition to these features, work is in progress to add a new command management capability. This capability will provide a way to manage a multi- platform command environment that can include geographically distributed computers. This is intended to help those teams that need to manage a shared on-board resource such as a facility class payload. The environment can be configured such that one individual can manage all the command activities associated with that payload. This paper will provide a summary of existing TReK capabilities and a description of the new command management capability. For example, 7'ReK can be used to receive payload data distributed

Shuttle OFT medical report: Summary of medical results from STS-1, STS-2, STS-3, and STS-4

NASA Technical Reports Server (NTRS)

Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

1983-01-01

The medical operations for the orbital test flights which includes a review of the health of the crews before, during, and immediately after the four shuttle orbital flights are reported. Health evaluation, health stabilization program, medical training, medical "kit" carried in flight, tests and countermeasures for space motion sickness, cardiovascular, biochemistry and endocrinology results, hematology and immunology analyses, medical microbiology, food and nutrition, potable water, Shuttle toxicology, radiological health, and cabin acoustical noise are reviewed. Information on environmental effects of Shuttle launch and landing, medical information management, and management, planning, and implementation of the medical program are included.

Chronic Medication and or Monitoring for Long Duration Space Flight: What Should The Policy Be?

NASA Technical Reports Server (NTRS)

Hamilton, Douglas R.

2004-01-01

While a private individual with a chronic medical condition could perhaps justifiably claim the right to become a "space tourist" through informed consent, NASA and other International crew members are national assets, trained at government expense to fulfill a mission considered essential to national goals. The medical requirements/policy for selection and certification of crewmembers for long duration missions to the International Space Station (ISS) should address: (1) Crewmembers with chronic conditions that require regular dosing of life-sustaining medication for the purposes of secondary or tertiary prevention (i.e. tumor suppression therapy or anticoagulation). (2) Crew members with conditions that will be worsened by spaceflight exposure, placing them at additional personal health risk though not necessarily increasing mission risk (i.e. previous radiation exposure or preflight osteopenia/osteoporosis) The following policies are recommended. A crewmember should not be assigned to an International Space Station mission who: (3) Requires medications to sustain life or who has a disease, which requires medical procedures or diagnostics to monitor and treat same. (4) Has medical condition, which would prevent participation as a candidate in many scientific and medical operational research studies, as their underlying condition would confound the collected data. (5) Requires specialized medical devices for monitoring or treatment of a medical condition, including conditions that require special provisions to conduct routine required countermeasure activities. (6) Who has a disease or requires treatment for same, and for which the effects of space travel may be deleterious to the short or long term health of the individual, An evidence-based approach will be used to provide rationale for policy recommendations under these scenarios. Operational impacts of allowing these medical conditions to fly on the ISS will also be presented.

Circadian misalignment affects sleep and medication use before and during spaceflight

PubMed Central

Flynn-Evans, Erin E; Barger, Laura K; Kubey, Alan A; Sullivan, Jason P; Czeisler, Charles A

2016-01-01

Sleep deficiency and the use of sleep-promoting medication are prevalent during spaceflight. Operations frequently dictate work during the biological night and sleep during the biological day, which contribute to circadian misalignment. We investigated whether circadian misalignment was associated with adverse sleep outcomes before (preflight) and during spaceflight missions aboard the International Space Station (ISS). Actigraphy and photometry data for 21 astronauts were collected over 3,248 days of long-duration spaceflight on the ISS and 11 days prior to launch (n=231 days). Sleep logs, collected one out of every 3 weeks in flight and daily on Earth, were used to determine medication use and subjective ratings of sleep quality. Actigraphy and photometry data were processed using Circadian Performance Simulation Software to calculate the estimated endogenous circadian temperature minimum. Sleep episodes were classified as aligned or misaligned relative to the estimated endogenous circadian temperature minimum. Mixed-effects regression models accounting for repeated measures were computed by data collection interval (preflight, flight) and circadian alignment status. The estimated endogenous circadian temperature minimum occurred outside sleep episodes on 13% of sleep episodes during preflight and on 19% of sleep episodes during spaceflight. The mean sleep duration in low-Earth orbit on the ISS was 6.4±1.2 h during aligned and 5.4±1.4 h (P<0.01) during misaligned sleep episodes. During aligned sleep episodes, astronauts rated their sleep quality as significantly better than during misaligned sleep episodes (66.8±17.7 vs. 60.2±21.0, P<0.01). Sleep-promoting medication use was significantly higher during misaligned (24%) compared with aligned (11%) sleep episodes (P<0.01). Use of any medication was significantly higher on days when sleep episodes were misaligned (63%) compared with when sleep episodes were aligned (49%; P<0.01). Circadian misalignment is associated with sleep deficiency and increased medication use during spaceflight. These findings suggest that there is an immediate need to deploy and assess effective countermeasures to minimize circadian misalignment and consequent adverse sleep outcomes both before and during spaceflight. PMID:28725719

Circadian misalignment affects sleep and medication use before and during spaceflight.

PubMed

Flynn-Evans, Erin E; Barger, Laura K; Kubey, Alan A; Sullivan, Jason P; Czeisler, Charles A

2016-01-01

Sleep deficiency and the use of sleep-promoting medication are prevalent during spaceflight. Operations frequently dictate work during the biological night and sleep during the biological day, which contribute to circadian misalignment. We investigated whether circadian misalignment was associated with adverse sleep outcomes before (preflight) and during spaceflight missions aboard the International Space Station (ISS). Actigraphy and photometry data for 21 astronauts were collected over 3,248 days of long-duration spaceflight on the ISS and 11 days prior to launch ( n =231 days). Sleep logs, collected one out of every 3 weeks in flight and daily on Earth, were used to determine medication use and subjective ratings of sleep quality. Actigraphy and photometry data were processed using Circadian Performance Simulation Software to calculate the estimated endogenous circadian temperature minimum. Sleep episodes were classified as aligned or misaligned relative to the estimated endogenous circadian temperature minimum. Mixed-effects regression models accounting for repeated measures were computed by data collection interval (preflight, flight) and circadian alignment status. The estimated endogenous circadian temperature minimum occurred outside sleep episodes on 13% of sleep episodes during preflight and on 19% of sleep episodes during spaceflight. The mean sleep duration in low-Earth orbit on the ISS was 6.4±1.2 h during aligned and 5.4±1.4 h ( P <0.01) during misaligned sleep episodes. During aligned sleep episodes, astronauts rated their sleep quality as significantly better than during misaligned sleep episodes (66.8±17.7 vs. 60.2±21.0, P <0.01). Sleep-promoting medication use was significantly higher during misaligned (24%) compared with aligned (11%) sleep episodes ( P <0.01). Use of any medication was significantly higher on days when sleep episodes were misaligned (63%) compared with when sleep episodes were aligned (49%; P <0.01). Circadian misalignment is associated with sleep deficiency and increased medication use during spaceflight. These findings suggest that there is an immediate need to deploy and assess effective countermeasures to minimize circadian misalignment and consequent adverse sleep outcomes both before and during spaceflight.

29 CFR 1926.50 - Medical services and first aid.

Code of Federal Regulations, 2010 CFR

2010-07-01

... supplies and equipment in the first aid kits. In a similar fashion, employers who have unique or changing..., gowns, face shields, masks and eye protection (see “Occupational Exposure to Blood borne Pathogens”, 29...

29 CFR 1926.50 - Medical services and first aid.

Code of Federal Regulations, 2011 CFR

2011-07-01

... supplies and equipment in the first aid kits. In a similar fashion, employers who have unique or changing..., gowns, face shields, masks and eye protection (see “Occupational Exposure to Blood borne Pathogens”, 29...

Helicopter use in rural trauma.

PubMed

Shepherd, Matthew Vincent; Trethewy, Christopher Ernest; Kennedy, John; Davis, Lin

2008-12-01

To profile a helicopter emergency medical service in rural Australia. To assess patient injury severities and outcomes. To compare missions involving ambulance officers with physicians. To determine any time advantage of the aircraft over ground transfer. Intention-to-treat analysis using retrospective case note review of all helicopter emergency medical service trauma patients from January 2004 to November 2006. Global positioning system mapping technology was used to compare one-way road transfer times with two-way helicopter retrieval. Two hundred and twenty-two missions were identified from the helicopter log. Forty missions were aborted in flight. Of 182 patients transported, 11 records were incomplete, leaving 171 for analysis. Fifty (29%) patients transported had an Injury Severity Score (ISS) > 15; the average ISS was 12.30 (standard error of the mean 0.82). The average calculated distance flown was 160.4 nautical miles (standard error of the mean 5.29; range 28-360 nautical miles). There was no significant difference in ISS between ambulance officers and physician groups (t = -1.17, P = 0.25, 95% CI -7.37-1.91). There was no difference in the incidence of severe injury (ISS > 15, P = 0.39) or mortality (P = 0.33) when the groups were compared. Air transport was significantly faster beyond 100 km, with a mean difference of 48 min (P = 0.00). We could not identify a significant survival benefit attributable to the addition of a doctor, although numbers for this comparison were small. Predicting missions where flight physicians might provide benefit remain imprecise and should be a priority area for prospective evaluation. We have demonstrated that in the absence of special circumstances, a helicopter response within 100 km from base does not improve time to definitive care.

Performance evaluation of the HepB Typer-Entecavir kit for detection of entecavir resistance mutations in chronic hepatitis B

PubMed Central

Ahn, Sang Hoon; Chun, Ji-Yong; Shin, Soo-Kyung; Park, Jun Yong; Yoo, Wangdon; Hong, Sun Pyo; Han, Kwang-Hyub

2013-01-01

Background/Aims Molecular diagnostic methods have enabled the rapid diagnosis of drug-resistant mutations in hepatitis B virus (HBV) and have reduced both unnecessary therapeutic interventions and medical costs. In this study we evaluated the analytical and clinical performances of the HepB Typer-Entecavir kit (GeneMatrix, Korea) in detecting entecavir-resistance-associated mutations. Methods The HepB Typer-Entecavir kit was evaluated for its limit of detection, interference, cross-reactivity, and precision using HBV reference standards made by diluting high-titer viral stocks in HBV-negative human serum. The performance of the HepB Typer-Entecavir kit for detecting mutations related to entecavir resistance was compared with direct sequencing for 396 clinical samples from 108 patients. Results Using the reference standards, the detection limit of the HepB Typer-Entecavir kit was found to be as low as 500 copies/mL. No cross-reactivity was observed, and elevated levels of various interfering substances did not adversely affect its analytical performance. The precision test conducted by repetitive analysis of 2,400 replicates with reference standards at various concentrations showed 99.9% agreement (2398/2400). The overall concordance rate between the HepB Typer-Entecavir kit and direct sequencing assays in 396 clinical samples was 99.5%. Conclusions The HepB Typer-Entecavir kit showed high reliability and precision, and comparable sensitivity and specificity for detecting mutant virus populations in reference and clinical samples in comparison with direct sequencing. Therefore, this assay would be clinically useful in the diagnosis of entecavir-resistance-associated mutations in chronic hepatitis B. PMID:24459645

Astronaut Jack Lousma - Inflight Medical Support System (IMSS) - JSC

NASA Image and Video Library

1973-01-01

S73-28423 (16 June 1973) --- Astronaut Jack R. Lousma, Skylab 3 pilot, reaches into a medical kit, part of the Inflight Medical Support System (IMSS), during training for the second manned Skylab Earth-orbital mission. This activity took place in the OWS trainer in the Mission Simulation and Training Facility at the Johnson Space Center (JSC). Other Skylab 3 crewmen are astronaut Alan L. Bean, commander, and scientist-astronaut Owen K. Garriott, science pilot. Photo credit: NASA

Analyzers Provide Water Security in Space and on Earth

NASA Technical Reports Server (NTRS)

2012-01-01

Resourcefulness is a key quality for living in space, and on the International Space Station (ISS), that means making the most of water supplies. In 2008, the installation of the Water Processing Assembly (WPA) onboard the ISS allowed the space station s crew to do just that. The WPA purifies moisture from nearly every possible source - sweat, water vapor, wastewater, and even urine - for drinking and oxygen generation. Capable of producing 35 gallons of potable, recycled water a day, the system has reduced the need for water delivered to the ISS by over 1,000 gallons a year, saving significant payload costs in the process. As with any drinking water, quality is a concern, particularly when that water has been recycled. This is an issue of particular interest in space, where ISS crewmembers would have to deal with any illness far from the nearest medical personnel and facilities. The WPA employs sensors that monitor water quality by measuring its conductivity, and rounding out the system s quality assurance methods is a device developed for NASA by a private industry partner. That company has now made the technology available for ensuring the purity of water for consumption and industrial uses on Earth.

Russian system of countermeasures on board of the International Space Station (ISS): the first results

NASA Astrophysics Data System (ADS)

Kozlovskaya, Inessa B.; Grigoriev, Anatoly I.

2004-08-01

The system of countermeasures used by Russian cosmonauts in space flights on board of International Space Station (ISS) was based on the developed and tested in flights on board of Russian space stations. It included as primary components: physical methods aimed to maintain the distribution of fluids at levels close to those experienced on Earth; physical exercises and loading suits aimed to load the musculoskeletal and the cardiovascular systems; measures that prevent the loss of fluids, mainly, water-salt additives which aid to maintain orthostatic tolerance and endurance to gravitational overloads during the return to Earth; well-balanced diet and medications directed to correct possible negative reactions of the body to weightlessness. Fulfillment of countermeasure's protocols inflight was thoroughly controlled. Efficacy of countermeasures used were assessed both in-and postflight. The results of studies showed that degrees of alterations recorded in different physiological systems after ISS space flights in Russian cosmonauts were significantly higher than those recorded after flights on the Russian space stations. This phenomenon was caused by the failure of the ISS crews to execute fully the prescribed countermeasures' protocols which was as a rule excused by technical imperfectness of exercise facilities, treadmill TVIS particularly.

Marked increase of final height by long-term aromatase inhibition in a boy with idiopathic short stature.

PubMed

Krebs, Andreas; Moske-Eick, Olaf; Doerfer, Jürgen; Roemer-Pergher, Cordula; van der Werf-Grohmann, Natascha; Schwab, Karl Otfried

2012-01-01

Growth hormone (GH) is the most frequently used treatment in children with idiopathic short stature (ISS). Aromatase inhibitor (AI) therapy is still in an experimental state, and both final height (FH) and long-term efficacy data in ISS have not been published. We present a 14.5-year-old boy with ISS and a height of 142.7 cm [standard deviation score (SDS) -2.79]. Based on the baseline bone age (BA) of 13.5-14 years, his predicted adult height (PAH) by Bayley/Pinneau was 154 cm (SDS -3.77)-158.2 (SDS -3.15). After a 5-year letrozole monotherapy, FH was 169 cm (SDS -1.57) showing a height difference between PAH and FH from 10.8 to 15 cm. No permanent side effects of the medication have been observed. Both a transient occurrence and a spontaneous recovery of decreased bone mineral apparent density were seen, verified by dual-energy X-ray absorptiometry. Spinal magnetic resonance imaging revealed no vertebral abnormalities. All therapy might be an effective and low-cost alternative to the use of GH. Further controlled trials should prove efficacy and safety of long-term AI therapy in boys with ISS.

The Integrated Medical Model: A Probabilistic Simulation Model for Predicting In-Flight Medical Risks

NASA Technical Reports Server (NTRS)

Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G.

2015-01-01

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting mass and volume constraints.

The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

NASA Technical Reports Server (NTRS)

Keenan, Alexandra; Young, Millennia; Saile, Lynn; Boley, Lynn; Walton, Marlei; Kerstman, Eric; Shah, Ronak; Goodenow, Debra A.; Myers, Jerry G., Jr.

2015-01-01

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting mass and volume constraints.

Assessment of a group of nigerian dental students' education on medical emergencies.

PubMed

Ehigiator, O; Ehizele, Ao; Ugbodaga, Pi

2014-03-01

The training of dental students in the management of medical emergencies is of utmost importance as they may encounter some of these emergencies at some point in their career. The aim of this study was to evaluate the medical emergency education in a Nigerian Dental School. This descriptive cross-sectional study was carried out among 124 final year dental students of the University of Benin, Benin City. Data was collected using a self-administered questionnaire. The questionnaire elicited information on demography, knowledge of inclusion of a medical emergency in the dental curriculum, knowledge of guidelines on medical emergency formulated by any dental authority, opinion on the comprehensiveness of the present training on medical emergency, type of medical emergency training received, previous encounter with a medical emergency, previous participation in emergency drills and knowledge of the content of an emergency kit. Descriptive statistics was carried out on the collected data. Only 58.1% (72/124) respondents were aware of the inclusion of a medical emergency in the dental curriculum and fewer, 17.7% (22/124), were aware of guidelines on medical emergency formulated by any dental authority. Fifty-two out of all the respondents (41.9%) claimed not to have received any form of training on medical emergency. Only 22.6% (28/123) had previously participated in an emergency drills and just 34.7% (43/124) had ever seen an emergency kit. It can be concluded from this study that the level of training and level of knowledge on medical emergencies of the studied dental students is below desirable standard. It is therefore necessary to put proper strategies in place to strengthen their identified areas of weakness.

The Use of the Integrated Medical Model for Forecasting and Mitigating Medical Risks for a Near-Earth Asteroid Mission

NASA Technical Reports Server (NTRS)

Kerstman, Eric; Saile, Lynn; Freire de Carvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma

2011-01-01

Introduction The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission managers and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight. Methods Stochastic computational methods are used to forecast probability distributions of medical events, crew health metrics, medical resource utilization, and probability estimates of medical evacuation and loss of crew life. The IMM can also optimize medical kits within the constraints of mass and volume for specified missions. The IMM was used to forecast medical evacuation and loss of crew life probabilities, as well as crew health metrics for a near-earth asteroid (NEA) mission. An optimized medical kit for this mission was proposed based on the IMM simulation. Discussion The IMM can provide information to the space program regarding medical risks, including crew medical impairment, medical evacuation and loss of crew life. This information is valuable to mission managers and the space medicine community in assessing risk and developing mitigation strategies. Exploration missions such as NEA missions will have significant mass and volume constraints applied to the medical system. Appropriate allocation of medical resources will be critical to mission success. The IMM capability of optimizing medical systems based on specific crew and mission profiles will be advantageous to medical system designers. Conclusion The IMM is a decision support tool that can provide estimates of the impact of medical events on human space flight missions, such as crew impairment, evacuation, and loss of crew life. It can be used to support the development of mitigation strategies and to propose optimized medical systems for specified space flight missions. Learning Objectives The audience will learn how an evidence-based decision support tool can be used to help assess risk, develop mitigation strategies, and optimize medical systems for exploration space flight missions.

28 CFR 97.20 - Standards to ensure the safety of violent prisoners during transport.

Code of Federal Regulations, 2010 CFR

2010-07-01

... physical safety of the prisoners during transport, including a first-aid kit and employees who are qualified to dispense medications and administer CPR and emergency first-aid; (d) Policies, practices, and...

Monitoring Your Blood Sugar Level

MedlinePlus

... orders an A1C test. However, you can also purchase over-the-counter A1C testing kits that you ... subject. Featured ContentPreparing Older Children to Make Medical Decisions for ThemselvesRead Article >>Preparing Older Children to Make ...

Electrical Impedance Tomography Technology (EITT) Project

NASA Technical Reports Server (NTRS)

Oliva-Buisson, Yvette J.

2014-01-01

Development of a portable, lightweight device providing two-dimensional tomographic imaging of the human body using impedance mapping. This technology can be developed to evaluate health risks and provide appropriate medical care on the ISS, during space travel and on the ground.

Musculoskeletal Changes, Injuries and Rehabilitation Associated with Spaceflight

NASA Technical Reports Server (NTRS)

Scheuring, Richard A.

2010-01-01

The in-flight musculoskeletal database provides the foundation for directing operationally-relevant research in space medicine. This effort will enable medical operations to develop medical kits, training programs, and preventive medicine strategies for future CxP missions: a) Quantify medications and medical supplies for next-generation spacecraft. b) Objective data for engineers to determine weight requirements. Flight surgeons can make specific recommendations to astronauts based on injury data, such as emphasizing hand protection while in-flight. EVA and spacecraft engineers can examine evidence-based data on injuries and design countermeasures to help prevent them.

[Possibility of the species identification using blood stains located on the material evidences and bone fragments with the method of solid phase enzyme immunoassay with "IgG general-EIA-BEST" kit and human immunoglobulin G].

PubMed

Sidorov, V L; Shvetsova, I V; Isakova, I V

2007-01-01

The authors give the comparative analysis of Russian and foreign forensic medical methods of species character identification of the blood from the stains on the material evidences and bone fragments. It is shown that for this purpose it is feasible to apply human immunoglobulin G (IgG) and solid phase enzyme immunoassay (EIA) with the kit "IgG general-EIA-BEST". In comparison with the methods used in Russia this method is more sensitive, convenient for objective registration and computer processing. The results of experiments shown that it is possible to use the kit "IgG general-EIA-BEST" in forensic medicine for the species character identification of the blood from the stains on the material evidences and bone fragments.

Classroom Materials from the Acoustical Society of America

NASA Astrophysics Data System (ADS)

Adams, W. K.; Clark, A.; Schneider, K.

2013-09-01

As part of the new education initiatives of the Acoustical Society of America (ASA), an activity kit for teachers that includes a variety of lessons addressing acoustics for a range of students (K-12) has been created. The "Sound and Music Activity Kit" is free to K-12 teachers. It includes materials sufficient to teach a class of 30 students plus a USB thumb drive containing 47 research-based, interactive, student-tested lessons, laboratory exercises, several assessments, and video clips of a class using the materials. ASA has also partnered with both the Optical Society of America (OSA) and the American Association of Physics Teachers. AAPT Physics Teaching Resource Agents (PTRA) have reviewed the lessons along with members of the ASA Teacher Activity Kit Committee. Topics include basic learning goals for teaching the physics of sound with examples and applications relating to medical imaging, animal bioacoustics, physical and psychological acoustics, speech, audiology, and architectural acoustics.

Relationship Between Carbon Dioxide Levels and Reported Congestion and Headaches on the International Space Station

NASA Technical Reports Server (NTRS)

Cole, Robert; Wear, Mary; Young, Millennia; Cobel, Christopher; Mason, Sara

2017-01-01

Congestion is commonly reported during spaceflight, and most crewmembers have reported using medications for congestion during International Space Station (ISS) missions. Although congestion has been attributed to fluid shifts during spaceflight, fluid status reaches equilibrium during the first week after launch while congestion continues to be reported throughout long duration missions. Congestion complaints have anecdotally been reported in relation to ISS CO2 levels; this evaluation was undertaken to determine whether or not an association exists. METHODS: Reported headaches, congestion symptoms, and CO2 levels were obtained for ISS expeditions 2-31, and time-weighted means and single-point maxima were determined for 24-hour (24hr) and 7-day (7d) periods prior to each weekly private medical conference. Multiple imputation addressed missing data, and logistic regression modeled the relationship between probability of reported event of congestion or headache and CO2 levels, adjusted for possible confounding covariates. The first seven days of spaceflight were not included to control for fluid shifts. Data were evaluated to determine the concentration of CO2 required to maintain the risk of congestion below 1% to allow for direct comparison with a previously published evaluation of CO2 concentrations and headache. RESULTS: This study confirmed a previously identified significant association between CO2 and headache and also found a significant association between CO2 and congestion. For each 1-mm Hg increase in CO2, the odds of a crew member reporting congestion doubled. The average 7-day CO2 would need to be maintained below 1.5 mmHg to keep the risk of congestion below 1%. The predicted probability curves of ISS headache and congestion curves appear parallel when plotted against ppCO2 levels with congestion occurring at approximately 1mmHg lower than a headache would be reported. DISCUSSION: While the cause of congestion is multifactorial, this study showed congestion is associated with CO2 levels on ISS. Data from additional expeditions could be incorporated to further assess this finding. CO2 levels are also associated with reports of headaches on ISS. While it may be expected for astronauts with congestion to also complain of headaches, these two symptoms are commonly mutually exclusive. Furthermore, it is unknown if a temporal CO2 relationship exists between congestion and headache on ISS. CO2 levels were time-weighted for 24hr and 7d, and thus the time course of congestion leading to headache was not assessed; however, congestion could be an early CO2-related symptom when compared to headache. Future studies evaluating the association of CO2-related congestion leading to headache would be difficult due to the relatively stable daily CO2 levels on ISS currently, but a systematic study could be implemented on-orbit if desired.

Smart Ultrasound Remote Guidance Experiment (SURGE) Preliminary Findings

NASA Technical Reports Server (NTRS)

Hurst, Victor; Dulchavsky, Scott; Garcia, Kathleen; Sargsyan, Ashot; Ebert, Doug

2009-01-01

To date, diagnostic quality ultrasound images were obtained aboard the International Space Station (ISS) using the ultrasound of the Human Research Facility (HRF) rack in the Laboratory module. Through the Advanced Diagnostic Ultrasound in Microgravity (ADUM) and the Braslet-M Occlusion Cuffs (BRASLET SDTO) studies, non-expert ultrasound operators aboard the ISS have performed cardiac, thoracic, abdominal, vascular, ocular, and musculoskeletal ultrasound assessments using remote guidance from ground-based ultrasound experts. With exploration class missions to the lunar and Martian surfaces on the horizon, crew medical officers will necessarily need to operate with greater autonomy given communication delays (round trip times of up to 5 seconds for the Moon and 90 minutes for Mars) and longer periods of communication blackouts (due to orbital constraints of communication assets). The SURGE project explored the feasibility and training requirements of having non-expert ultrasound operators perform autonomous ultrasound assessments in a simulated exploration mission outpost. The project aimed to identify experience, training, and human factors requirements for crew medical officers to perform autonomous ultrasonography. All of these aims pertained to the following risks from the NASA Bioastronautics Road Map: 1) Risk 18: Major Illness and Trauna; 2) Risk 20) Ambulatory Care; 3) Risk 22: Medical Informatics, Technologies, and Support Systems; and 4) Risk 23: Medical Skill Training and Maintenance.

Performance of the Extravehicular Mobility Unit (EMU) Airlock Coolant Loop Remediation (A/L CLR) Hardware - Final

NASA Technical Reports Server (NTRS)

Steele, John W.; Rector, Tony; Gazda, Daniel; Lewis, John

2011-01-01

An EMU water processing kit (Airlock Coolant Loop Recovery -- A/L CLR) was developed as a corrective action to Extravehicular Mobility Unit (EMU) coolant flow disruptions experienced on the International Space Station (ISS) in May of 2004 and thereafter. A conservative duty cycle and set of use parameters for A/L CLR use and component life were initially developed and implemented based on prior analysis results and analytical modeling. Several initiatives were undertaken to optimize the duty cycle and use parameters of the hardware. Examination of post-flight samples and EMU Coolant Loop hardware provided invaluable information on the performance of the A/L CLR and has allowed for an optimization of the process. The intent of this paper is to detail the evolution of the A/L CLR hardware, efforts to optimize the duty cycle and use parameters, and the final recommendations for implementation in the post-Shuttle retirement era.

Home delivery of an injury prevention kit for children in four French cities: a controlled randomized trial

PubMed Central

Sznajder, M; Leduc, S; Janvrin, M; Bonnin, M; Aegerter, P; Baudier, F; Chevallier, B; Macarthur, C

2003-01-01

Objectives: Home delivery of counselling and safety devices to prevent child injuries could help parents to adopt safe behaviour. The aim of this study was to test a safety kit designed and used in Quebec (Canada). Design and subjects: One hundred families from four towns in the Paris suburbs were visited at home by nurses or doctors when their child reached 6–9 months. Selection criteria were: primipara, medical problem, psychological, and/or socioeconomic difficulties. Interventions: During the first visit, 50 families (group 1) received counselling and a kit including preventive devices and pamphlets about indoor injuries and ways to avoid them. The other 50 families (group 2) received counselling but not the kit. A second home visit was made 6–8 weeks later. Main outcome measures: The number of safety improvements was calculated 6–8 weeks after a first home visit. Perceived usefulness of the kit was collected from families and from interviewers. Results: Between the first and the second visits, safety improvement was significantly higher in the group with the kit. This was mainly related to the risk of fall (p<0.02), fire and burns (p<0.001), poisoning (p<0.01), and suffocation (p<0.001). For improvement related to devices provided in the kit, the difference between the groups was significant: 64.4% improvement in group 1 versus 41.2% in group 2 (p<0.01). The relative risk (RR) of safety improvement between groups was 1.56 (95% confidence interval (CI) 1.35 to 1.80). Even for improvements not related to the kit the difference remained significant: 31.2% in group 1 versus 20.2% in group 2 (p<0.05); RR = 1.54 (95% CI 1.22 to 1.93). Conclusion: Routine home visits by social services offer a good opportunity to tackle child injury prevention. Free delivery of prevention kits and counselling allow families to modify their behaviour and homes so as to reduce risks. PMID:12966017

A Novel Approach to Assay DNA Methylation in Prostate Cancer

DTIC Science & Technology

2016-10-01

prepared into libraries according to standard protocols using Bioo Scientific’s DNA Sample Kit (cat. no. 514101, Austin , TX , USA). Libraries were...Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT: Approved for Public Release; Distribution Unlimited...ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 11. SPONSOR/MONITOR’S

Pharmacologic considerations for Shuttle astronauts

NASA Technical Reports Server (NTRS)

Santy, Patricia A.; Bungo, Michael W.

1991-01-01

Medication usage by crewmembers in the preflight and inflight mission periods is common in the Shuttle Program. The most common medical reports for which medication is used are: space motion sickness (SMS), sleeplessness, headache, and backache. A number of medications are available in the Shuttle Medical Kit to treat these problems. Currently, astronauts test all frequently used medications before mission assignment to identify potential side-effects, problems related to performance, personal likes/dislikes, and individual therapeutic effect. However, microgravity-induced changes in drug pharmacokinetics, in combination with multiple operational factors, may significantly alter crewmember responses inflight. This article discusses those factors that may impact pharmacologic efficacy during Shuttle missions.

Medical Data Architecture Project Status

NASA Technical Reports Server (NTRS)

Krihak, M.; Middour, C.; Lindsey, A.; Marker, N.; Wolfe, S.; Winther, S.; Ronzano, K.; Bolles, D.; Toscano, W.; Shaw, T.

2017-01-01

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current International Space Station (ISS) medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable an increasingly autonomous crew than the current ISS paradigm. The MDA will develop capabilities that support automated data collection, and the necessary functionality and challenges in executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. To attain this goal, the first year of the MDA project focused on reducing technical risk, developing documentation and instituting iterative development processes that established the basis for the first version of MDA software (or Test Bed 1). Test Bed 1 is based on a nominal operations scenario authored by the ExMC Element Scientist. This narrative was decomposed into a Concept of Operations that formed the basis for Test Bed 1 requirements. These requirements were successfully vetted through the MDA Test Bed 1 System Requirements Review, which permitted the MDA project to begin software code development and component integration. This paper highlights the MDA objectives, development processes, and accomplishments, and identifies the fiscal year 2017 milestones and deliverables in the upcoming year.

New Pharmacology Studies on the ISS

NASA Technical Reports Server (NTRS)

Wotring, Virginia E.; Pour, S.

2015-01-01

It is known that medications degrade over time and that extreme storage conditions will hasten their degradation. This is the basis of the HRP Risk of Ineffective or Toxic Medications Due to Long Term Storage. Gaps include questions about the effects of the spaceflight environment and about the potential for safe use of medications beyond their expiration dates. There are also open questions regarding effects of the spaceflight environment on human physiology and subsequent changes in how medications act on the body; these unanswered questions gave rise to the HRP Concern of Clinically Relevant Unpredicted Effects of Medication. Studies designed to address this Risk and Concern are described below.

29 CFR 1910.151 - Medical services and first aid.

Code of Federal Regulations, 2011 CFR

2011-07-01

... supplies and equipment in the first aid kits. In a similar fashion, employers who have unique or changing..., gowns, face shields, masks, and eye protection. [39 FR 23502, June 27, 1974, as amended at 63 FR 33466...

29 CFR 1910.151 - Medical services and first aid.

Code of Federal Regulations, 2010 CFR

2010-07-01

... supplies and equipment in the first aid kits. In a similar fashion, employers who have unique or changing..., gowns, face shields, masks, and eye protection. [39 FR 23502, June 27, 1974, as amended at 63 FR 33466...

Prescription and over-the-counter medications tool kit.

DOT National Transportation Integrated Search

2011-04-01

Automatic vehicle location (AVL) is a computer-based vehicle tracking system. For transit, the actual real-time position of each vehicle is measured and its location is relayed to a control center. Actual position determination and relay techniques v...

Abbreviated Injury Scale: not a reliable basis for summation of injury severity in trauma facilities?

PubMed

Ringdal, Kjetil G; Skaga, Nils Oddvar; Hestnes, Morten; Steen, Petter Andreas; Røislien, Jo; Rehn, Marius; Røise, Olav; Krüger, Andreas J; Lossius, Hans Morten

2013-05-01

Injury severity is most frequently classified using the Abbreviated Injury Scale (AIS) as a basis for the Injury Severity Score (ISS) and the New Injury Severity Score (NISS), which are used for assessment of overall injury severity in the multiply injured patient and in outcome prediction. European trauma registries recommended the AIS 2008 edition, but the levels of inter-rater agreement and reliability of ISS and NISS, associated with its use, have not been reported. Nineteen Norwegian AIS-certified trauma registry coders were invited to score 50 real, anonymised patient medical records using AIS 2008. Rater agreements for ISS and NISS were analysed using Bland-Altman plots with 95% limits of agreement (LoA). A clinically acceptable LoA range was set at ± 9 units. Reliability was analysed using a two-way mixed model intraclass correlation coefficient (ICC) statistics with corresponding 95% confidence intervals (CI) and hierarchical agglomerative clustering. Ten coders submitted their coding results. Of their AIS codes, 2189 (61.5%) agreed with a reference standard, 1187 (31.1%) real injuries were missed, and 392 non-existing injuries were recorded. All LoAs were wider than the predefined, clinically acceptable limit of ± 9, for both ISS and NISS. The joint ICC (range) between each rater and the reference standard was 0.51 (0.29,0.86) for ISS and 0.51 (0.27,0.78) for NISS. The joint ICC (range) for inter-rater reliability was 0.49 (0.19,0.85) for ISS and 0.49 (0.16,0.82) for NISS. Univariate linear regression analyses indicated a significant relationship between the number of correctly AIS-coded injuries and total number of cases coded during the rater's career, but no significant relationship between the rater-against-reference ISS and NISS ICC values and total number of cases coded during the rater's career. Based on AIS 2008, ISS and NISS were not reliable for summarising anatomic injury severity in this study. This result indicates a limitation in their use as benchmarking tools for trauma system performance. Copyright © 2012 Elsevier Ltd. All rights reserved.

Crew Configuration, Ingress/Egress Procedures, and In-Flight Caregiving Capacity in a Space Ambulance Based on the Boeing X-37B

NASA Astrophysics Data System (ADS)

Halberg, Ephriam Etan

This study proposes that a Boeing X-37B space plane, its dimensions and performance characteristics estimated from publicly available documents, diagrams, and photographs, could be internally redesigned as a medical evacuation (ambulance) vehicle for the International Space Station. As of 2017, there is currently no spacecraft designed to accommodate a contingency medical evacuation wherein a crew member aboard the ISS is injured or ailing and must be returned to Earth for immediate medical attention. The X-37B is an unmanned vehicle with a history of success in both sub-orbital testing and all four of its long-duration orbital missions to date. Research conducted at UC Davis suggests that it is possible to retain the outer mold line of the X-37B while expanding the internal payload compartment to a volume sufficient for a crew of three--pilot, crew medical officer, and injured crew member--throughout ISS un-dock and atmospheric entry, descent, and landing. In addition to crew life support systems, this re-purposed X-37B, hereafter referred to as the X-37SA (Space Ambulance), includes medical equipment for stabilization of a patient in-transit. This study suggests an optimal, ergonomic crew configuration and berthing port location, procedures for microgravity ingress and 1G egress, a minimum medical equipment list and location within the crew cabin for the medical care and monitoring equipment. Conceptual crew configuration, ingress/egress procedures, and patient/equipment access are validated via physical simulation in a full-scale mockup of the proposed X-37SA crew cabin.

Second Harmonic Imaging improves Echocardiograph Quality on board the International Space Station

NASA Technical Reports Server (NTRS)

Garcia, Kathleen; Sargsyan, Ashot; Hamilton, Douglas; Martin, David; Ebert, Douglas; Melton, Shannon; Dulchavsky, Scott

2008-01-01

Ultrasound (US) capabilities have been part of the Human Research Facility (HRF) on board the International Space Station (ISS) since 2001. The US equipment on board the ISS includes a first-generation Tissue Harmonic Imaging (THI) option. Harmonic imaging (HI) is the second harmonic response of the tissue to the ultrasound beam and produces robust tissue detail and signal. Since this is a first-generation THI, there are inherent limitations in tissue penetration. As a breakthrough technology, HI extensively advanced the field of ultrasound. In cardiac applications, it drastically improves endocardial border detection and has become a common imaging modality. U.S. images were captured and stored as JPEG stills from the ISS video downlink. US images with and without harmonic imaging option were randomized and provided to volunteers without medical education or US skills for identification of endocardial border. The results were processed and analyzed using applicable statistical calculations. The measurements in US images using HI improved measurement consistency and reproducibility among observers when compared to fundamental imaging. HI has been embraced by the imaging community at large as it improves the quality and data validity of US studies, especially in difficult-to-image cases. Even with the limitations of the first generation THI, HI improved the quality and measurability of many of the downlinked images from the ISS and should be an option utilized with cardiac imaging on board the ISS in all future space missions.

C3-PRO: Connecting ResearchKit to the Health System Using i2b2 and FHIR.

PubMed

Pfiffner, Pascal B; Pinyol, Isaac; Natter, Marc D; Mandl, Kenneth D

2016-01-01

A renewed interest by consumer information technology giants in the healthcare domain is focused on transforming smartphones into personal health data storage devices. With the introduction of the open source ResearchKit, Apple provides a framework for researchers to inform and consent research subjects, and to readily collect personal health data and patient reported outcomes (PRO) from distributed populations. However, being research backend agnostic, ResearchKit does not provide data transmission facilities, leaving research apps disconnected from the health system. Personal health data and PROs are of the most value when presented in context along with health system data. Our aim was to build a toolchain that allows easy and secure integration of personal health and PRO data into an open source platform widely adopted across 140 academic medical centers. We present C3-PRO: the Consent, Contact, and Community framework for Patient Reported Outcomes. This open source toolchain connects, in a standards-compliant fashion, any ResearchKit app to the widely-used clinical research infrastructure Informatics for Integrating Biology and the Bedside (i2b2). C3-PRO leverages the emerging health data standard Fast Healthcare Interoperability Resources (FHIR).

C3-PRO: Connecting ResearchKit to the Health System Using i2b2 and FHIR

PubMed Central

Pfiffner, Pascal B.; Pinyol, Isaac; Natter, Marc D.; Mandl, Kenneth D.

2016-01-01

A renewed interest by consumer information technology giants in the healthcare domain is focused on transforming smartphones into personal health data storage devices. With the introduction of the open source ResearchKit, Apple provides a framework for researchers to inform and consent research subjects, and to readily collect personal health data and patient reported outcomes (PRO) from distributed populations. However, being research backend agnostic, ResearchKit does not provide data transmission facilities, leaving research apps disconnected from the health system. Personal health data and PROs are of the most value when presented in context along with health system data. Our aim was to build a toolchain that allows easy and secure integration of personal health and PRO data into an open source platform widely adopted across 140 academic medical centers. We present C3-PRO: the Consent, Contact, and Community framework for Patient Reported Outcomes. This open source toolchain connects, in a standards-compliant fashion, any ResearchKit app to the widely-used clinical research infrastructure Informatics for Integrating Biology and the Bedside (i2b2). C3-PRO leverages the emerging health data standard Fast Healthcare Interoperability Resources (FHIR). PMID:27031856

HAMS II Quarterly Progress Report (Technical and Financial)

DTIC Science & Technology

2015-01-09

Resistance - Flow Relationships .................................................................................. 10 Figure 3. Pulse Oximeter Front-end...19 Figure 10. Pulse Oximeter versus NIRS...TMS320C5515 DSP Medical Development Kit (MDK) for Pulse Oximeter Implementation. This evaluation system provides the capability to leverage into the

Emergency Physicians as Good Samaritans: Survey of Frequency, Locations, Supplies and Medications

PubMed Central

Burkholder, Taylor W.; King, Renee A.

2016-01-01

Introduction Little is known about the frequency and locations in which emergency physicians (EPs) are bystanders to an accident or emergency; equally uncertain is which contents of an “emergency kit” may be useful during such events. The aim of this study was to describe the frequency and locations of Good Samaritan acts by EPs and also determine which emergency kit supplies and medications were most commonly used by Good Samaritans. Methods We conducted an electronic survey among a convenience sample of EPs in Colorado. Results Respondents reported a median frequency of 2.0 Good Samaritan acts per five years of practice, with the most common locations being sports and entertainment events (25%), road traffic accidents (21%), and wilderness settings (19%). Of those who had acted as Good Samaritans, 86% reported that at least one supply would have been useful during the most recent event, and 66% reported at least one medication would have been useful. The most useful supplies were gloves (54%), dressings (34%), and a stethoscope (20%), while the most useful medications were oxygen (19%), intravenous fluids (17%), and epinephrine (14%). Conclusion The majority of EPs can expect to provide Good Samaritan care during their careers and would be better prepared by carrying a kit with common supplies and medications where they are most likely to use them. PMID:26823924

Multi-Gas Monitor (MGM)

NASA Technical Reports Server (NTRS)

Pilgrim, Jeff; Limero, Thomas

2015-01-01

Multi-Gas Monitor is a flight experiment, a technology demonstration to test the ability of tunable diode laser spectroscopy based instrument to stay in calibration long term and follow events and dynamics occurring with the cabin atmosphere. MGM measures 4 gases: oxygen, carbon monoxide, ammonia and water vapor, as well as temperature and pressure. This month marked one year of successful and continuous MGM operation on ISS. The crew successfully tested the ammonia channel using a commercially available inhalant. MGM has detected some interesting dynamics inside Japanese Experiment Module (JEM) as a result of CO2 thruster firings from the SPHERES/RINGS payload and water spikes from dry out cycling of the JEM heat exchangers. Results to date have given us high confidence in the technology such that we believe this could have applications in the energy and medical sectors. This presentation will summarize the testing and results of the unit on ISS and suggest areas of use within the energy and medical arenas.

Naval Medical R and D News, Volume 9, Issue 12, December 2017

DTIC Science & Technology

2017-12-01

1907, Mary Mallon was a carrier of typhoid fever. Like other enteric diseases typhoid is primarily transmitted by ingesting contaminated food or...electricity, food , water…and then we arrived to provide support, help and literally…comfort,” said Gutierrez. Gutierrez, an infectious disease clinician and...Iss. 12 4 NMRC-A Shares Importance of New Clinical Research Center in Malaysia From Naval Medical Research Center - Asia Public Affairs SINGAPORE

Differences in Pre and Post Vascular Patterning of Retinas from ISS Crew Members and HDT Subjects by VESGEN Analysis

NASA Technical Reports Server (NTRS)

Murray, M. C.; Vizzeri, G.; Taibbi, G.; Mason, S. S.; Young, M. H.; Zanello, S. B.; Parsons-Wingerter, P. A.

2018-01-01

Accelerated research by NASA [1] has investigated the significant risks for visual and ocular impairments Spaceflight Associated Neuro-Ocular Syndrome /Visual Impairment/Intracranial Pressure (SANS/VIIP) incurred by microgravity spaceflight, especially long-duration missions. Our study investigates the role of blood vessels in the incidence and etiology of SANS/VIIP within the retinas of Astronaut crewmembers pre-and post-flight to the International Space Station (ISS) by NASA's VESsel GENeration Analysis (VESGEN). The response of retinal vessels in crewmembers to microgravity was compared to that of retinal vessels to Head-Down Tilt (HDT) in subjects undergoing 70-Day Bed Rest. The study tests the proposed hypothesis that cephalad fluid shifts missions, resulting in ocular and visual impairments, are necessarily mediated in part by retinal blood vessels, and are therefore accompanied by significant remodeling of retinal vasculature.Vascular patterns in the retinas of crew members and HDTBR subjects extracted from 30° infrared (IR) Heidelberg Spectralis® images collected pre/postflight and pre/post HDTBR, respectively, were analyzed by VESGEN (patent pending). a mature, automated software developed as a research discovery tool for progressive vascular diseases in the retina and other tissues [2]. The weighted, multi-parametric VESGEN analysis generates maps of branching arterial and venous trees and quantification by parameters such as the fractal dimension (Df, a modern measure of vascular space-filling capacity), vessel diameters, and densities of vessel length and number classified into specific branching generations by vascular physiological branching rules [2,3]. The retrospective study approved by NASA’s Institutional Review Board included six HDT subjects (NASA Flight Analogs Research Unit [FARU] Campaign 11; for example, [4]) and eight ISS crewmembers monitored by routine occupational surveillance who provided their study consents to NASA’s Lifetime Surveillance of Astronaut Health (LSAH). For the initial blinded VESGEN phase, ophthalmic retinal images were masked as to subject identity and pre- and post-status. In the second unblinded phase, VESGEN results were analyzed according to the pre- and post-status of left and right retinas matched to each subject. To complete our study, vascular results will be subjected to NASA biostatistical analysis and correlated with other ophthalmic and medical findings. Preliminary results for changes in the pre- to post-status of vascular patterning in the retinas of crewmembers and HDT subjects are strikingly opposite. By Df and other vascular branching measures, the space-filling capacity of arterial and venous trees decreased in a substantial subset of crewmembers (11/16 retinas). In contrast, vascular densities increased in a substantial subset of HDT subjects by the same parameters (6/10 retinas, currently excluding one anomalous subject). To conclude the study, biostatistical and medical analyses will be of critical importance for investigating the validity of these vascular findings. Vascular densities appeared to decrease in the retinas of crewmembers following ISS Missions, and increase in subjects after HDT. The vascular increases and decreases most likely derive primarily from limits of resolution to the ophthalmic imaging that does not capture the smallest vessels, rather than from vessel growth or atrophy. Differences in arterial and venous response to cephalad fluid shifts induced by ISS and HDT may have resulted from a long-duration conditioning phenomenon (for example, 6-month ISS missions compared to 70-day HDT), or the presence of gravity in HDT compared to microgravity onboard the ISS. To conclude our study, the biostatistical and medical analyses will be of critical importance for investigating the validity and significance of the VESGEN findings.

STS-29 Discovery, OV-103, crewmembers during bench review at Boeing FEPF

NASA Image and Video Library

1989-01-20

S89-26240 (20 Jan 1989) --- Four of the five STS-29 crewmembers inspect the content of their emergency medical and medication kits during the recent bench review of middeck locker equipment avaialable for their scheduled March 1989 flight. From left to right are Astronauts James H. Buchli, John E. Blaha, James P. Bagian and Michael L. Coats. Not pictured is Robert C. Springer.

Management of the Post-Shuttle Extravehicular Mobility Unit (EMU) Water Circuits

NASA Technical Reports Server (NTRS)

Steele, John W.; Etter, David; Rector, Tony; Hill, Terry; Wells, Kevin

2011-01-01

The EMU incorporates two separate water circuits for the rejection of metabolic heat from the astronaut and the cooling of electrical components. The first (the Transport Water Loop) circulates in a semi-closed-loop manner and absorbs heat into a Liquid Coolant and Ventilation Garment (LCVG) warn by the astronaut. The second (the Feed Water Loop) provides water to a cooling device (Sublimator) with a porous plate, and that water subsequently sublimates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. Efforts are underway to streamline the use of a water processing kit (ALCLR) that is being used to periodically clean and disinfect the Transport Loop Water. Those efforts include a fine tuning of the duty cycle based on a review of prior performance data as well as an assessment of a fixed installation of this kit into the EMU backpack or within on-orbit EMU interface hardware. Furthermore, testing is being conducted to ensure compatibility between the International Space Station (ISS) Water Processor Assembly (WPA) effluent and the EMU Sublimator as a prelude to using the WPA effluent as influent to the EMU Feed Water loop. This work is undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post-Shuttle 6-year service life.

Management of the Post-Shuttle Extravehicular Mobility Unit (EMU) Water Circuits

NASA Technical Reports Server (NTRS)

Steele, John W.; Etter, David; Rector, Tony; Hill, Terry; Wells, Kevin

2012-01-01

The EMU incorporates two separate water circuits for the rejection of metabolic heat from the astronaut and the cooling of electrical components. The first (the Transport Water Loop) circulates in a semi-closed-loop manner and absorbs heat into a Liquid Coolant and Ventilation Garment (LCVG) worn by the astronaut. The second (the Feed-water Loop) provides water to a cooling device (Sublimator) with a porous plate, and that water subsequently sublimates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. Efforts are underway to streamline the use of a water processing kit (ALCLR) that is being used to periodically clean and disinfect the Transport Loop Water. Those efforts include a fine tuning of the duty cycle based on a review of prior performance data as well as an assessment of a fixed installation of this kit into the EMU backpack, within on-orbit EMU interface hardware or as a stand-alone unit. Furthermore, testing is being conducted to ensure compatibility between the International Space Station (ISS) Water Processor Assembly (WPA) effluent and the EMU Sublimator as a prelude to using the WPA effluent as influent to the EMU Feed Water loop. This work is undertaken to reduce the crewtime and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a 6-year service life.

HIV/AIDS related commodities supply chain management in public health facilities of Addis Ababa, Ethiopia: a cross-sectional survey.

PubMed

Berhanemeskel, Eyerusalem; Beedemariam, Gebremedhin; Fenta, Teferi Gedif

2016-01-01

A wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia. A descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach. The study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, while all of hospitals had emergency order more than 3 times within 6 months prior to the study. All of the hospitals and nearly half of the health centers had an emergency order of test kits more than 3 times in the past 6 months. Overall, nearly 3/4th of the health facilities faced stock-out of one or more ARV medicines and test kits on the day of visit. There was no adequate data on patient medication record and stock status of HIV/AIDS related commodities. Moreover there were frequent stock-outs of ARV medicines and HIV test kits, which was an indicator of the weak supply chain management. Hospitals and health centers, therefore, should devise a system to capture and make use of patient medication record and stock status information so as to ensure continuous supply of the commodities.

Colorectal Cancer Screening Rates Increased after Exposure to the Patient-Centered Medical Home (PCMH).

PubMed

Green, Beverly B; Anderson, Melissa L; Chubak, Jessica; Baldwin, Laura Mae; Tuzzio, Leah; Catz, Sheryl; Cole, Alison; Vernon, Sally W

2016-01-01

The patient-centered medical home (PCMH) includes comprehensive chronic illness and preventive services, including identifying patients who are overdue for colorectal cancer screening (CRCS). The association between PCMH implementation and CRCS during the Systems of Support to Increase Colorectal Cancer Screening Trial (SOS) is described. The SOS enrolled 4664 patients from 21 clinics from August 2008 to November 2009. Patients were randomized to usual care, mailed fecal kits, kits plus brief assistance, or kits plus assistance and navigation. A PCMH model that included a workflow for facilitating CRCS was implemented at all study clinics in late 2009. Patients enrolled early had little exposure to the PCMH, whereas patients enrolled later were exposed during most of their first year in the trial. Logistic regression models were used to assess the association between PCMH exposure and CRCS. Usual care patients with ≥8 months in the PCMH had higher CRCS rates than those with ≤4 months in the PCMH (adjusted difference, 10.1%; 95% confidence interval, 5.7-14.6). SOS interventions led to significant increases in CRCS, but the magnitude of effect was attenuated by exposure to the PCMH (P for interaction = .01). Exposure to a PCMH was associated with higher CRCS rates. Automated mailed and centrally delivered stepped interventions increased CRCS rates, even in the presence of a PCMH. © Copyright 2016 by the American Board of Family Medicine.

Modifying a Commercial Centrifuge to Reduce Electromagnetic Interference and Evaluating Functionality of Ultrasound Equipment

NASA Technical Reports Server (NTRS)

Greening, Gage J.

2016-01-01

The Project Management and Engineering Branch (SF4) supports the Human Health and Performance Directorate (HH&P) and is responsible for developing and supporting human systems hardware for the International Space Station (ISS). When a principal investigator's (PI) medical research project on the ISS is accepted, SF4 develops the necessary hardware and software to transport to the ISS. The two projects I primarily worked on were the centrifuge and ultrasound projects. Centrifuge: One concern with spacecraft such as the ISS is electromagnetic interference (EMI) from onboard equipment, typically from radio waves (frequencies of 3 kHz to 300 GHz), which can negatively affect nearby circuitry. Standard commercial centrifuges produce EMI above safety limits, so my task was to help reduce EMI production from this equipment. Two centrifuges were tested: one unmodified as a control and one modified. To reduce EMI below safety limits, one centrifuge was modified to become a Faraday shield, in which significant electrical contact was made between all regions of the centrifuge housing. This included removing non-conductive paint, applying conductive fabric to the lid and foam sealer, adding a 10,000 µF decoupling capacitor across the power supply, and adding copper adhesive-mount gaskets to the housing interior. EMI testing of both centrifuges was performed in the EMI/EMC Control Test and Measurement Facility. EMI for both centrifuges was below safety limits for frequencies between 10 MHz and 15 GHz (pass); however, between 14 kHz and 10 MHz, EMI for the unmodified centrifuge exceeded safety limits (fail) as expected. Alternatively, for the modified centrifuge with the Faraday shield, EMI was below the safely limit of 55 dBµV/m for electromagnetic frequencies between 14 kHz and 10 MHz. This result indicates our modifications were successful. The successful EMI test allowed us to communicate with the vendor what modifications they needed to make to their commercial unit to meet our specifications and to understand what needs to be done in lab to the new centrifuge. Our modifications will provide a standard for readying centrifuges for future missions. Once the new modified centrifuge arrives by the vendor, it will need to undergo EMI testing again for validation. The centrifuge is also in the process of compatibility testing with a custom stowage drawer, which is an ongoing project in SF4. Both of these items will be payloads on future missions to the ISS for various research purposes. Ultrasound: ISS currently has an onboard ultrasound (Ultrasound 2 system) for research and medical purposes. Every piece of medical flight hardware has an equivalent ground-unit so instrumentation can be routinely evaluated and transported to the ISS if necessary. The ground-unit ultrasound equipment must be evaluated every six months using a task performance sheet (TPS). A TPS is a document, written by the appropriate scientists and engineers, which describes how to run equipment and is written in such a way that astronauts with unspecialized training can follow the tasks. I was responsible for performing six TPSs on a combination of three ultrasounds and two video power converters (VPCs). Performing a TPS involves checking out and computationally documenting each piece of equipment removed from storage locations, setting up hardware and software, performing tasks to verify functionality, returning equipment, and logging items back into the computerized system. My work revealed all ground-unit ultrasounds were functioning properly. Because of proper function, a discrepancy report (DR) did not have to be opened. The TPS was then passed along to the Quality Engineering (QE) for review and ultimately given to Quality Assurance (QA). Other projects: In addition to my main projects, I participated in other tasks including troubleshooting an EEG headband, volunteering for an ultrasound training research study, and conformal coating printed circuit boards. My internship at SF4 has helped me understand how space systems hardware development for the ISS fits into NASA's mission and vision.

Coxiellosis in domestic livestock of Puducherry and Tamil Nadu: Detection of Coxiella burnetii DNA by polymerase chain reaction in slaughtered ruminants

PubMed Central

Pradeep, Jothimani; Stephen, Selvaraj; Pooja, Pratheesh; Akshayavardhini, Anbalagan; Sangeetha, Balakrishnan; Antony, Prabakar Xavier

2017-01-01

Background and Aim:: In the course of our Indian Council of Medical Research project on coxiellosis in Puducherry and Tamil Nadu, 5.64% goat, 1.85% sheep, 1.06% buffaloes, and 0.97% cattle were positive for Coxiella burnetii antibodies by enzyme linked immunosorbent assay kit (IDEXX, Liebefeld, Switzerland). In this preliminary study, we have proceeded to look for C. burnetii DNA in those antibody positive specimens employing an imported commercial C. burnetii polymerase chain reaction (PCR) kit. Materials and Methods:: Blood samples were collected during slaughtering. All 15 blood samples of antibody positive ruminants and three antibody negative samples were subjected to conventional Trans-PCR assay with a commercial PCR kit (Genekam Biotechnology AG, Duisburg, Germany). An in-house Trans-PCR was included in the study for comparison. Results:: A total of 15 antibody positive and three antibody-negative serum samples belonging to 11 goat, 4 sheep, 1 cattle, and 2 buffaloes were tested in duplicate for the presence of C. burnetii DNA by the commercial agar gel PCR kit and an in-house Trans-PCR. Only one buffalo serum sample was positive for C. burnetii with a band at 243 bp in in-house Trans-PCR. Discussion:: Seropositivity for C. burnetii need not necessarily translate into infectivity status of the animal. Conversely, seronegative ruminants can shed C. burnetii. Rapid disintegration of C. burnetii DNA during the storage period is an important impediment in QF-PCR research. This is the first time the performance of this commercial PCR kit is being validated in India. Conclusion:: Commercial PCR kit, Genekam did not identify any positive sample, probably because it targeted a larger amplicon of 687 bp. PMID:28717320

Serological Diagnosis of Acute Scrub Typhus in Southern India: Evaluation of InBios Scrub Typhus Detect IgM Rapid Test and Comparison with other Serological Tests.

PubMed

Anitharaj, Velmurugan; Stephen, Selvaraj; Pradeep, Jothimani; Park, Sungman; Kim, Seung-Han; Kim, Young Jin; Kim, Eun-Ye; Kim, Yoon-Won

2016-11-01

Scrub Typhus (ST) is being reported from different parts of India in the recent past. However, the diagnosis and confirmation of ST cases require specific serological and molecular diagnostic tests. Both rapid and conventional ELISA tests need to be properly evaluated. Evaluation of a new ST IgM Immunochromatography (ICT) test kit (InBios Scrub Typhus Detect IgM Rapid Test) and compare it with another rapid kit, conventional ELISA kit and Weil-Felix (WF) test. This prospective study was carried out in Mahatma Gandhi Medical College and Research Institute, Puducherry, during November 2015 to June 2016. Clinically suspected 220 ST patients were examined by a new kit, InBios Scrub Typhus Detect IgM Rapid Test, taking the conventional InBios Scrub Typhus Detect IgM ELISA as reference. Additional comparison was made with ImmuneMed Scrub Typhus Rapid, and WF test (single OXK titers ≥1:320). Statistical analysis was performed (Chi-square, Spearman's correlation and Kappa) using IBM SPSS Statistics 17 for Windows (SPSS Inc; Chicago, USA). Percentage Sensitivity, Specificity, Positive Predictive and Negative Predictive Values for InBios, ImmuneMed and WF were 99.25, 93.02, 95.68, 98.77; 94.87, 94.19, 96.21, 92.05 and 50.38, 95.51, 94.29, 56.67 respectively. A total of 134 patients were positive in reference standard InBios IgM ELISA. This new rapid ST IgM kit validated for the first time in India, showed good sensitivity and specificity. As a Point-of-Care (PoC) test, the kit would be helpful in both urban and remote rural parts of India.

Serological Diagnosis of Acute Scrub Typhus in Southern India: Evaluation of InBios Scrub Typhus Detect IgM Rapid Test and Comparison with other Serological Tests

PubMed Central

Anitharaj, Velmurugan; Pradeep, Jothimani; Park, Sungman; Kim, Seung-Han; Kim, Young Jin; Kim, Eun-Ye; Kim, Yoon-Won

2016-01-01

Introduction Scrub Typhus (ST) is being reported from different parts of India in the recent past. However, the diagnosis and confirmation of ST cases require specific serological and molecular diagnostic tests. Both rapid and conventional ELISA tests need to be properly evaluated. Aim Evaluation of a new ST IgM Immunochromatography (ICT) test kit (InBios Scrub Typhus Detect IgM Rapid Test) and compare it with another rapid kit, conventional ELISA kit and Weil-Felix (WF) test. Materials and Methods This prospective study was carried out in Mahatma Gandhi Medical College and Research Institute, Puducherry, during November 2015 to June 2016. Clinically suspected 220 ST patients were examined by a new kit, InBios Scrub Typhus Detect IgM Rapid Test, taking the conventional InBios Scrub Typhus Detect IgM ELISA as reference. Additional comparison was made with ImmuneMed Scrub Typhus Rapid, and WF test (single OXK titers ≥1:320). Statistical analysis was performed (Chi-square, Spearman’s correlation and Kappa) using IBM SPSS Statistics 17 for Windows (SPSS Inc; Chicago, USA). Results Percentage Sensitivity, Specificity, Positive Predictive and Negative Predictive Values for InBios, ImmuneMed and WF were 99.25, 93.02, 95.68, 98.77; 94.87, 94.19, 96.21, 92.05 and 50.38, 95.51, 94.29, 56.67 respectively. A total of 134 patients were positive in reference standard InBios IgM ELISA. Conclusion This new rapid ST IgM kit validated for the first time in India, showed good sensitivity and specificity. As a Point-of-Care (PoC) test, the kit would be helpful in both urban and remote rural parts of India. PMID:28050364

Technologies for safe births.

PubMed

1984-01-01

The basic elements of a safe birth are proper prenatal care, adequate preparation of the mother, health worker, and site, awareness of the progress of labor and safe delivery, recognition of danger signs, and appropriate follow-up care. Technologies are differentiated by determining 1) the needs of rural birth attendants, 2) the nature of delivery kits, 3) proper cleanliness of the hands and equipment, and appropriate use of 5) disinfecting equipment, 6) drugs and medications, 7) the vertical position, 8) specialized instruments, and 9) records and support materials. Alternatives for measuring time are indicated. Customized kits available from UNICEF are described; some of the problems with these kits are reported. The logistics, referral procedures, and training and supervision needed for appropriate program managements are discussed. Adapting technologies to the local environment requires assessing the practices of traditional birth attendants (TBAs), the provision of kits (cost, ease of use and maintenance, replacement, durability, availability), the training required for proper use of equipment, the logistics of kit use, side effects of technologies, community attitudes, and evaluation. The advantages and disadvantages of including or not including particular supplies in the kit are discussed, i.e., the container for boiling water would either be a local pot or the aluminum carrying case. In lieu of a fingernail brush, a twig may be used for nail cleaning. Hand washing where water shortages exist might entail using a tin with a hole plugged with a stick to let water trickle as needed. Antiseptic solutions such a Dettol or Savlon can be used where a severe shortage exists. Basic equipment includes: soap and water, a container for boiling, other sterile containers, a protective cover of delivery area, towels, swabs, an optional apron, cord ties, a cutting instrument, gauze, a receiving blanket, records, and a carrying case.

2005 9th Annual Army Small Business Conference

DTIC Science & Technology

2005-11-03

field commanders who conduct acquisitions. All the Army’s major commands located in the United States will be represented. The conference...Engineer Squad Vehicle i r i l Mobile Gun System il yst Medical Evacuation Vehicle i l v ti i l Reconnaissance Vehicle iss i l Mortar Carrier rt r rri r...Manned Systems Unmanned Air Vehicles Class I ARV-A (L) Small (Manpackable) UGV Non-Line of Sight Cannon Non-Line of Sight Mortar Medical Treatment and

Performance and diagnostic usefulness of commercially available enzyme linked immunosorbent assay and rapid kits for detection of HIV, HBV and HCV in India.

PubMed

Maity, Susmita; Nandi, Srijita; Biswas, Subrata; Sadhukhan, Salil Kumar; Saha, Malay Kumar

2012-11-26

HIV, HBV and HCV pose a major public health problem throughout the world. Detection of infection markers for these agents is a major challenge for testing laboratories in a resource poor setting. As blood transfusion is an important activity saving millions of live every year, it also carries a risk of transfusion transmissible infections caused by these fatal blood borne pathogens if the quality of testing is compromised. Conventional ELISA is regarded as the mostly used screening technique but due to limitations like high cost, unavailability in many blood banks and testing sites, involvement of costly instruments, time taking nature and requirement of highly skilled personnel for interpretation, rapid tests are gaining more importance and warrants comparison of performance. A comparative study between these two techniques has been performed using commercially available diagnostic kits to assess their efficacy for detection of HIV, HBV and HCV infections. Rapid kits were more efficient in specificity with synthetic antigens along with high PPV than ELISA in most cases. Comparison between different ELISA kits revealed that Microlisa HIV and Hepalisa (J. Mitra & Co. Pvt. Ltd.); ERBA LISA HIV1 + 2, ERBA LISA Hepatitis B and ERBA LISA HCV (Transasia Bio-medicals Ltd.) gives uniform result with good performance in terms of sensitivity, specificity, PPV, NPV and efficiency, whereas, Microlisa HCV (J. Mitra & Co. Pvt. Ltd.), Microscreen HBsAg ELISA and INNOVA HCV (Span Diagnostics Ltd.) did not perform well. Rapid kits were also having high degree of sensitivity and specificity (100%) except in HIV Comb and HCV Comb (J. Mitra & Co. Pvt. Ltd.). The kit efficiency didn't vary significantly among different companies and lots in all the cases except for HCV ELISA showing statistically significant variation (p < 0.01) among three kit types. ELISA is a good screening assay for markers of HIV, HBV and HCV infections. Rapid tests are useful for further detection of false positive samples. ELISA seems the appropriate assay in blood bank. For availability of quality commercial diagnostic assays, evaluation of kit may be helpful.

Performance and diagnostic usefulness of commercially available enzyme linked immunosorbent assay and rapid kits for detection of HIV, HBV and HCV in India

PubMed Central

2012-01-01

Background HIV, HBV and HCV pose a major public health problem throughout the world. Detection of infection markers for these agents is a major challenge for testing laboratories in a resource poor setting. As blood transfusion is an important activity saving millions of live every year, it also carries a risk of transfusion transmissible infections caused by these fatal blood borne pathogens if the quality of testing is compromised. Conventional ELISA is regarded as the mostly used screening technique but due to limitations like high cost, unavailability in many blood banks and testing sites, involvement of costly instruments, time taking nature and requirement of highly skilled personnel for interpretation, rapid tests are gaining more importance and warrants comparison of performance. Results A comparative study between these two techniques has been performed using commercially available diagnostic kits to assess their efficacy for detection of HIV, HBV and HCV infections. Rapid kits were more efficient in specificity with synthetic antigens along with high PPV than ELISA in most cases. Comparison between different ELISA kits revealed that Microlisa HIV and Hepalisa (J. Mitra & Co. Pvt. Ltd.); ERBA LISA HIV1 + 2, ERBA LISA Hepatitis B and ERBA LISA HCV (Transasia Bio-medicals Ltd.) gives uniform result with good performance in terms of sensitivity, specificity, PPV, NPV and efficiency, whereas, Microlisa HCV (J. Mitra & Co. Pvt. Ltd.), Microscreen HBsAg ELISA and INNOVA HCV (Span Diagnostics Ltd.) did not perform well. Rapid kits were also having high degree of sensitivity and specificity (100%) except in HIV Comb and HCV Comb (J. Mitra & Co. Pvt. Ltd.). The kit efficiency didn’t vary significantly among different companies and lots in all the cases except for HCV ELISA showing statistically significant variation (p < 0.01) among three kit types. Conclusions ELISA is a good screening assay for markers of HIV, HBV and HCV infections. Rapid tests are useful for further detection of false positive samples. ELISA seems the appropriate assay in blood bank. For availability of quality commercial diagnostic assays, evaluation of kit may be helpful. PMID:23181517

Mutant KIT as imatinib-sensitive target in metastatic sinonasal carcinoma.

PubMed

Dieter, S M; Heining, C; Agaimy, A; Huebschmann, D; Bonekamp, D; Hutter, B; Ehrenberg, K R; Fröhlich, M; Schlesner, M; Scholl, C; Schlemmer, H-P; Wolf, S; Mavratzas, A; Jung, C S; Gröschel, S; von Kalle, C; Eils, R; Brors, B; Penzel, R; Kriegsmann, M; Reuss, D E; Schirmacher, P; Stenzinger, A; Federspil, P A; Weichert, W; Glimm, H; Fröhling, S

2017-01-01

Sinonasal carcinomas (SNCs) comprise various rare tumor types that are characterized by marked histologic diversity and largely unknown molecular profiles, yet share an overall poor prognosis owing to an aggressive clinical course and frequent late-stage diagnosis. The lack of effective systemic therapies for locally advanced or metastatic SNC poses a major challenge to therapeutic decision making for individual patients. We here aimed to identify actionable genetic alterations in a patient with metastatic SNC whose tumor, despite all diagnostic efforts, could not be assigned to any known SNC category and was refractory to multimodal therapy. We used whole-exome and transcriptome sequencing to identify a KIT exon 11 mutation (c.1733_1735del, p.D579del) as potentially druggable target in this patient and carried out cancer hotspot panel sequencing to detect secondary resistance-conferring mutations in KIT. Furthermore, as a step towards clinical exploitation of the recently described signatures of mutational processes in cancer genomes, we established and applied a novel bioinformatics algorithm that enables supervised analysis of the mutational catalogs of individual tumors. Molecularly guided treatment with imatinib in analogy to the management of gastrointestinal stromal tumor (GIST) resulted in a dramatic and durable response with remission of nearly all tumor manifestations, indicating a dominant driver function of mutant KIT in this tumor. KIT dependency was further validated by a secondary KIT exon 17 mutation (c.2459_2462delATTCinsG, p.D820_S821delinsG) that was detected upon tumor progression after 10 months of imatinib treatment and provided a rationale for salvage therapy with regorafenib, which has activity against KIT exon 11/17 mutant GIST. These observations highlight the potential of unbiased genomic profiling for uncovering the vulnerabilities of individual malignancies, particularly in rare and unclassifiable tumors, and underscore that KIT exon 11 mutations represent tractable therapeutic targets across different histologies. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Efficacy and safety of nilotinib in patients with KIT-mutated metastatic or inoperable melanoma: final results from the global, single-arm, phase II TEAM trial.

PubMed

Guo, J; Carvajal, R D; Dummer, R; Hauschild, A; Daud, A; Bastian, B C; Markovic, S N; Queirolo, P; Arance, A; Berking, C; Camargo, V; Herchenhorn, D; Petrella, T M; Schadendorf, D; Sharfman, W; Testori, A; Novick, S; Hertle, S; Nourry, C; Chen, Q; Hodi, F S

2017-06-01

The single-arm, phase II Tasigna Efficacy in Advanced Melanoma (TEAM) trial evaluated the KIT-selective tyrosine kinase inhibitor nilotinib in patients with KIT-mutated advanced melanoma without prior KIT inhibitor treatment. Forty-two patients with KIT-mutated advanced melanoma were enrolled and treated with nilotinib 400 mg twice daily. TEAM originally included a comparator arm of dacarbazine (DTIC)-treated patients; the design was amended to a single-arm trial due to an observed low number of KIT-mutated melanomas. Thirteen patients were randomized to DTIC before the protocol amendment removing this study arm. The primary endpoint was objective response rate (ORR), determined according to Response Evaluation Criteria In Solid Tumors. ORR was 26.2% (n = 11/42; 95% CI, 13.9%-42.0%), sufficient to reject the null hypothesis (ORR ≤10%). All observed responses were partial responses (PRs; median response duration, 7.1 months). Twenty patients (47.6%) had stable disease and 10 (23.8%) had progressive disease; 1 (2.4%) response was unknown. Ten of the 11 responding patients had exon 11 mutations, four with an L576P mutation. The median progression-free survival and overall survival were 4.2 and 18.0 months, respectively. Three of the 13 patients on DTIC achieved a PR, and another patient had a PR following switch to nilotinib. Nilotinib activity in patients with advanced KIT-mutated melanoma was similar to historical data from imatinib-treated patients. DTIC treatment showed potential activity, although the low patient number limits interpretation. Similar to previously reported results with imatinib, nilotinib showed greater activity among patients with an exon 11 mutation, including L576P, suggesting that nilotinib may be an effective treatment option for patients with specific KIT mutations. ClinicalTrials.gov, NCT01028222. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

HMS Tonometry Payload

NASA Image and Video Library

2012-04-06

ISS030-E-200591 (6 April 2012) --- In the International Space Station?s Destiny laboratory, NASA astronaut Dan Burbank (left), Expedition 30 commander, uses the Health Maintenance System Tonometry payload to perform an intraocular pressure test on NASA astronaut Don Pettit, flight engineer. The activity was supervised via live Ku-band video by medical ground personnel.

Prescription and over-the-counter medications tool kit (April, 2011 version)

DOT National Transportation Integrated Search

2011-04-01

This Toolkit is a compilation of policies, procedures, forms, and training resources that represent the best practices being used throughout the U.S. by a variety of transit systems. It does not represent all of the effective means that transit syste...

21 CFR 864.7490 - Sulfhemoglobin assay.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Sulfhemoglobin assay. 864.7490 Section 864.7490 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7490 Sulfhemoglobin...

21 CFR 864.7490 - Sulfhemoglobin assay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Sulfhemoglobin assay. 864.7490 Section 864.7490 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7490 Sulfhemoglobin...

21 CFR 864.7425 - Carboxyhemoglobin assay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Carboxyhemoglobin assay. 864.7425 Section 864.7425 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7425 Carboxyhemoglobin...

21 CFR 864.7490 - Sulfhemoglobin assay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Sulfhemoglobin assay. 864.7490 Section 864.7490 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7490 Sulfhemoglobin...

21 CFR 864.7425 - Carboxyhemoglobin assay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Carboxyhemoglobin assay. 864.7425 Section 864.7425 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7425 Carboxyhemoglobin...

21 CFR 864.7490 - Sulfhemoglobin assay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Sulfhemoglobin assay. 864.7490 Section 864.7490 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7490 Sulfhemoglobin...

21 CFR 864.7425 - Carboxyhemoglobin assay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Carboxyhemoglobin assay. 864.7425 Section 864.7425 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7425 Carboxyhemoglobin...

21 CFR 864.7490 - Sulfhemoglobin assay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Sulfhemoglobin assay. 864.7490 Section 864.7490 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7490 Sulfhemoglobin...

21 CFR 864.7425 - Carboxyhemoglobin assay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Carboxyhemoglobin assay. 864.7425 Section 864.7425 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7425 Carboxyhemoglobin...

AMO EXPRESS: A Command and Control Experiment for Crew Autonomy Onboard the International Space Station

NASA Technical Reports Server (NTRS)

Stetson, Howard K.; Frank, Jeremy; Cornelius, Randy; Haddock, Angie; Wang, Lui; Garner, Larry

2015-01-01

NASA is investigating a range of future human spaceflight missions, including both Mars-distance and Near Earth Object (NEO) targets. Of significant importance for these missions is the balance between crew autonomy and vehicle automation. As distance from Earth results in increasing communication delays, future crews need both the capability and authority to independently make decisions. However, small crews cannot take on all functions performed by ground today, and so vehicles must be more automated to reduce the crew workload for such missions. NASA's Advanced Exploration Systems Program funded Autonomous Mission Operations (AMO) project conducted an autonomous command and control experiment on-board the International Space Station that demonstrated single action intelligent procedures for crew command and control. The target problem was to enable crew initialization of a facility class rack with power and thermal interfaces, and involving core and payload command and telemetry processing, without support from ground controllers. This autonomous operations capability is enabling in scenarios such as initialization of a medical facility to respond to a crew medical emergency, and representative of other spacecraft autonomy challenges. The experiment was conducted using the Expedite the Processing of Experiments for Space Station (EXPRESS) rack 7, which was located in the Port 2 location within the U.S Laboratory onboard the International Space Station (ISS). Activation and deactivation of this facility is time consuming and operationally intensive, requiring coordination of three flight control positions, 47 nominal steps, 57 commands, 276 telemetry checks, and coordination of multiple ISS systems (both core and payload). Utilization of Draper Laboratory's Timeliner software, deployed on-board the ISS within the Command and Control (C&C) computers and the Payload computers, allowed development of the automated procedures specific to ISS without having to certify and employ novel software for procedure development and execution. The procedures contained the ground procedure logic and actions as possible to include fault detection and recovery capabilities.

NASA's Astronant Family Support Office

NASA Technical Reports Server (NTRS)

Beven, Gary; Curtis, Kelly D.; Holland, Al W.; Sipes, Walter; VanderArk, Steve

2014-01-01

During the NASA-Mir program of the 1990s and due to the challenges inherent in the International Space Station training schedule and operations tempo, it was clear that a special focus on supporting families was a key to overall mission success for the ISS crewmembers pre-, in- and post-flight. To that end, in January 2001 the first Family Services Coordinator was hired by the Behavioral Health and Performance group at NASA JSC and matrixed from Medical Operations into the Astronaut Office's organization. The initial roles and responsibilities were driven by critical needs, including facilitating family communication during training deployments, providing mission-specific and other relevant trainings for spouses, serving as liaison for families with NASA organizations such as Medical Operations, NASA management and the Astronaut Office, and providing assistance to ensure success of an Astronaut Spouses Group. The role of the Family Support Office (FSO) has modified as the ISS Program matured and the needs of families changed. The FSO is currently an integral part of the Astronaut Office's ISS Operations Branch. It still serves the critical function of providing information to families, as well as being the primary contact for US and international partner families with resources at JSC. Since crews launch and return on Russian vehicles, the FSO has the added responsibility for coordinating with Flight Crew Operations, the families, and their guests for Soyuz launches, landings, and Direct Return to Houston post-flight. This presentation will provide a summary of the family support services provided for astronauts, and how they have changed with the Program and families the FSO serves. Considerations for future FSO services will be discussed briefly as NASA proposes one year missions and beyond ISS missions. Learning Objective: 1) Obtain an understanding of the reasons a Family Support Office was important for NASA. 2) Become familiar with the services provided for astronauts and their families and how they changed with the Program and family needs.

[DNA analysis of chromosome Y in the area of the azoospermia factor (AZF) in infertile men].

PubMed

Kolárová, J; Santavá, A; Vrtĕl, R

2001-09-01

Establishment of investigation of sterile male DNA in AZF region--choice of loci and primers for investigation, optimization of PCR conditions (polymerase chain reaction). For practice. Department of Medical Genetics and Foetal Medicine, Faculty of Medicine, Palacky University and Faculty Hospital Olomouc. PCR amplification of DNA isolated from blood of sterile men and consequential electrophoresis of synthesized DNA fragments to appoint microdeletions in AZF. From January to June 2000 were detected the microdeletions in AZF of 3 out of 79 sterile men (3.80%) by means of the Experteam firm kit. From July to December 2000 were tested and optimized conditions of amplification of 10 AZF loci to substitute the kit and they were used for examination of the first 20 sterile men of our collection. In our laboratory was established routine examination male sterility related to microdeletions in AZF. With our collection of loci was substituted the original Experteam firm kit and was widened spectrum of observed loci.

NASA Bioreactors Advance Disease Treatments

NASA Technical Reports Server (NTRS)

2009-01-01

The International Space Station (ISS) is falling. This is no threat to the astronauts onboard, however, because falling is part of the ISS staying in orbit. The absence of gravity beyond the Earth s atmosphere is actually an illusion; at the ISS s orbital altitude of approximately 250 miles above the surface, the planet s gravitational pull is only 12-percent weaker than on the ground. Gravity is constantly pulling the ISS back to Earth, but the space station is also constantly traveling at nearly 18,000 miles per hour. This means that, even though the ISS is falling toward Earth, it is moving sideways fast enough to continually miss impacting the planet. The balance between the force of gravity and the ISS s motion creates a stable orbit, and the fact that the ISS and everything in it including the astronauts are falling at an equal rate creates the condition of weightlessness called microgravity. The constant falling of objects in orbit is not only an important principle in space, but it is also a key element of a revolutionary NASA technology here on Earth that may soon help cure medical ailments from heart disease to diabetes. In the mid-1980s, NASA researchers at Johnson Space Center were investigating the effects of long-term microgravity on human tissues. At the time, the Agency s shuttle fleet was grounded following the 1986 Space Shuttle Challenger disaster, and researchers had no access to the microgravity conditions of space. To provide a method for recreating such conditions on Earth, Johnson s David Wolf, Tinh Trinh, and Ray Schwarz developed that same year a horizontal, rotating device called a rotating wall bioreactor that allowed the growth of human cells in simulated weightlessness. Previously, cell cultures on Earth could only be grown two-dimensionally in Petri dishes, because gravity would cause the multiplying cells to sink within their growth medium. These cells do not look or function like real human cells, which grow three-dimensionally in the body. Experiments conducted by Johnson scientist Dr. Thomas Goodwin proved that the NASA bioreactor could successfully cultivate cells using simulated microgravity, resulting in three-dimensional tissues that more closely approximate those in the body. Further experiments conducted on space shuttle missions and by Wolf as an astronaut on the Mir space station demonstrated that the bioreactor s effects were even further expanded in space, resulting in remarkable levels of tissue formation. While the bioreactor may one day culture red blood cells for injured astronauts or single-celled organisms like algae as food or oxygen producers for a Mars colony, the technology s cell growth capability offers significant opportunities for terrestrial medical research right now. A small Texas company is taking advantage of the NASA technology to advance promising treatment applications for diseases both common and obscure.

21 CFR 864.7720 - Prothrombin consumption test.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Prothrombin consumption test. 864.7720 Section 864.7720 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7720 Prothrombin...

21 CFR 864.7415 - Abnormal hemoglobin assay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Abnormal hemoglobin assay. 864.7415 Section 864.7415 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7415 Abnormal...

21 CFR 864.7375 - Glutathione reductase assay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Glutathione reductase assay. 864.7375 Section 864.7375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7375 Glutathione...

21 CFR 864.7720 - Prothrombin consumption test.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Prothrombin consumption test. 864.7720 Section 864.7720 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7720 Prothrombin...

21 CFR 864.7900 - Thromboplastin generation test.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Thromboplastin generation test. 864.7900 Section 864.7900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7900...

21 CFR 864.7900 - Thromboplastin generation test.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Thromboplastin generation test. 864.7900 Section 864.7900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7900...

21 CFR 864.7720 - Prothrombin consumption test.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Prothrombin consumption test. 864.7720 Section 864.7720 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7720 Prothrombin...

21 CFR 864.7375 - Glutathione reductase assay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Glutathione reductase assay. 864.7375 Section 864.7375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7375 Glutathione...

21 CFR 864.7720 - Prothrombin consumption test.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Prothrombin consumption test. 864.7720 Section 864.7720 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7720 Prothrombin...

21 CFR 864.7720 - Prothrombin consumption test.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Prothrombin consumption test. 864.7720 Section 864.7720 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7720 Prothrombin...

21 CFR 864.7375 - Glutathione reductase assay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Glutathione reductase assay. 864.7375 Section 864.7375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7375 Glutathione...

21 CFR 864.7415 - Abnormal hemoglobin assay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Abnormal hemoglobin assay. 864.7415 Section 864.7415 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7415 Abnormal...

21 CFR 864.7900 - Thromboplastin generation test.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Thromboplastin generation test. 864.7900 Section 864.7900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7900...

21 CFR 864.7900 - Thromboplastin generation test.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Thromboplastin generation test. 864.7900 Section 864.7900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7900...

21 CFR 864.7900 - Thromboplastin generation test.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Thromboplastin generation test. 864.7900 Section 864.7900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7900...

21 CFR 864.7375 - Glutathione reductase assay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Glutathione reductase assay. 864.7375 Section 864.7375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7375 Glutathione...

21 CFR 864.7375 - Glutathione reductase assay.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Glutathione reductase assay. 864.7375 Section 864.7375 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7375 Glutathione...

21 CFR 864.7415 - Abnormal hemoglobin assay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Abnormal hemoglobin assay. 864.7415 Section 864.7415 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7415 Abnormal...

Career Exploration Program Exit Presentation

NASA Technical Reports Server (NTRS)

Wotring, Virginia; Hood, Andrew

2013-01-01

Mouse liver cells on short-term shuttle flights (STS- 135) have been shown to exhibit changes. By replicating aspects of spaceflight in the laboratory, we can conduct experiments without impacting mission resources. Astronauts are on a high-iron diet during spaceflight. Galactic Cosmic Rays (GCRs) and Solar Particle Events (SPEs) are ionizing radiation sources that can alter physiological functions. Preliminary medication usage data from the International Space Station (ISS) crew shows that the most common reasons for using medications in space are the same for healthy people on earth.

Expedition 8 Returns Home

NASA Image and Video Library

2004-04-30

JSC2004-E-21252 (30 April 2004) --- Astronaut C. Michael Foale, Expedition 8 commander and NASA ISS science officer, is carried in a chair from the Soyuz landing site to an inflatable medical tent after he and his crewmates, cosmonaut Alexander Y. Kaleri (out of frame), Soyuz flight engineer representing Russia’s Federal Space Agency, and European Space Agency (ESA) astronaut Andre Kuipers (out of frame) of the Netherlands, successfully landed in north central Kazakhstan on April 30, 2004, in their Soyuz TMA-3 capsule. Foale and Kaleri completed 195 days in space aboard the International Space Station (ISS), while Kuipers returned after an 11-day research mission as part of a commercial agreement between ESA and Russia’s Federal Space Agency. Photo Credit: NASA/Bill Ingalls

A System Approach to Navy Medical Education and Training. Appendix 23. Urology Technician.

DTIC Science & Technology

1974-08-31

IOBSERVE/RECORD OR DESCRIBE CHARACTERISTICS OF DRAINAGE FROM IINTERNAL BODY ORGANS 8 1OBSERVE/RECORD OR DESCRIBE CHARACTERISTICS OF DRAINAGE FROM...WHICH STAFF MEMBER IPATIENT SHOULD SEE 16 ICHECK COLOR OF SKIN, E.G. CYANOSIS, BLANCHING, JAUNDICE, IMOTTLING 17 ICHECK TEXTURE OF SKIN, E.G. DRY...POSSIBLE IPATIENT USE I 29 IDETERMINE MEDICATIONS AND SUPPLIES FOR DRUG KITS 30 ICHECK/COUNT NARCOTICS/CONTROLLED DRUGS 31 1DO AN INVENTORY OF DRUGS

Study of capability of microorganisms to develop on construction materials used in space objects

NASA Astrophysics Data System (ADS)

Rakova, N.; Svistunova, Y.; Novikova, N.

One of the most topical issues nowadays in the whole set of space research is the study of microbiological risks (medical, technical, technological). Experiments held onboard MIR station and International Space Station (ISS) clearly demonstrated capacity of microorganisms to contaminate the environment, equipment and belonging of habitual compartments of space objects. In this connection microorganisms-biodestructors play an important role. In their vital functioning they are capable of causing biological damage of different polymers, biocorrosion of metals which can lead to serious difficulties in performing long-term flights, namely the planned mission to Mars. Our purpose was to study capability of growth and reproduction of microorganisms on construction materials of various chemical composition as the first stage of biodestruction process. In our research we used "flight" strains of bacteria (Bacillus subtilus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Pseudomonas pumilus etc.) recovered from the ISS environment in several missions. For control we used "earth" bacteria species with typical properties. To model the environment of the ISS we took construction materials which are widely used in the interior and equipment of the ISS. The results we've obtained show that some microorganisms are capable of living and reproducing themselves on construction materials and their capability is more pronounced than that of the "earth" species. The best capability for growth and reproduction was characteristic of Bacillus subtilus.

Evaluation of the Oxygen Concentrator Prototypes: Pressure Swing Adsorption Prototype and Electrochemical Prototype

NASA Technical Reports Server (NTRS)

Gilkey, Kelly M.; Olson, Sandra L.

2015-01-01

An oxygen concentrator is needed to provide enriched oxygen in support of medical contingency operations for future exploration human spaceflight programs. It would provide continuous oxygen to an ill or injured crew member in a closed cabin environment. Oxygen concentration technology is being pursued to concentrate oxygen from the ambient environment so oxygen as a consumable resource can be reduced. Because oxygen is a critical resource in manned spaceflight, using an oxygen concentrator to pull oxygen out of the ambient environment instead of using compressed oxygen can provide better optimization of resources. The overall goal of this project is to develop an oxygen concentrator module that minimizes the hardware mass, volume, and power footprint while still performing at the required clinical capabilities. Should a medical event occur that requires patient oxygenation, the release of 100 percent oxygen into a small closed cabin environment can rapidly raise oxygen levels to the vehicles fire limit. The use of an oxygen concentrator to enrich oxygen from the ambient air and concentrate it to the point where it can be used for medical purposes means no oxygen is needed from the ultra-high purity (99.5+% O2) oxygen reserve tanks. By not adding oxygen from compressed tanks to the cabin environment, oxygen levels can be kept below the vehicle fire limit thereby extending the duration of care provided to an oxygenated patient without environmental control system intervention to keep the cabin oxygen levels below the fire limits. The oxygen concentrator will be a Food and Drug Administration (FDA) clearable device. A demonstration unit for the International Space Station (ISS) is planned to verify the technology and provide oxygen capability. For the ISS, the demonstration unit should not exceed 10 kg (approximately 22 lb), which is the soft stowage mass limit for launch on resupply vehicles for the ISS. The unit's size should allow for transport within the spacecraft to an ill crewmember. The user interface needs to be designed for ease of use by the local care provider and with consideration to the limited amount of training available to the astronaut corps for medical equipment and procedures.

Benefits for Health; NASA

NASA Technical Reports Server (NTRS)

Perchonok, Michele

2014-01-01

The goal of HRP is to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. Presentation discusses (1) Bone Health: Vitamin D, Fish Consumption and Exercise (2) Medical Support in Remote Areas (3) ISS Ultrasound 4) Dry electrode EKG System (5) Environmental Factors and Psychological Health.

Evaluation of Low-Pressure Cold Plasma for Disinfection of ISS Grown Produce and Metal Instruments

NASA Technical Reports Server (NTRS)

Hummerick, Mary E.; Hintze, Paul E.; Maloney, Philip R.; Spencer, Lashelle E.; Coutts, Janelle L.; Franco, Carolina

2016-01-01

Low pressure cold plasma, using breathing air as the plasma gas, has been shown to be effective at precision cleaning aerospace hardware at Kennedy Space Center.Both atmospheric and low pressure plasmas are relatively new technologies being investigated for disinfecting agricultural commodities and medical instruments.

A New Active Space Radiation Instruments for the International Space Station, A-DREAMS

NASA Astrophysics Data System (ADS)

Uchihori, Yukio; Kodaira, Satoshi; Kitamura, Hisashi; Kobayashi, Shingo

For future space experiments in the International Space Station (ISS) or other satellites, radiation detectors, A-DREAMS (Active Dosimeter for Radiation Environment and Astronautic Monitoring in Space), using single or multiple silicon semi-conductor detectors have been developed. The first version of the detectors were produced and calibrated with particle accelerators. National Institute of Radiological Sciences has a medical heavy ion accelerator (HIMAC) for cancer therapy and a cyclotron accelerator. The detector was irradiated with high energy heavy ions and protons in HIMAC and the cyclotron and calibrated the energy resolution and linearity for deposited energies of these particles. We are planned to be going to use the new instrument in an international project, the new MATROSHKA experiment which is directed by members in the Institute of Bio-Medical Problem (IBMP) in Russia and German Space Center (DLR) in Germany. In the project, the dose distribution in human torso phantom will be investigated for several months in the ISS. For the project, a new type of the instruments is under development in NIRS and the current situation will be reported in this paper.

Monitoring Bone Health after Spaceflight: Data Mining to Support an Epidemiological Analysis of Age-related Bone Loss in Astronauts

NASA Technical Reports Server (NTRS)

Baker, K. S,; Amin, S.; Sibonga, Jean D.

2009-01-01

Through the epidemiological analysis of bone data, HRP is seeking evidence as to whether the prolonged exposure to microgravity of low earth orbit predisposes crewmembers to an earlier onset of osteoporosis. While this collaborative Epidemiological Project may be currently limited by the number of ISS persons providing relevant spaceflight medical data, a positive note is that it compares medical data of astronauts to data of an age-matched (not elderly) population that is followed longitudinally with similar technologies. The inclusion of data from non-ISS and non-NASA crewmembers is also being pursued. The ultimate goal of this study is to provide critical information for NASA to understand the impact of low physical or minimal weight-bearing activity on the aging process as well as to direct its development of countermeasures and rehabilitation programs to influence skeletal recovery. However, in order to optimize these results NASA needs to better define the requirements for long term monitoring and encourage both active and retired astronauts to contribute to a legacy of data that will define human health risks in space.

76 FR 17136 - Medical Devices; Availability of Safety and Effectiveness Summaries for Premarket Approval...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... section 515(d)(4) and (e)(2) of the Federal Food, Drug, and Cosmetic Act (the FD&C Act) (21 U.S.C. 360e(d......... Dako Denmark A/S..... HercepTest kit Approved October 20, 2010. P080009 Ethicon Endo-Surgery, SEDASYS...

46 CFR 197.314 - First aid and treatment equipment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... treatment equipment. (a) Each dive location must have— (1) A medical kit approved by a physician that... communications system to obtain emergency assistance except when the vessel or facility ship-to-shore, two-way communications system is readily available. (c) Each dive location supporting mixed-gas dives, dives deeper than...

46 CFR 197.314 - First aid and treatment equipment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... treatment equipment. (a) Each dive location must have— (1) A medical kit approved by a physician that... communications system to obtain emergency assistance except when the vessel or facility ship-to-shore, two-way communications system is readily available. (c) Each dive location supporting mixed-gas dives, dives deeper than...

46 CFR 197.314 - First aid and treatment equipment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... treatment equipment. (a) Each dive location must have— (1) A medical kit approved by a physician that... communications system to obtain emergency assistance except when the vessel or facility ship-to-shore, two-way communications system is readily available. (c) Each dive location supporting mixed-gas dives, dives deeper than...

21 CFR 864.7455 - Fetal hemoglobin assay.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Fetal hemoglobin assay. 864.7455 Section 864.7455...) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7455 Fetal hemoglobin assay. (a) Identification. A fetal hemoglobin assay is a device that is used to determine the presence...

21 CFR 864.7455 - Fetal hemoglobin assay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fetal hemoglobin assay. 864.7455 Section 864.7455...) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7455 Fetal hemoglobin assay. (a) Identification. A fetal hemoglobin assay is a device that is used to determine the presence...

21 CFR 864.7060 - Antithrombin III assay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Antithrombin III assay. 864.7060 Section 864.7060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7060 Antithrombin III...

21 CFR 864.7525 - Heparin assay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Heparin assay. 864.7525 Section 864.7525 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7525 Heparin assay. (a) Identification. A...

21 CFR 864.7695 - Platelet factor 4 radioimmunoassay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Platelet factor 4 radioimmunoassay. 864.7695 Section 864.7695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7695 Platelet...

21 CFR 864.7400 - Hemoglobin A 2 assay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hemoglobin A 2 assay. 864.7400 Section 864.7400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7400 Hemoglobin A 2...

21 CFR 864.7735 - Prothrombin-proconvertin test and thrombotest.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Prothrombin-proconvertin test and thrombotest. 864.7735 Section 864.7735 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864...

21 CFR 864.7060 - Antithrombin III assay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Antithrombin III assay. 864.7060 Section 864.7060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7060 Antithrombin III...

21 CFR 864.7060 - Antithrombin III assay.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Antithrombin III assay. 864.7060 Section 864.7060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7060 Antithrombin III...

21 CFR 864.7400 - Hemoglobin A2 assay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hemoglobin A2 assay. 864.7400 Section 864.7400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7400 Hemoglobin A2...

21 CFR 864.7695 - Platelet factor 4 radioimmunoassay.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Platelet factor 4 radioimmunoassay. 864.7695 Section 864.7695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7695 Platelet...

21 CFR 864.7060 - Antithrombin III assay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Antithrombin III assay. 864.7060 Section 864.7060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7060 Antithrombin III...

21 CFR 864.7695 - Platelet factor 4 radioimmunoassay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Platelet factor 4 radioimmunoassay. 864.7695 Section 864.7695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7695 Platelet...

21 CFR 864.7750 - Prothrombin time test.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Prothrombin time test. 864.7750 Section 864.7750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7750 Prothrombin time...

21 CFR 864.7925 - Partial thromboplastin time tests.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Partial thromboplastin time tests. 864.7925 Section 864.7925 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7925 Partial...

21 CFR 864.7750 - Prothrombin time test.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Prothrombin time test. 864.7750 Section 864.7750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7750 Prothrombin time...

21 CFR 864.7750 - Prothrombin time test.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Prothrombin time test. 864.7750 Section 864.7750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7750 Prothrombin time...

21 CFR 864.7875 - Thrombin time test.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Thrombin time test. 864.7875 Section 864.7875 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7875 Thrombin time test. (a...

21 CFR 864.7290 - Factor deficiency test.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Factor deficiency test. 864.7290 Section 864.7290 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7290 Factor deficiency...

21 CFR 864.7875 - Thrombin time test.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Thrombin time test. 864.7875 Section 864.7875 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7875 Thrombin time test. (a...

21 CFR 864.7695 - Platelet factor 4 radioimmunoassay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Platelet factor 4 radioimmunoassay. 864.7695 Section 864.7695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7695 Platelet...

21 CFR 864.7290 - Factor deficiency test.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Factor deficiency test. 864.7290 Section 864.7290 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7290 Factor deficiency...

21 CFR 864.7735 - Prothrombin-proconvertin test and thrombotest.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Prothrombin-proconvertin test and thrombotest. 864.7735 Section 864.7735 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864...

21 CFR 864.7925 - Partial thromboplastin time tests.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Partial thromboplastin time tests. 864.7925 Section 864.7925 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7925 Partial...

21 CFR 864.7925 - Partial thromboplastin time tests.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Partial thromboplastin time tests. 864.7925 Section 864.7925 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7925 Partial...

21 CFR 864.7735 - Prothrombin-proconvertin test and thrombotest.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Prothrombin-proconvertin test and thrombotest. 864.7735 Section 864.7735 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864...

21 CFR 864.7735 - Prothrombin-proconvertin test and thrombotest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Prothrombin-proconvertin test and thrombotest. 864.7735 Section 864.7735 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864...

21 CFR 864.7925 - Partial thromboplastin time tests.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Partial thromboplastin time tests. 864.7925 Section 864.7925 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7925 Partial...

21 CFR 864.7400 - Hemoglobin A 2 assay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hemoglobin A 2 assay. 864.7400 Section 864.7400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7400 Hemoglobin A 2...

21 CFR 864.7750 - Prothrombin time test.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Prothrombin time test. 864.7750 Section 864.7750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7750 Prothrombin time...

21 CFR 864.7455 - Fetal hemoglobin assay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Fetal hemoglobin assay. 864.7455 Section 864.7455 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7455 Fetal hemoglobin...

21 CFR 864.7060 - Antithrombin III assay.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Antithrombin III assay. 864.7060 Section 864.7060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7060 Antithrombin III...

21 CFR 864.7875 - Thrombin time test.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Thrombin time test. 864.7875 Section 864.7875 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7875 Thrombin time test. (a...

21 CFR 864.7290 - Factor deficiency test.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Factor deficiency test. 864.7290 Section 864.7290 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7290 Factor deficiency...

21 CFR 864.7875 - Thrombin time test.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Thrombin time test. 864.7875 Section 864.7875 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7875 Thrombin time test. (a...

21 CFR 864.7525 - Heparin assay.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Heparin assay. 864.7525 Section 864.7525 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7525 Heparin assay. (a) Identification. A...

21 CFR 864.7925 - Partial thromboplastin time tests.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Partial thromboplastin time tests. 864.7925 Section 864.7925 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7925 Partial...

21 CFR 864.7455 - Fetal hemoglobin assay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Fetal hemoglobin assay. 864.7455 Section 864.7455 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7455 Fetal hemoglobin...

21 CFR 864.7290 - Factor deficiency test.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Factor deficiency test. 864.7290 Section 864.7290 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7290 Factor deficiency...

21 CFR 864.7695 - Platelet factor 4 radioimmunoassay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Platelet factor 4 radioimmunoassay. 864.7695 Section 864.7695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7695 Platelet...

21 CFR 864.7525 - Heparin assay.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Heparin assay. 864.7525 Section 864.7525 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7525 Heparin assay. (a) Identification. A...

21 CFR 864.7735 - Prothrombin-proconvertin test and thrombotest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Prothrombin-proconvertin test and thrombotest. 864.7735 Section 864.7735 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864...

21 CFR 864.7525 - Heparin assay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Heparin assay. 864.7525 Section 864.7525 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7525 Heparin assay. (a) Identification. A...

21 CFR 864.7875 - Thrombin time test.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Thrombin time test. 864.7875 Section 864.7875 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7875 Thrombin time test. (a...

21 CFR 864.7455 - Fetal hemoglobin assay.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Fetal hemoglobin assay. 864.7455 Section 864.7455 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7455 Fetal hemoglobin...

21 CFR 864.7525 - Heparin assay.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Heparin assay. 864.7525 Section 864.7525 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7525 Heparin assay. (a) Identification. A...

46 CFR 197.454 - First aid and treatment equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false First aid and treatment equipment. 197.454 Section 197.454 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE OCCUPATIONAL SAFETY AND... Equipment § 197.454 First aid and treatment equipment. The diving supervisor shall ensure that medical kits...

Colorectal Cancer Screening Rates Increased after Exposure to the Patient-Centered Medical Home (PCMH)

PubMed Central

Green, Beverly B.; Anderson, Melissa L.; Chubak, Jessica; Baldwin, Laura Mae; Tuzzio, Leah; Catz, Sheryl; Cole, Alison; Vernon, Sally W.

2016-01-01

Objective The patient-centered medical home (PCMH) includes comprehensive chronic illness and preventive services, including identifying patients who are overdue for colorectal cancer screening (CRCS). The association between PCMH implementation and CRCS during the Systems of Support to Increase Colorectal Cancer Screening Trial (SOS) is described. Methods The SOS enrolled 4664 patients from 21 clinics from August 2008 to November 2009. Patients were randomized to usual care, mailed fecal kits, kits plus brief assistance, or kits plus assistance and navigation. A PCMH model that included a workflow for facilitating CRCS was implemented at all study clinics in late 2009. Patients enrolled early had little exposure to the PCMH, whereas patients enrolled later were exposed during most of their first year in the trial. Logistic regression models were used to assess the association between PCMH exposure and CRCS. Results Usual care patients with ≥8 months in the PCMH had higher CRCS rates than those with ≤4 months in the PCMH (adjusted difference, 10.1%; 95% confidence interval, 5.7–14.6). SOS interventions led to significant increases in CRCS, but the magnitude of effect was attenuated by exposure to the PCMH (P for interaction = .01). Conclusion Exposure to a PCMH was associated with higher CRCS rates. Automated mailed and centrally delivered stepped interventions increased CRCS rates, even in the presence of a PCMH. (J Am Board Fam Med 2016;29:191–200.) PMID:26957375

Performance evaluation of a chemiluminescence microparticle immunoassay for CK-MB.

PubMed

Lin, Zhi-Yuan; Fang, Yi-Zhen; Jin, Hong-Wei; Lin, Hua-Yue; Dai, Zhang; Luo, Qing; Li, Hong-Wei; Lin, Yan-Ling; Huang, Shui-Zhen; Gao, Lei; Xu, Fei-Hai; Zhang, Zhong-Ying

2018-03-31

To verify and evaluate the performance characteristics of a creatine kinase phosphokinase isoenzymes MB (CK-MB) assay kit, which produced by Xiamen Innodx Biotech Co. Ltd. Evaluation was carried out according to "Guidelines for principle of analysis performance evaluation of in vitro diagnostic reagent." The performance parameters included detection limit, linearity range, reportable range, recovery test, precision verification, interference test, cross-reactivity, matrix effect, and method comparison. The detection limit was 0.1 ng/mL. The assay had clinical linearity over range of 0.1 ng/mL-500 ng/mL. Reportable range was from 0.1 ng/mL to 1000 ng/mL. The average percent of recovery was 99.66%. The coefficient of variation (CV) for within-run and between-run of low CK-MB sample was 5.55% and 6.16%, respectively. As for high-level sample, it was 7.88% and 7.80%. In medical decision level, the relative deviation (Bias) of all interference tests was lower than 15%. When the sample had mild-hemolysis; hemoglobin ≤15 g/L; triglyceride ≤17 mmol/L; bilirubin ≤427.5 μmol/L; rheumatoid factor ≤206U/mL, there was no significant interference to be found. Moreover, assay kit had no cross-reaction with CK-MM and CK-BB. At last, total diagnostic accuracy of kit was 93.24%, when compared with refer kit. Overall the results of the verification study indicated the performance of kit is met the requirements of the clinical test. © 2018 Wiley Periodicals, Inc.

Improved technical success and radiation safety of adrenal vein sampling using rapid, semi-quantitative point-of-care cortisol measurement.

PubMed

Page, Michael M; Taranto, Mario; Ramsay, Duncan; van Schie, Greg; Glendenning, Paul; Gillett, Melissa J; Vasikaran, Samuel D

2018-01-01

Objective Primary aldosteronism is a curable cause of hypertension which can be treated surgically or medically depending on the findings of adrenal vein sampling studies. Adrenal vein sampling studies are technically demanding with a high failure rate in many centres. The use of intraprocedural cortisol measurement could improve the success rates of adrenal vein sampling but may be impracticable due to cost and effects on procedural duration. Design Retrospective review of the results of adrenal vein sampling procedures since commencement of point-of-care cortisol measurement using a novel single-use semi-quantitative measuring device for cortisol, the adrenal vein sampling Accuracy Kit. Success rate and complications of adrenal vein sampling procedures before and after use of the adrenal vein sampling Accuracy Kit. Routine use of the adrenal vein sampling Accuracy Kit device for intraprocedural measurement of cortisol commenced in 2016. Results Technical success rate of adrenal vein sampling increased from 63% of 99 procedures to 90% of 48 procedures ( P = 0.0007) after implementation of the adrenal vein sampling Accuracy Kit. Failure of right adrenal vein cannulation was the main reason for an unsuccessful study. Radiation dose decreased from 34.2 Gy.cm 2 (interquartile range, 15.8-85.9) to 15.7 Gy.cm 2 (6.9-47.3) ( P = 0.009). No complications were noted, and implementation costs were minimal. Conclusions Point-of-care cortisol measurement during adrenal vein sampling improved cannulation success rates and reduced radiation exposure. The use of the adrenal vein sampling Accuracy Kit is now standard practice at our centre.

Towards intelligent diagnostic system employing integration of mathematical and engineering model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Isa, Nor Ashidi Mat

The development of medical diagnostic system has been one of the main research fields during years. The goal of the medical diagnostic system is to place a nosological system that could ease the diagnostic evaluation normally performed by scientists and doctors. Efficient diagnostic evaluation is essentials and requires broad knowledge in order to improve conventional diagnostic system. Several approaches on developing the medical diagnostic system have been designed and tested since the earliest 60s. Attempts on improving their performance have been made which utilizes the fields of artificial intelligence, statistical analyses, mathematical model and engineering theories. With the availability ofmore » the microcomputer and software development as well as the promising aforementioned fields, medical diagnostic prototypes could be developed. In general, the medical diagnostic system consists of several stages, namely the 1) data acquisition, 2) feature extraction, 3) feature selection, and 4) classifications stages. Data acquisition stage plays an important role in converting the inputs measured from the real world physical conditions to the digital numeric values that can be manipulated by the computer system. One of the common medical inputs could be medical microscopic images, radiographic images, magnetic resonance image (MRI) as well as medical signals such as electrocardiogram (ECG) and electroencephalogram (EEG). Normally, the scientist or doctors have to deal with myriad of data and redundant to be processed. In order to reduce the complexity of the diagnosis process, only the significant features of the raw data such as peak value of the ECG signal or size of lesion in the mammogram images will be extracted and considered in the subsequent stages. Mathematical models and statistical analyses will be performed to select the most significant features to be classified. The statistical analyses such as principal component analysis and discriminant analysis as well as mathematical model of clustering technique have been widely used in developing the medical diagnostic systems. The selected features will be classified using mathematical models that embedded engineering theory such as artificial intelligence, support vector machine, neural network and fuzzy-neuro system. These classifiers will provide the diagnostic results without human intervention. Among many publishable researches, several prototypes have been developed namely NeuralPap, Neural Mammo, and Cervix Kit. The former system (NeuralPap) is an automatic intelligent diagnostic system for classifying and distinguishing between the normal and cervical cancerous cells. Meanwhile, the Cervix Kit is a portable Field-programmable gate array (FPGA)-based cervical diagnostic kit that could automatically diagnose the cancerous cell based on the images obtained during sampling test. Besides the cervical diagnostic system, the Neural Mammo system is developed to specifically aid the diagnosis of breast cancer using a fine needle aspiration image.« less

Towards intelligent diagnostic system employing integration of mathematical and engineering model

NASA Astrophysics Data System (ADS)

Isa, Nor Ashidi Mat

2015-05-01

The development of medical diagnostic system has been one of the main research fields during years. The goal of the medical diagnostic system is to place a nosological system that could ease the diagnostic evaluation normally performed by scientists and doctors. Efficient diagnostic evaluation is essentials and requires broad knowledge in order to improve conventional diagnostic system. Several approaches on developing the medical diagnostic system have been designed and tested since the earliest 60s. Attempts on improving their performance have been made which utilizes the fields of artificial intelligence, statistical analyses, mathematical model and engineering theories. With the availability of the microcomputer and software development as well as the promising aforementioned fields, medical diagnostic prototypes could be developed. In general, the medical diagnostic system consists of several stages, namely the 1) data acquisition, 2) feature extraction, 3) feature selection, and 4) classifications stages. Data acquisition stage plays an important role in converting the inputs measured from the real world physical conditions to the digital numeric values that can be manipulated by the computer system. One of the common medical inputs could be medical microscopic images, radiographic images, magnetic resonance image (MRI) as well as medical signals such as electrocardiogram (ECG) and electroencephalogram (EEG). Normally, the scientist or doctors have to deal with myriad of data and redundant to be processed. In order to reduce the complexity of the diagnosis process, only the significant features of the raw data such as peak value of the ECG signal or size of lesion in the mammogram images will be extracted and considered in the subsequent stages. Mathematical models and statistical analyses will be performed to select the most significant features to be classified. The statistical analyses such as principal component analysis and discriminant analysis as well as mathematical model of clustering technique have been widely used in developing the medical diagnostic systems. The selected features will be classified using mathematical models that embedded engineering theory such as artificial intelligence, support vector machine, neural network and fuzzy-neuro system. These classifiers will provide the diagnostic results without human intervention. Among many publishable researches, several prototypes have been developed namely NeuralPap, Neural Mammo, and Cervix Kit. The former system (NeuralPap) is an automatic intelligent diagnostic system for classifying and distinguishing between the normal and cervical cancerous cells. Meanwhile, the Cervix Kit is a portable Field-programmable gate array (FPGA)-based cervical diagnostic kit that could automatically diagnose the cancerous cell based on the images obtained during sampling test. Besides the cervical diagnostic system, the Neural Mammo system is developed to specifically aid the diagnosis of breast cancer using a fine needle aspiration image.

Sensitivity Analysis of the Integrated Medical Model for ISS Programs

NASA Technical Reports Server (NTRS)

Goodenow, D. A.; Myers, J. G.; Arellano, J.; Boley, L.; Garcia, Y.; Saile, L.; Walton, M.; Kerstman, E.; Reyes, D.; Young, M.

2016-01-01

Sensitivity analysis estimates the relative contribution of the uncertainty in input values to the uncertainty of model outputs. Partial Rank Correlation Coefficient (PRCC) and Standardized Rank Regression Coefficient (SRRC) are methods of conducting sensitivity analysis on nonlinear simulation models like the Integrated Medical Model (IMM). The PRCC method estimates the sensitivity using partial correlation of the ranks of the generated input values to each generated output value. The partial part is so named because adjustments are made for the linear effects of all the other input values in the calculation of correlation between a particular input and each output. In SRRC, standardized regression-based coefficients measure the sensitivity of each input, adjusted for all the other inputs, on each output. Because the relative ranking of each of the inputs and outputs is used, as opposed to the values themselves, both methods accommodate the nonlinear relationship of the underlying model. As part of the IMM v4.0 validation study, simulations are available that predict 33 person-missions on ISS and 111 person-missions on STS. These simulated data predictions feed the sensitivity analysis procedures. The inputs to the sensitivity procedures include the number occurrences of each of the one hundred IMM medical conditions generated over the simulations and the associated IMM outputs: total quality time lost (QTL), number of evacuations (EVAC), and number of loss of crew lives (LOCL). The IMM team will report the results of using PRCC and SRRC on IMM v4.0 predictions of the ISS and STS missions created as part of the external validation study. Tornado plots will assist in the visualization of the condition-related input sensitivities to each of the main outcomes. The outcomes of this sensitivity analysis will drive review focus by identifying conditions where changes in uncertainty could drive changes in overall model output uncertainty. These efforts are an integral part of the overall verification, validation, and credibility review of IMM v4.0.

Contact isolation is a risk factor for venous thromboembolism in trauma patients.

PubMed

Reed, Christopher R; Ferguson, Robert A; Peng, Yiming; Collier, Bryan R; Bradburn, Eric H; Toms, Alice R; Fogel, Sandy L; Baker, Christopher C; Hamill, Mark E

2015-11-01

Contact isolation (CI) is a series of precautions used to prevent the transmission of medically significant infectious pathogens in the health care setting. Our institution's implementation of CI includes limiting patient movement to the assigned room. Our objective was to define the association between CI and venous thromboembolism (VTE) at our Level I trauma center. Our institution's prospective trauma database was retrospectively queried for all patients admitted to the trauma service between January 1, 2011, and December 31, 2012. Data including demographics, Injury Severity Score (ISS), preexisting medical conditions, injury type, and VTE development were collected. CI status data were obtained from our institution's infection control database. χ2 was used to examine the unadjusted relationship between CI status and VTE. As the groups were not equivalent, logistic regression was then used to examine the relationship between CI and VTE while adjusting for relevant covariates including sex, age, ISS, and comorbidities. Of the 4,423 trauma patients admitted during the study period, 4,318 (97.6%) had complete records and were included in subsequent analyses. A total of 249 (5.8%) of the patients were on CI. VTE occurred in 44 patients (17.7%) on CI versus 141 patients (3.5%) who were not isolated (p < 0.0001; odds ratio, 6.0; 95% confidence interval, 4.1-8.6). With the use of lasso [least absolute shrinkage and selection operator] regression to adjust for patient risk factors, this relationship remained highly significant (p < 0.0001; odds ratio, 2.61; 95% confidence interval, 1.7-4.0). CI, ISS, hospital length of stay, and cardiac comorbidity were associated with VTE. After adjustment for other risk factors, CI remained most strongly associated with VTE. Although any medical intervention may come with unintended consequences, the risks and benefits of CI in this population need to be reevaluated. Further study is planned to identify opportunities to mitigate this increased VTE risk. Prognostic/epidemiologic study, level III; therapeutic study, level IV.

Space medicine innovation and telehealth concept implementation for medical care during exploration-class missions

NASA Astrophysics Data System (ADS)

Martin, Annie; Sullivan, Patrick; Beaudry, Catherine; Kuyumjian, Raffi; Comtois, Jean-Marc

2012-12-01

Medical care on the International Space Station (ISS) is provided using real-time communication with limited medical data transmission. In the occurrence of an off-nominal medical event, the medical care paradigm employed is 'stabilization and transportation', involving real-time management from ground and immediate return to Earth in the event that the medical contingency could not be resolved in due time in space. In preparation for future missions beyond Low-Earth orbit (LEO), medical concepts of operations are being developed to ensure adequate support for the new mission profiles: increased distance, duration and communication delays, as well as impossibility of emergency returns and limitations in terms of medical equipment availability. The current ISS paradigm of medical care would no longer be adequate due to these new constraints. The Operational Space Medicine group at the Canadian Space Agency (CSA) is looking towards synergies between terrestrial and space medicine concepts for the delivery of medical care to deal with the new challenges of human space exploration as well as to provide benefits to the Canadian population. Remote and rural communities on Earth are, in fact, facing similar problems such as isolation, remoteness to tertiary care centers, resource scarcity, difficult (and expensive) emergency transfers, limited access to physicians and specialists and limited training of medical and nursing staff. There are a number of researchers and organizations, outside the space communities, working in the area of telehealth. They are designing and implementing terrestrial telehealth programs using real-time and store-and-forward techniques to provide isolated populations access to medical care. The cross-fertilization of space-Earth research could provide support for increased spin-off and spin-in effects and stimulate telehealth and space medicine innovations to engage in the new era of human space exploration. This paper will discuss the benefits of space-Earth research projects for the advancement of both terrestrial and space medicine and will use examples of operational space medicine projects conducted at the CSA in areas such as remote training, tele-mentoring and remote control of an ultrasound.

Remotely Guided Breast Sonography for Long-Term Space Missions: A Case Report and Discussion.

PubMed

Silva-Martinez, Jackelynne P; Sorice Genaro, Andreia; Wen, Hui Annie; Glauber, Naama; Russomano, Thais

2017-12-01

Space radiation can cause different types of cancers in crewmembers, especially during long-term space missions. To date, a complete bilateral breast ultrasound has not been performed at the International Space Station (ISS). A breast screening imaging technique could be a useful tool for early identification of breast cancer in astronauts. We hypothesized that breast ultrasound performed by a crewmember while being remotely guided by a specialist from the ground could be an essential tool for medical diagnosis in space. This project aimed to test an ultrasound screening protocol for breast tissue using real-time remotely guided telemedicine techniques. One female volunteer, with no previous medical experience, performed a self-scanned bilateral breast ultrasound exam guided by a remote sonographer. Dynamic ultrasound images were collected using a 25 mm broadband linear array transducer. To simulate fluid shift on the volunteer during microgravity, the bed was tilted -6°. Recorded ultrasound images were analyzed by radiologists, comparing the findings with a gold standard. The experiment demonstrated that real-time remotely guided sonography exam is feasible and can yield meaningful clinical results. This case study showed that remotely guided breast ultrasound can be performed and might become an important tool for diagnosis of breast cancer in space missions. The results cannot be generalized based on one subject, and additional research is warranted in this area in addition to its validation on the ISS. This technique, however, has potential for use as part of preventive medicine procedures for long-term space missions at the ISS, and eventually for human settlements on the Moon and Mars.

Prognostics and health management (PHM) for astronauts: a collaboration project on the International Space Station

NASA Astrophysics Data System (ADS)

Popov, Alexandre; Fink, Wolfgang; Hess, Andrew

2016-05-01

Long-duration missions bring numerous risks that must be understood and mitigated in order to keep astronauts healthy, rather than treat a diagnosed health disorder. Having a limited medical support from mission control center on space exploration missions, crew members need a personal health-tracking tool to predict and assess his/her health risks if no preventive measures are taken. This paper refines a concept employing technologies from Prognostics and Health Management (PHM) for systems, namely real-time health monitoring and condition-based health maintenance with predictive diagnostics capabilities. Mapping particular PHM-based solutions to some Human Health and Performance (HH&P) technology candidates, namely by NASA designation, the Autonomous Medical Decision technology and the Integrated Biomedical Informatics technology, this conceptual paper emphasize key points that make the concept different from that of both current conventional medicine and telemedicine including space medicine. The primary benefit of the technologies development for the HH&P domain is the ability to successfully achieve affordable human space missions to Low Earth Orbit (LEO) and beyond. Space missions on the International Space Station (ISS) program directly contribute to the knowledge base and advancements in the HH&P domain, thanks to continued operations on the ISS, a unique human-tended test platform and the only test bed within the space environment. The concept is to be validated on the ISS, the only "test bed" on which to prepare for future manned exploration missions. The paper authors believe that early self-diagnostic coupled with autonomous identification of proper preventive responses on negative trends are critical in order to keep astronauts healthy.

A Comparison of Expedition Medical Condition List Treatment Directives with Integrated Medical Model Simulation Data Presentation and Briefing Report

NASA Technical Reports Server (NTRS)

Lewis, Robert

2013-01-01

This aerospace medicine clerkship project is under the direction of Dr. Sharmila Watkins and is in cooperation with Dr. Eric Kerstman and Dr. Ronak Shah. The questions of the research project are: 1. What are the main drivers of evacuation and loss of crew life (LOCL) on three Design Reference Missions (DRMs): Near Earth Asteroid (NEA), Lunar Sortie and Lunar Outpost using an inexhaustible International Space Station medical kit 2. What are the treatment designations for these driving medical conditions as listed in Expedition Medical Condition List (EMCL) 3. Do the drivers make sense in the context of the given Design Reference Mission (DRM) 4. Do any EMCL treatment designations need re-assessing.

Human Factors Assessment and Redesign of the ISS Respiratory Support Pack (RSP) Cue Card

NASA Technical Reports Server (NTRS)

Byrne, Vicky; Hudy, Cynthia; Whitmore, Mihriban; Smith, Danielle

2007-01-01

The Respiratory Support Pack (RSP) is a medical pack onboard the International Space Station (ISS) that contains much of the necessary equipment for providing aid to a conscious or unconscious crewmember in respiratory distress. Inside the RSP lid pocket is a 5.5 by 11 inch paper procedural cue card, which is used by a Crew Medical Officer (CMO) to set up the equipment and deliver oxygen to a crewmember. In training, crewmembers expressed concerns about the readability and usability of the cue card; consequently, updating the cue card was prioritized as an activity to be completed. The Usability Testing and Analysis Facility at the Johnson Space Center (JSC) evaluated the original layout of the cue card, and proposed several new cue card designs based on human factors principles. The approach taken for the assessment was an iterative process. First, in order to completely understand the issues with the RSP cue card, crewmember post training comments regarding the RSP cue card were taken into consideration. Over the course of the iterative process, the procedural information was reorganized into a linear flow after the removal of irrelevant (non-emergency) content. Pictures, color coding, and borders were added to highlight key components in the RSP to aid in quickly identifying those components. There were minimal changes to the actual text content. Three studies were conducted using non-medically trained JSC personnel (total of 34 participants). Non-medically trained personnel participated in order to approximate a scenario of limited CMO exposure to the RSP equipment and training (which can occur six months prior to the mission). In each study, participants were asked to perform two respiratory distress scenarios using one of the cue card designs to simulate resuscitation (using a mannequin along with the hardware). Procedure completion time, errors, and subjective ratings were recorded. The last iteration of the cue card featured a schematic of the RSP, colors, borders, and simplification of the flow of information. The time to complete the RSP procedure was reduced by approximately three minutes with the new design. In an emergency situation, three minutes significantly increases the probability of saving a life. In addition, participants showed the highest preference for this design. The results of the studies and the new design were presented to a focus group of astronauts, flight surgeons, medical trainers, and procedures personnel. The final cue card was presented to a medical control board and approved for flight. The revised RSP cue card is currently onboard ISS.

Development of an assay of seven biochemical items, HbA1c, and hematocrit using a small amount of blood collected from the fingertip.

PubMed

Shinya, Sugimoto; Masaru, Akimoto; Akira, Hayakawa; Eisaku, Hokazono; Susumu, Osawa

2012-01-18

Lifestyle-related diseases in Japan account for 30% of the entire medical expenditure of the country and cause 60% of all deaths. For the prevention of lifestyle-related diseases, medical examination by laboratory tests on metabolic syndrome is important. To undertake examination by collection of blood from a fingertip, we developed the "Well Kit". About 65 μl of blood collected from a fingertip was diluted with buffer solution, which contained two internal standard materials. The kit also separated corpuscles and diluted plasma with a special filter. It measured the obtained diluted plasma using the JCA-BM2250. This measurement system was evaluated for the quantitative analysis of 8 items. The uncertainties of tested items of this measurement system were 1.7% to 6.4%. The coefficients of correlation of all tested items between this measurement value and the venous plasma sample value were 0.876-0.991, and hematocrit was 0.958. This system for testing blood collected from a fingertip is simple to use and can be applied in testing for metabolic syndrome. In addition, this testing system is useful in the medical examination of the personal healthcare and inhabitants. Copyright © 2011 Elsevier B.V. All rights reserved.

Injury severity at presentation is not associated with long-term vocational outcome in British Military brain injury.

PubMed

Bahadur, Sardar; McGilloway, E; Etherington, J

2016-04-01

Injury Severity Score (ISS) and GCS can be retrospective markers of injury severity, but if used by clinicians to decide on the treatment of acutely brain-injured casualties at the point of injury may potentially limit interventions on people who may ultimately survive with good functional outcomes. ISS/GCS and long-term outcomes were reviewed by assessing all UK military neurorehabilitation patients with an operational/combat brain injury treated over 4 years (February 2008-July 2012) at Defence Medical Rehabilitation Centre (Headley Court). 34 participants from 9 operational tours of Iraq and Afghanistan were analysed. Overall, 44% of injuries were due to improvised explosive devices (IEDs) and 41% from gunshot wounds; 70.9% of injuries were penetrating wounds with the remainder due to blast/blunt trauma or combined injury. The primary injury was head/neck in 76.5%, although eight patients (23.4%) requiring neurorehabilitation were initially 'non-head injury'. Eight patients (26.5%) sustained more than 10 injuries, and 18 had between three and nine injuries. Eleven patients (32%) had an initial GCS of 3, and 16 (47%) had ISS of 75 (deemed 'unsurvivable'). All patients with ISS of 75 were long-term survivors. At 4 months after discharge, 47% (16) were fully independent, and a further 41% (14) were independent in own homes, but needed assistance with some activities, such as paying bills. Over three-quarters (27 patients, 79%) returned to full/part-time work, 11 of whom returned to military duties; 93% of 'unsurvivable' ISS, and 91% of patients with GCS of 3 were capable of returning/returned to work. In total, 7/11 casualties returning to military duties had major trauma ISS, and two were 'unsurvivable'. All seven casualties with both GCS 3 and ISS 75 survived and returned to independence (help with some activities). ISS/GCS at the point of injury does not reflect eventual outcome. IEDs/gunshots cause the greatest number of injuries and the highest incidence of brain injury. Brain injury should be considered in every battlefield casualty, irrespective of whether the head/neck/spinal cord was avoided. ISS should not be considered indicative or predictive of long-term prognosis/quality of life/employability as brain injury in this small cohort is both survivable and recoverable. It should not be used as a retrospective guide to alter treatment pathways, as there is poor correlation with long-term outcome. Subsequent neurorehabilitation should always be considered because survival, return to independence and full employment are very likely. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Miniature Biosensor with Health Risk Assessment Feedback

NASA Technical Reports Server (NTRS)

Hanson, Andrea; Downs, Meghan; Kalogera, Kent; Buxton, Roxanne; Cooper, Tommy; Cooper, Alan; Cooper, Ross

2016-01-01

Heart rate (HR) monitoring is a medical requirement during exercise on the International Space Station (ISS), fitness tests, and extravehicular activity (EVA); however, NASA does not currently have the technology to consistently and accurately monitor HR and other physiological data during these activities. Performance of currently available HR monitor technologies is dependent on uninterrupted contact with the torso and are prone to data drop-out and motion artifact. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a high performance, robust earbud based biosensor with focused efforts on improved HR data quality during exercise or EVA. A health risk assessment algorithm will further advance the goals of autonomous crew health care for exploration missions.

An Overview of ISS Human Research Data Sharing

NASA Technical Reports Server (NTRS)

Morshedi, Pasha

2015-01-01

This presentation is an attempt to clarify several aspects of the current procedures, tools, and challenges of human data sharing for ISS flight activities. There are several binary variables to consider with respect to human spaceflight data sharing: Medical vs. Research, Active Flight vs. Non-Flight, Tactical vs. Supplemental, Prospective vs. Retrospective. This presentation will address each of these variables and how they determine which processes and mechanisms are used both to document and facilitate human data sharing. Some of these variables will likely be so obvious that they induce eye rolls. Please bear with us. We're trying to make these slides fairly rudimentary for a wide, (eventually) international audience. Other distinctions are made if data originated from a NASA vs. IP crewmember. Those distinctions will be made apparent when needed.

Evaluation of four commercial biuret reagent kits of serum total protein by the American Association for Clinical Chemistry reference measurement procedure.

PubMed

He, Meilin; Zhang, Jie

2011-06-01

In China, the traceability of clinical chemistry methods is still immature. Therefore, it is necessary to establish a reference measurement procedure and evaluate commercial reagent kits using such established procedures. We reproduced the reference measurement procedure for serum total protein, as recommended by the American Association for Clinical Chemistry (AACC). We evaluated the performance by Clinical Laboratory Standard Institute (CLSI) guidelines EP15-A and EP6-A. Subsequently, four commercial reagent kits were evaluated by the reproduced reference procedure following CLSI guideline EP9-A2. The performance of the reproduced reference procedure was as follows: CVs ranged from 0.47% to 0.85% at medical decision levels (X(c)) of 45 g/L, 60 g/L and 80 g/L. Linearity was Y=1.0022X-0.2121 (r=0.9999), and recovery ranged from 100.2% to 102.4%. The External Quality Assessment Scheme for Reference Laboratories in Laboratory Medicine (RELA) was applied, and the result was within the limit of equivalence. The linear relationships of four commercial reagent kits, Merit Choice, KHB, Leadman, and Olympus, were, respectively: Y=0.9922X+0.5776 (r=0.9961); Y=0.9936X+0.4316 (r=0.9992); Y=0.9949X+0.9129 (r=0.9987) and Y=0.9923X+0.8876 (r=0.9989). KHB showed slight negative bias, and the mean±SD was -0.03±0.60 g/L. Merit Choice, Leadman, and Olympus all showed positive bias, and the mean±SDs were 0.02±0.63 g/L, 0.55±0.77 g/L and 0.34±0.71 g/L, respectively. The correlation and bias of four commercial reagent kits for serum total protein were found to be acceptable. Thus, these reagent kits can be used reliably in China.

Disaster preparedness and response improvement: comparison of the 2010 Haiti earthquake-related diagnoses with baseline medical data.

PubMed

van Berlaer, Gerlant; Staes, Tom; Danschutter, Dirk; Ackermans, Ronald; Zannini, Stefano; Rossi, Gabriele; Buyl, Ronald; Gijs, Geert; Debacker, Michel; Hubloue, Ives

2017-10-01

Disaster medicine research generally lacks control groups. This study aims to describe categories of diagnoses encountered by the Belgian First Aid and Support Team after the 2010 Haiti earthquake and extract earthquake-related changes from comparison with comparable baseline data. The hypothesis is that besides earthquake-related trauma, medical problems emerge soon, questioning an appropriate composition of Foreign Medical Teams and Interagency Emergency Health Kits. Using a descriptive cohort study design, diagnoses of patients presenting to the Belgian field hospital were prospectively registered during 4 weeks after the earthquake and compared with those recorded similarly by Médecins Sans Frontières in the same area and time span in previous and later years. Of 7000 triaged postearthquake patients, 3500 were admitted, of whom 2795 were included and analysed. In the fortnight after the earthquake, 90% suffered from injury. In the following fortnight, medical diseases emerged, particularly respiratory (23%) and digestive (14%). More than 53% developed infections within 3 weeks after the event. Médecins Sans Frontières registered 6407 patients in 2009; 6033 in 2011; and 7300 in 2012. A comparison indicates that postearthquake patients suffered significantly less from violence, but more from wounds, respiratory, digestive and ophthalmological diseases. This is the first comparison of postearthquake diagnoses with baseline data. Within 2 weeks after the acute phase of an earthquake, respiratory, digestive and ophthalmological problems will emerge to the prejudice of trauma. This fact should be anticipated when composing Foreign Medical Teams and Interagency Emergency Health Kits to be sent to the disaster site.

Nurses' Motivations for Web-Based Learning and the Role of Internet Self-Efficacy

ERIC Educational Resources Information Center

Liang, Jyh-Chong; Wu, Szu-Hsien

2010-01-01

The purpose of this study was to investigate clinical nurses' Internet self-efficacy and motivations toward Web-based learning. The sample consisted of 256 volunteer nurses from one selected medical centre in Taiwan. This study used the Internet Self-efficacy Survey (ISS) and the Motivations about Web-based Continuing Learning Survey (MWCL) for…

Naval Medical R and D News, February 2017, Volume 9, Issue 2

DTIC Science & Technology

2017-02-01

insectary will be an important asset to continue the fight against vector borne diseases like malaria and dengue fever. “The work that will take...infection of human monocytes by dengue immune sera.... February 2017 | Vol. 9 Iss .2 Follow All Recent R&D News on the Enterprise Website NMR&D News is a

U. S. Naval Forces, Vietnam Monthly Historical Summary for December 1970

DTIC Science & Technology

1971-02-15

cable 3 cans of pull friction fuze lighters 2 electronic repair kits 1 bag of outboard motor repair parts 4 large bags of medical supplies and food ...problems encountered in the operation such as an operation order in Franch which the Vietnamese participants could not readsand raw and un:rained Cambodian

Integrated Clinical Training for Space Flight Using a High-Fidelity Patient Simulator in a Simulated Microgravity Environment

NASA Technical Reports Server (NTRS)

Hurst, Victor; Doerr, Harold K.; Polk, J. D.; Schmid, Josef; Parazynksi, Scott; Kelly, Scott

2007-01-01

This viewgraph presentation reviews the use of telemedicine in a simulated microgravity environment using a patient simulator. For decades, telemedicine techniques have been used in terrestrial environments by many cohorts with varied clinical experience. The success of these techniques has been recently expanded to include microgravity environments aboard the International Space Station (ISS). In order to investigate how an astronaut crew medical officer will execute medical tasks in a microgravity environment, while being remotely guided by a flight surgeon, the Medical Operation Support Team (MOST) used the simulated microgravity environment provided aboard DC-9 aircraft teams of crew medical officers, and remote flight surgeons performed several tasks on a patient simulator.

A novel prognostic model in myeloma based on co-segregating adverse FISH lesions and the ISS: analysis of patients treated in the MRC Myeloma IX trial.

PubMed

Boyd, K D; Ross, F M; Chiecchio, L; Dagrada, G P; Konn, Z J; Tapper, W J; Walker, B A; Wardell, C P; Gregory, W M; Szubert, A J; Bell, S E; Child, J A; Jackson, G H; Davies, F E; Morgan, G J

2012-02-01

The association of genetic lesions detected by fluorescence in situ hybridization (FISH) with survival was analyzed in 1069 patients with newly presenting myeloma treated in the Medical Research Council Myeloma IX trial, with the aim of identifying patients associated with the worst prognosis. A comprehensive FISH panel was performed, and the lesions associated with short progression-free survival and overall survival (OS) in multivariate analysis were +1q21, del(17p13) and an adverse immunoglobulin heavy chain gene (IGH) translocation group incorporating t(4;14), t(14;16) and t(14;20). These lesions frequently co-segregated, and there was an association between the accumulation of these adverse FISH lesions and a progressive impairment of survival. This observation was used to define a series of risk groups based on number of adverse lesions. Taking this approach, we defined a favorable risk group by the absence of adverse genetic lesions, an intermediate group with one adverse lesion and a high-risk group defined by the co-segregation of >1 adverse lesion. This genetic grouping was independent of the International Staging System (ISS) and so was integrated with the ISS to identify an ultra-high-risk group defined by ISS II or III and >1 adverse lesion. This group constituted 13.8% of patients and was associated with a median OS of 19.4 months.

Diagnostic ultrasound and telemedicine utilization in the international space station

NASA Astrophysics Data System (ADS)

Carter, Stephen J.; Stewart, Brent K.; Kushmerick, Martin J.; Langer, Steve G.; Schmiedl, Udo P.; Winter, Thomas C.; Conley, Kevin E.; Jubrias, Sharon A.

1999-01-01

Clinical diagnostic ultrasound (US) is experiencing an expanding role that is well suited to application on the International Space Station (ISS). Diagnostic US can be used to reduce the risks associated with long duration human space flight by providing a non-invasive tool with head-to-toe diagnostic capability in both biomedical research and crew health care. General health care of the astronauts will be diagnosed with US, e.g., kidney stones, gall bladder disease, appendicitis, etc. Initial studies will focus on detection of ``ureteral jets'' in the bladder. This is a non-invasive test to rule out obstructive uropathy from kidney stones with minimal requirements for crew training. Biomedical research experiments, focusing on the effects of the microgravity environment, will be performed using both the HHU and the HDI 5000. US will be used to evaluate bone density and muscle mass in this environment. Prolonged or emergency EVAs may occur with the ISS. The hand-held ultrasound unit (HHU) and its telemedicine capability will be used in EVA settings to monitor events such as decompression sickness (DCS) microbubble formation in the cardiovascular system. There will be telemetry links between the HHU and the ATL/Lockheed Martin rack mounted HDI 5000 in the ISS Human Research Facility (HRF), as well as between the HRF and medical expertise on the ground. These links will provide the ISS with both real-time and store-and-forward telemedicine capabilities. The HHU can also be used with the existing telemedicine instrument pack (TIP).

Crew Health and Performance Improvements with Reduced Carbon Dioxide Levels and the Resource Impact to Accomplish Those Reductions

NASA Technical Reports Server (NTRS)

James, John T.; Meyers, Valerie E.; Sipes, Walter; Scully, Robert R.; Matty, Christopher M.

2011-01-01

Carbon dioxide (CO2) removal is one of the primary functions of the International Space Station (ISS) atmosphere revitalization systems. Primary CO2 removal is via the ISS s two Carbon Dioxide Removal Assemblies (CDRAs) and the Russian carbon dioxide removal assembly (Vozdukh); both of these systems are regenerable, meaning that their CO2 removal capacity theoretically remains constant as long as the system is operating. Contingency CO2 removal capability is provided by lithium hydroxide (LiOH) canisters, which are consumable, meaning that their CO2 removal capability disappears once the resource is used. With the advent of 6 crew ISS operations, experience showing that CDRA failures are not uncommon, and anecdotal association of crew symptoms with CO2 values just above 4 mmHg, the question arises: How much lower do we keep CO2 levels to minimize the risk to crew health and performance, and what will the operational cost to the CDRAs be to do it? The primary crew health concerns center on the interaction of increased intracranial pressure from fluid shifts and the increased intracranial blood flow induced by CO2. Typical acute symptoms include headache, minor visual disturbances, and subtle behavioral changes. The historical database of CO2 exposures since the beginning of ISS operations has been compared to the incidence of crew symptoms reported in private medical conferences. We have used this database in an attempt to establish an association between the CO2 levels and the risk of crew symptoms. This comparison will answer the question of the level needed to protect the crew from acute effects. As for the second part of the question, operation of the ISS s regenerable CO2 removal capability reduces the limited life of constituent parts. It also consumes limited electrical power and thermal control resources. Operation of consumable CO2 removal capability (LiOH) uses finite consumable materials, which must be replenished in the long term. Therefore, increased CO2 removal means increased resource use, with increased logistical capability to maintain necessary resources on board ISS. We must strike a balance between sufficiently low CO2 levels to maintain crew health and CO2 levels which are operationally feasible for the ISS program

A smartphone-based system for the automated management of point-of-care test results in hospitals.

PubMed

Jang, Dasom; Shin, Soo-Yong; Seo, Dong-Woo; Joo, Segyeong; Huh, Soo-Jin

2015-04-01

Managing test results is an important issue in hospitals because of the increasing use of point-of-care testing (POCT). Here, we propose a smartphone-based system for automatically managing POCT test results. We developed the system to provide convenience to the medical staffs. The system recognizes the patient identification or prescription number of the test by reading barcodes and provides a countdown to indicate when the results will be ready. When the countdown in finished, a picture of the test result is transferred to the electronic medical record server using the Health Level 7 protocol. Human immunodeficiency virus (HIV) kits were selected in this research because HIV is a life-threatening infectious virus, especially for the medical staff who treat undiagnosed patients. The performance of the system was verified from a survey of the users. The performance of the system was tested at the emergency room (ER) for 10 months using commercially available POCT kits for detecting HIV. The survey showed that, in total, 80% and 0% of users reported positive or negative feedback, respectively. The staff also reported that the system reduced total processing time by approximately 32 min, in addition to reducing workload. The developed automated management system was successfully tested at an ER for 10 months. The survey results show that the system is effective and that medical staff members who used the system are satisfied with using the system at the ER.

Estimating the Risk of Renal Stone Events during Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Reyes, David; Kerstman, Eric; Gray, Gary; Locke, James

2014-01-01

Introduction: Given the bone loss and increased urinary calcium excretion in the microgravity environment, persons participating in long-duration spaceflight may have an increased risk for renal stone formation. Renal stones are often an incidental finding of abdominal imaging studies done for other reasons. Thus, some crewmembers may have undiscovered, asymptomatic stones prior to their mission. Methods: An extensive literature search was conducted concerning the natural history of asymptomatic renal stones. For comparison, simulations were done using the Integrated Medical Model (IMM). The IMM is an evidence-based decision support tool that provides risk analysis and has the capability to optimize medical systems for missions by minimizing the occurrence of adverse mission outcomes such as evacuation and loss of crew life within specified mass and volume constraints. Results: The literature of the natural history of asymptomatic renal stones in the general medical population shows that the probability of symptomatic event is 8% to 34% at 1 to 3 years for stones < 7 mm. Extrapolated to a 6-month mission, for stones < 5 to 7 mm, the risk for any stone event is about 4 to 6%, with a 0.7% to 4% risk for intervention, respectively. IMM simulations compare favorably with risk estimates garnered from the terrestrial literature. The IMM forecasts that symptomatic renal stones may be one of the top drivers for medical evacuation of an International Space Station (ISS) mission. Discussion: Although the likelihood of a stone event is low, the consequences could be severe due to limitations of current ISS medical capabilities. Therefore, these risks need to be quantified to aid planning, limit crew morbidity and mitigate mission impacts. This will be especially critical for missions beyond earth orbit, where evacuation may not be an option.

Estimating the Risk of Renal Stone Events During Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Reyes, David; Kerstman, Eric; Locke, James

2014-01-01

Introduction: Given the bone loss and increased urinary calcium excretion in the microgravity environment, persons participating in long-duration spaceflight may have an increased risk for renal stone formation. Renal stones are often an incidental finding of abdominal imaging studies done for other reasons. Thus, some crewmembers may have undiscovered, asymptomatic stones prior to their mission. Methods: An extensive literature search was conducted concerning the natural history of asymptomatic renal stones. For comparison, simulations were done using the Integrated Medical Model (IMM). The IMM is an evidence-based decision support tool that provides risk analysis and has the capability to optimize medical systems for missions by minimizing the occurrence of adverse mission outcomes such as evacuation and loss of crew life within specified mass and volume constraints. Results: The literature of the natural history of asymptomatic renal stones in the general medical population shows that the probability of symptomatic event is 8% to 34% at 1 to 3 years for stones < 7 mm. Extrapolated to a 6-month mission, for stones < 5 to 7 mm, the risk for any stone event is about 4 to 6%, with a 0.7% to 4% risk for intervention, respectively. IMM simulations compare favorably with risk estimates garnered from the terrestrial literature. The IMM forecasts that symptomatic renal stones may be one of the top drivers for medical evacuation of an International Space Station (ISS) mission. Discussion: Although the likelihood of a stone event is low, the consequences could be severe due to limitations of current ISS medical capabilities. Therefore, these risks need to be quantified to aid planning, limit crew morbidity and mitigate mission impacts. This will be especially critical for missions beyond earth orbit, where evacuation may not be an option.

'In situ simulation' versus 'off site simulation' in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Unexpected obstetric emergencies threaten the safety of pregnant women. As emergencies are rare, they are difficult to learn. Therefore, simulation-based medical education (SBME) seems relevant. In non-systematic reviews on SBME, medical simulation has been suggested to be associated with improved learner outcomes. However, many questions on how SBME can be optimized remain unanswered. One unresolved issue is how 'in situ simulation' (ISS) versus 'off site simulation' (OSS) impact learning. ISS means simulation-based training in the actual patient care unit (in other words, the labor room and operating room). OSS means training in facilities away from the actual patient care unit, either at a simulation centre or in hospital rooms that have been set up for this purpose. Methods and design The objective of this randomized trial is to study the effect of ISS versus OSS on individual learning outcome, safety attitude, motivation, stress, and team performance amongst multi-professional obstetric-anesthesia teams. The trial is a single-centre randomized superiority trial including 100 participants. The inclusion criteria were health-care professionals employed at the department of obstetrics or anesthesia at Rigshospitalet, Copenhagen, who were working on shifts and gave written informed consent. Exclusion criteria were managers with staff responsibilities, and staff who were actively taking part in preparation of the trial. The same obstetric multi-professional training was conducted in the two simulation settings. The experimental group was exposed to training in the ISS setting, and the control group in the OSS setting. The primary outcome is the individual score on a knowledge test. Exploratory outcomes are individual scores on a safety attitudes questionnaire, a stress inventory, salivary cortisol levels, an intrinsic motivation inventory, results from a questionnaire evaluating perceptions of the simulation and suggested changes needed in the organization, a team-based score on video-assessed team performance and on selected clinical performance. Discussion The perspective is to provide new knowledge on contextual effects of different simulation settings. Trial registration ClincialTrials.gov NCT01792674. PMID:23870501

Surface, Water, and Air Biocharacterization (SWAB) Flight Experiment

NASA Technical Reports Server (NTRS)

Castro, V. A.; Ott, C. M.; Pierson, D. L.

2012-01-01

The determination of risk from infectious disease during spaceflight missions is composed of several factors including both the concentration and characteristics of the microorganisms to which the crew are exposed. Thus, having a good understanding of the microbial ecology aboard spacecraft provides the necessary information to mitigate health risks to the crew. While preventive measures are taken to minimize the presence of pathogens on spacecraft, medically significant organisms have been isolated from both the Mir and International Space Station (ISS). Historically, the method for isolation and identification of microorganisms from spacecraft environmental samples depended upon their growth on culture media. Unfortunately, only a fraction of the organisms may grow on a specific culture medium, potentially omitting those microorganisms whose nutritional and physical requirements for growth are not met. To address this bias in our understanding of the ISS environment, the Surface, Water, and Air Biocharacterization (SWAB) Flight Experiment was designed to investigate and develop monitoring technology to provide better microbial characterization. For the SWAB flight experiment, we hypothesized that environmental analysis using non-culture-based technologies would reveal microorganisms, allergens, and microbial toxins not previously reported in spacecraft, allowing for a more complete health assessment. Key findings during this experiment included: a) Generally, advanced molecular techniques were able to reveal a few organisms not recovered using culture-based methods; however, there is no indication that current monitoring is "missing" any medically significant bacteria or fungi. b) Molecular techniques have tremendous potential for microbial monitoring, however, sample preparation and data analysis present challenges for spaceflight hardware. c) Analytical results indicate that some molecular techniques, such as denaturing gradient gel electrophoresis (DGGE), can be much less sensitive than culture-based methods. d) More sensitive molecular techniques, such as quantitative polymerase chain reaction (QPCR), were able to identify viral DNA from ISS environments, suggesting potential transfer of the organism between crewmembers. In addition, the hardware selected for this experiment represented advances for next-generation sample collection. The advanced nature of this collection hardware was noted, when the Sartorius MD8 Air Port air sampler from the SWAB experiment remained on board ISS at the request of JAXA investigators, who intend to use it in completion of their microbial ecology experiment.