Legacy of Biomedical Research During the Space Shuttle Program

The Space Shuttle Program provided many opportunities to study the role of spaceflight on human life for over 30 years and represented the longest and largest US human spaceflight program. Outcomes of the research were understanding the effect of spaceflight on human physiology and performance, countermeasures, operational protocols, and hardware. The Shuttle flights were relatively short, < 16 days and routinely had 4 to 6 crewmembers for a total of 135 flights. Biomedical research was conducted on the Space Shuttle using various vehicle resources. Specially constructed pressurized laboratories called Spacelab and SPACEHAB housed many laboratory instruments to accomplish experiments in the Shuttle s large payload bay. In addition to these laboratory flights, nearly every mission had dedicated human life science research experiments conducted in the Shuttle middeck. Most Shuttle astronauts participated in some life sciences research experiments either as test subjects or test operators. While middeck experiments resulted in a low sample per mission compared to many Earth-based studies, this participation allowed investigators to have repetition of tests over the years on successive Shuttle flights. In addition, as a prelude to the International Space Station (ISS), NASA used the Space Shuttle as a platform for assessing future ISS hardware systems and procedures. The purpose of this panel is to provide an understanding of science integration activities required to implement Shuttle research, review biomedical research, characterize countermeasures developed for Shuttle and ISS as well as discuss lessons learned that may support commercial crew endeavors. Panel topics include research integration, cardiovascular physiology, neurosciences, skeletal muscle, and exercise physiology. Learning Objective: The panel provides an overview from the Space Shuttle Program regarding research integration, scientific results, lessons learned from biomedical research and countermeasure development

Physiological responses to wearing the space shuttle launch and entry suit and the prototype advanced crew escape suit compared to the unsuited condition

The launch and entry suit (LES) is a life support suit worn during Orbiter ascent and descent. The impact of suit weight and restricted mobility on egress from the Orbiter during an emergency is unknown. An alternate suit - the advanced crew escape suite (ACES) - is being evaluated. The physiological responses to ambulatory exercise of six subjects wearing the LES and ACES were measured and compared to those measurements taken while unsuited. Dependent variables included heart rate and metabolic response to treadmill walking at 5.6 km/h (3.5 mph), and also bilateral concentric muscle strength about the knee, shoulder, and elbow. No significant (p greater than 0.06) differences in heart rate or metabolic variables were measured in either suit while walking at 5.6 km/h. Significant (p less than 0.05) decreases in all metabolic variables were remarked when both suits were compared to the unsuited condition. There were no significant (p greater than 0.05) differences among the three suit conditions at 30 or 180 deg/s for muscles about the elbow and knee; however, about the shoulder, a significant (p = 0.0215) difference between the ACES and the unsuited condition was noted. Therefore, wearing a life support suit while performing Orbiter egress imposes a significant metabolic demand on crewmembers. Selective upper body strength movements may be compromised

Developing and Implementing an Online Course Framework

Integration of technology tools and resources is imperative when working with today’s students as many are expecting to encounter various apps and media-based software in the curriculum. It is important, however, to have a clear purpose for integrating technology into the classroom; technology should not be integrated into the curriculum simply for the sake of doing so! To assist with purposeful integration, faculty members from Nova Southeastern University and St. Thomas University created a Technology Integration Learning Community (TILC); an online professional learning community where members teach each other about the latest and greatest technological tools and share ideas for integration into the curriculum. Anytime an instructor is thinking of integrating technology into a classroom, it is important to use a model or framework as a guide to enhance the objectives or outcomes as well as ensure accessibility for all students. Therefore, the TILC developed The TILC Online Course Framework (TOCF), based on the ASSURE model (Smaldino, Lowther, Russell, & Mims, 2016), to guide this technology integration

Developing and Implementing an Online Course Framework

Integration of technology tools and resources is imperative when working with today’s students as many are expecting to encounter various apps and media-based software in the curriculum. It is important, however, to have a clear purpose for integrating technology into the classroom; technology should not be integrated into the curriculum simply for the sake of doing so! To assist with purposeful integration, faculty members from Nova Southeastern University and St. Thomas University created a Technology Integration Learning Community (TILC); an online professional learning community where members teach each other about the latest and greatest technological tools and share ideas for integration into the curriculum. Anytime an instructor is thinking of integrating technology into a classroom, it is important to use a model or framework as a guide to enhance the objectives or outcomes as well as ensure accessibility for all students. Therefore, the TILC developed The TILC Online Course Framework (TOCF), based on the ASSURE model (Smaldino, Lowther, Russell, & Mims, 2016), to guide this technology integration

Bacterial vaginosis among women at high risk for HIV in Uganda: high rate of recurrent diagnosis despite treatment.

OBJECTIVES: Bacterial vaginosis (BV) is associated with increased risk for sexually transmitted infections (STIs) and HIV acquisition. This study describes the epidemiology of BV in a cohort of women at high risk for STI/HIV in Uganda over 2 years of follow-up between 2008-2011. METHODS: 1027 sex workers or bar workers were enrolled and asked to attend 3-monthly follow-up visits. Factors associated with prevalent BV were analysed using multivariate random-effects logistic regression. The effect of treatment on subsequent episodes of BV was evaluated with survival analysis. RESULTS: Prevalences of BV and HIV at enrolment were 56% (573/1027) and 37% (382/1027), respectively. Overall, 905 (88%) women tested positive for BV at least once in the study, over a median of four visits. Younger age, a higher number of previous sexual partners and current alcohol use were independently associated with prevalent BV. BV was associated with STIs, including HIV. Hormonal contraception and condom use were protective against BV. Among 853 treated BV cases, 72% tested positive again within 3 months. There was no difference in time to subsequent BV diagnosis between treated and untreated women. CONCLUSIONS: BV was highly prevalent and persistent in this cohort despite treatment. More effective treatment strategies are urgently needed

Contextualized analysis of a needs assessment using the Theoretical Domains Framework: a case example in endocrinology

Background: The Theoretical Domains Framework (TDF) is a set of 14 domains of behavior change that provide a framework for the critical issues and factors influencing optimal knowledge translation. Considering that a previous study has identified optimal knowledge translation techniques for each TDF domain, it was hypothesized that the TDF could be used to contextualize and interpret findings from a behavioral and educational needs assessment. To illustrate this hypothesis, findings and recommendations drawn from a 2012 national behavioral and educational needs assessment conducted with healthcare providers who treat and manage Growth and Growth Hormone Disorders, will be discussed using the TDF. Methods: This needs assessment utilized a mixed-methods research approach that included a combination of: [a] data sources (Endocrinologists (n:120), Pediatric Endocrinologists (n:53), Pediatricians (n:52)), [b] data collection methods (focus groups, interviews, online survey), [c] analysis methodologies (qualitative - analyzed through thematic analysis, quantitative - analyzed using frequencies, cross-tabulations, and gap analysis). Triangulation was used to generate trustworthy findings on the clinical practice gaps of endocrinologists, pediatric endocrinologists, and general pediatricians in their provision of care to adult patients with adult growth hormone deficiency or acromegaly, or children/teenagers with pediatric growth disorders. The identified gaps were then broken into key underlying determinants, categorized according to the TDF domains, and linked to optimal behavioral change techniques. Results: The needs assessment identified 13 gaps, each with one or more underlying determinant(s). Overall, these determinants were mapped to 9 of the 14 TDF domains. The Beliefs about Consequences domain was identified as a contributing determinant to 7 of the 13 challenges. Five of the gaps could be related to the Skills domain, while three were linked to the Knowledge domain. Conclusions: The TDF categorization of the needs assessment findings allowed recommendation of appropriate behavior change techniques for each underlying determinant, and facilitated communication and understanding of the identified issues to a broader audience. This approach provides a means for health education researchers to categorize gaps and challenges identified through educational needs assessments, and facilitates the application of these findings by educators and knowledge translators, by linking the gaps to recommended behavioral change techniques

Eccentric and concentric muscle performance following 7 days of simulated weightlessness

Changes in skeletal muscle strength occur in response to chronic disuse or insufficient functional loading. The purpose of this study was to examine changes in muscle performance of the lower extremity and torso prior to and immediately after 7 days of simulated weightlessness (horizontal bed rest). A Biodex was used to determine concentric and eccentric peak torque and angle at peak torque for the back, abdomen, quadriceps, hamstring, soleus, and tibialis anterior. A reference angle of 0 degrees was set at full extension. Data were analyzed by ANOVA

Solid-state NMR evidence for inequivalent GvpA subunits in gas vesicles

Gas vesicles are organelles that provide buoyancy to the aquatic microorganisms that harbor them. The gas vesicle shell consists almost exclusively of the hydrophobic 70-residue gas vesicle protein A, arranged in an ordered array. Solid-state NMR spectra of intact collapsed gas vesicles from the cyanobacterium Anabaena flos-aquae show duplication of certain gas vesicle protein A resonances, indicating that specific sites experience at least two different local environments. Interpretation of these results in terms of an asymmetric dimer repeat unit can reconcile otherwise conflicting features of the primary, secondary, tertiary, and quaternary structures of the gas vesicle protein. In particular, the asymmetric dimer can explain how the hydrogen bonds in the β-sheet portion of the molecule can be oriented optimally for strength while promoting stabilizing aromatic and electrostatic side-chain interactions among highly conserved residues and creating a large hydrophobic surface suitable for preventing water condensation inside the vesicle.National Institutes of Health (U.S.) (Grant EB002175)National Institutes of Health (U.S.) (Grant EB003151)National Institutes of Health (U.S.) (Grant EB002026

Teaching tobacco dependence treatment and counseling skills during medical school: rationale and design of the Medical Students helping patients Quit tobacco (MSQuit) group randomized controlled trial

INTRODUCTION: Physician-delivered tobacco treatment using the 5As is clinically recommended, yet its use has been limited. Lack of adequate training and confidence to provide tobacco treatment is cited as leading reasons for limited 5A use. Tobacco dependence treatment training while in medical school is recommended, but is minimally provided. The MSQuit trial (Medical Students helping patients Quit tobacco) aims to determine if a multi-modal and theoretically-guided tobacco educational intervention will improve tobacco dependence treatment skills (i.e. 5As) among medical students. METHODS/DESIGN: 10 U.S. medical schools were pair-matched and randomized in a group-randomized controlled trial to evaluate whether a multi-modal educational (MME) intervention compared to traditional education (TE) will improve observed tobacco treatment skills. MME is primarily composed of TE approaches (i.e. didactics) plus a 1st year web-based course and preceptor-facilitated training during a 3rd year clerkship rotation. The primary outcome measure is an objective score on an Objective Structured Clinical Examination (OSCE) tobacco-counseling smoking case among 3rd year medical students from schools who implemented the MME or TE. DISCUSSION: MSQuit is the first randomized to evaluate whether a tobacco treatment educational intervention implemented during medical school will improve medical students\u27 tobacco treatment skills. We hypothesize that the MME intervention will better prepare students in tobacco dependence treatment as measured by the OSCE. If a comprehensive tobacco treatment educational learning approach is effective, while also feasible and acceptable to implement, then medical schools may substantially influence skill development and use of the 5As among future physicians. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved