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

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 noisereduction, 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 signaltonoise quality from a conventional stethoscope (Littman 2218BE) and an electronic stethoscope (Litmann 3200). Borborygmi, pulmonic, and cardiac sound quality was ranked with both stethoscopes. Signaltonoise 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

Facial Soft Tissue Measurement in Microgravity-induces Fluid Shifts

Fluid shifts are a wellknown phenomenon in microgravity, and one result is facial edema. Objective measurement of tissue thickness in a standardized location could provide a correlate with the severity of the fluid shift. Previous studies of forehead tissue thickness (TTf) suggest that when exposed to environments that cause fluid shifts, including hypergravity, headdown tilt, and highaltitude/lowpressure, TTf changes in a consistent and measurable fashion. However, the technique in past studies is not well described or standardized. The International Space Station (ISS) houses an ultrasound (US) system capable of accurate submillimeter measurements of TTf. We undertook to measure TTf during longduration space flight using a new accurate, repeatable and transferable technique. Methods: Inflight and postflight Bmode ultrasound images of a single astronaut's facial soft tissues were obtained using a Vividq US system with a 12LRS highfrequency linear array probe (General Electric, USA). Strictly midsagittal images were obtained involving the lower frontal bone, the nasofrontal angle, and the osseocartilaginous junction below. Single images were chosen for comparison that contained identical views of the bony landmarks and identical acoustical interface between the probe and skin. Using Gingko CADx DICOM viewing software, soft tissue thickness was measured at a right angle to the most prominent point of the inferior frontal bone to the epidermis. Four independent thickness measurements were made. Conclusions: Forehead tissue thickness measurement by ultrasound in microgravity is feasible, and our data suggest a decrease in tissue thickness upon return from microgravity environment, which is likely related to the cessation of fluid shifts. Further study is warranted to standardize the technique with regard to the individual variability of the local anatomy in this area

Neurovestibular Effects of Long-Duration Spaceflight: A Summary of Mir-Phase 1 Experiences

Space motion sickness and associated neurovestibular dysfunction though not completely understood - have been relatively well clinically and operationally characterized on short-duration (1-2 week) Space Shuttle missions (Oman, et al, 1984, 1986; Thornton, et al, 1987; Reschke, et al, 1994). Between March 1995 and June 1998, seven NASA astronauts flew on the Russian Mir space station, as "Phase 1" of the joint effort to build the International Space Station, and provided NASA with invaluable experience on the operational and biomedical problems associated with flights of up to six months in duration. The goal of this paper is to provide a summary of the available information on neurovestibular dysfunction, space motion sickness, and readaptation to Earth's gravity on the NASA Mir flights, based on a set of medical questionnaire data, transcripts, and interviews which are available from the NASA-Mir Phase I program. Records were incomplete and anecdotal. All references to specific crewmembers have been removed, to respect their individual privacy. Material was excerpted from multiple sources of information relating to neurologic function, sensory illusions and motion sickness of NASA-Mir Phase I Program crewmembers. Data were compiled by epoch (in-flight vs landing/postflight) and grouped by neurovestibular topic. The information was recorded either contemporaneously during or within days after landing, or retrospectively weeks to months later. Space motion sickness symptoms are more intense and longer in duration. Sense of spatial orientation takes at least a month to become "natural and instinctive" in space station structures, but mental survey knowledge is apparently not completely developed even after 3 months in some cases. Visual reorientation illusions (VRI) are more easily induced after long exposure to weightlessness. Head movements can cause illusory spinning sensations for up to 7 days postflight. Postural and balance control does not fully recover for at least a month postflight

SpaceDock: A Performance Task Platform for Spaceflight Operations

Preliminary evidence during both short- and long-duration spaceflight indicates that perceptual-motor coordination changes occur and persist in-flight. However, there is presently no in-flight method for evaluating astronaut performance on mission-critical tasks such as docking. We present a portable platform we have developed for attempting and evaluating docking, and describe the results of a pilot study wherein flight novices learned the docking task. Methods: A dual-joystick, six degrees of freedom platform-called SpaceDock-was developed to enable portable, adaptable performance testing in a spaceflight operations setting. Upon this platform, a simplified docking task was created, involving a constant rate of approach towards a docking target and requiring the user to correct translation in two dimensions and attitude orientation along one dimension (either pitch or roll). Ten flight naive subjects performed the task over a 45 min period and all joystick inputs and timings were collected, from which we could successfully reconstruct travel paths, input profiles and relative target displacements. Results: Subjects exhibited significant improvements in docking over the course of the experiment. Learning to compensate for roll-alterations was robust, whereas compensation for pitch-alterations was not in evidence in this population and relatively short training period. Conclusion: The SpaceDock platform can provide a novel method for training and testing subjects, on a spaceflight-relevant task, and can be used to examine behavioral learning, strategy use, and has been adapted for use in brain imaging experiments

Direct Signal-to-Noise Quality Comparison Between an Electronic aud Conventional Stethoscope Aboard the International Space Station

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Measurement in Microgravity-Induced Fluid Shifts Presentation

No abstract availabl

Alternative splicing and the progesterone receptor in breast cancer

Progesterone receptor status is a marker for hormone responsiveness and disease prognosis in breast cancer. Progesterone receptor negative tumours have generally been shown to have a poorer prognosis than progesterone receptor positive tumours. The observed loss of progesterone receptor could be through a range of mechanisms, including the generation of alternatively spliced progesterone receptor variants that are not detectable by current screening methods. Many progesterone receptor mRNA variants have been described with deletions of various whole, multiple or partial exons that encode differing protein functional domains. These variants may alter the progestin responsiveness of a tissue and contribute to the abnormal growth associated with breast cancer. Absence of specific functional domains from these spliced variants may also make them undetectable or indistinguishable from full length progesterone receptor by conventional antibodies. A comprehensive investigation into the expression profile and activity of progesterone receptor spliced variants in breast cancer is required to advance our understanding of tumour hormone receptor status. This, in turn, may aid the development of new biomarkers of disease prognosis and improve adjuvant treatment decisions