Planning for Space Station Freedom laboratory payload integration

Space Station Freedom is being developed to support extensive missions involving microgravity research and applications. Requirements for on-orbit payload integration and the simultaneous payload integration of multiple mission increments will provide the stimulus to develop new streamlined integration procedures in order to take advantage of the increased capabilities offered by Freedom. The United States Laboratory and its user accommodations are described. The process of integrating users' experiments and equipment into the United States Laboratory and the Pressurized Logistics Modules is described. This process includes the strategic and tactical phases of Space Station utilization planning. The support that the Work Package 01 Utilization office will provide to the users and hardware developers, in the form of Experiment Integration Engineers, early accommodation assessments, and physical integration of experiment equipment, is described. Plans for integrated payload analytical integration are also described

U.S. Billion-ton Update: Biomass Supply for a Bioenergy and Bioproducts Industry

The Report, Biomass as Feedstock for a Bioenergy and Bioproducts Industry: The Technical Feasibility of a Billion-Ton Annual Supply (generally referred to as the Billion-Ton Study or 2005 BTS), was an estimate of “potential” biomass within the contiguous United States based on numerous assumptions about current and future inventory and production capacity, availability, and technology. In the 2005 BTS, a strategic analysis was undertaken to determine if U.S. agriculture and forest resources have the capability to potentially produce at least one billion dry tons of biomass annually, in a sustainable manner—enough to displace approximately 30% of the country’s present petroleum consumption. To ensure reasonable confidence in the study results, an effort was made to use relatively conservative assumptions. However, for both agriculture and forestry, the resource potential was not restricted by price. That is, all identified biomass was potentially available, even though some potential feedstock would more than likely be too expensive to actually be economically available. In addition to updating the 2005 study, this report attempts to address a number of its shortcoming

Methyl methacrylate and respiratory sensitization: A Critical review

Methyl methacrylate (MMA) is a respiratory irritant and dermal sensitizer that has been associated with occupational asthma in a small number of case reports. Those reports have raised concern that it might be a respiratory sensitizer. To better understand that possibility, we reviewed the in silico, in chemico, in vitro, and in vivo toxicology literature, and also epidemiologic and occupational medicine reports related to the respiratory effects of MMA. Numerous in silico and in chemico studies indicate that MMA is unlikely to be a respiratory sensitizer. The few in vitro studies suggest that MMA has generally weak effects. In vivo studies have documented contact skin sensitization, nonspecific cytotoxicity, and weakly positive responses on local lymph node assay; guinea pig and mouse inhalation sensitization tests have not been performed. Cohort and cross-sectional worker studies reported irritation of eyes, nose, and upper respiratory tract associated with short-term peaks exposures, but little evidence for respiratory sensitization or asthma. Nineteen case reports described asthma, laryngitis, or hypersensitivity pneumonitis in MMA-exposed workers; however, exposures were either not well described or involved mixtures containing more reactive respiratory sensitizers and irritants.The weight of evidence, both experimental and observational, argues that MMA is not a respiratory sensitizer

LVAD coordinator effects on outcomes in patients undergoing LVAD implantation: The Methodist DeBakey Heart Center experience Betreuung von patienten an linksventrikulären unterstü tzungssystemen mittels koordinator: Erfahrungen des Methodist DeBakey Heart Centers

Linksventrikuläre mechanische Supportsysteme, left ventricular assist devices oder kurz LVAD, erlauben, Patientien mit terminalen Herzversagen bis zur Transplantation zu unterstützen. Dies hat positiven Einfluss zum einen auf die Überlebensrate als auch auf mögliche peri-operative Komplikationen. Wir berichten über unsere Erfahrungen mit einem LVAD-Koordinator, insbesondere hinsichtlich Patientengenesung und Inzidenz an Komplikationen.In der Zeit vom Juni 2000 und Januar 2002 erhielten 28 Patienten mit terminaler therapierefrakterer Herzinsuffizienz ein linksventrikuläres Assist Device, 14 Patienten in der Zeit vor Einsatz eines LVAD-Koordinators und weitere 14 Patienten unter der Betreuung eines LVAD-Koordinators. Die untersuchten Kriterien waren dabei Auftreten von Infektionen, lebensbedrohlichen Thromboembolien, Blutungsereignissen und Kostenaufwand, definiert als reine Krankenhauskosten ohne Personal- und Materialkosten.In der Prä-Koordinator-Gruppe wurden 2 Patienten mit Ihrem LVAD nach Hause entlassen, 7 Patienten (50%) entwickelten eine therapiepflichtige Infektion, 5 Patienten (35%) hatten lebensbedrohliche thrombembolische Komplikationen. 6 Patienten aus dieser Gruppe wurden transplantiert und 8 Patienten verstarben an dem Unterstützungssystem, woraus sich eine Überlebensrate von 42% errechnet. In der von einem LVAD-Koordinator betreuten Patientengruppe wurden 7 Patienten mit ihrem LVAD nach Hause entlassen, 4 Patienten entwickelten Infektionen und 1 Patient cerebrale Thrombembolien mit irreversiblen neurologischen Schäden. 10 Patienten wurden transplantiert, 3 Patienten verstarben am Assist Device und 1 Patient war bei Studienende noch am Assist Device. Die Überlebensrate in dieser Gruppe war 78%.Der Einsatz eines LVAD-Koordinators für die Betreuung von an linksventrikulären Assist Devices befindlichen Patienten trug in unserem Patienten-Kollektiv zu einer höheren Überlebensrate, niedrigeren Komplikationsrate und auch niedrigeren Krankenhauskosten bei.Use of left ventricular assist devices (LVAD) for support of endstage heart failure patients as a bridge to cardiac transplantation creates opportunities both for improved patient survival rate and for lower peri-operative complications. We investigated the effect on patient outcomes and incidence of complication of assigning an LVAD coordinator for heightened clinical monitoring and patient management in this population.Between June 2000 and January 2002, 28 patients with terminal heart failure underwent LVAD implantation, 14 patients prior to LVAD-coordinator employment and 14 patients under supervision of the LVAD coordinator. Patients’ records were retrospectively analyzed for incidence of infection, life-threatening thromboembolic and bleeding events, and hospital charges.In the pre-coordinator group, two patients were discharged home while on LVAD support. Seven patients (50%) developed infections requiring antibiotic treatment; five patients (35%) had severe life-threatening thromboembolic events. Six patients were transplanted and eight patients died while on LVAD support, giving an overall survival of 42% in this group. In the post-coordinator group, seven patients were discharged home while on LVAD support. Four patients developed infections, one patient had a severe life-threatening thromboembolic event. Ten patients were successfully transplanted, one patient is currently supported on the device, and 3 patients died, for an overall survival of 78% in this group.The use of a fulltime professional coordinator has had a beneficial impact on patient outcomes. Patient survival was improved, device-related complications were reduced and eligible patients could be discharged safely from the hospital

Placement of a left ventricular assist device in a patient with dextrocardia

Dextrocardia most commonly presents in the setting of situs inversus, but it may occur as an isolated anomaly with normal position of the abdominal organs. Herein we present a 54-year-old man with ischemic cardiomyopathy and dextrocardia with normal position of the abdominal organs who presented with an exacerbation of congestive heart failure requiring inotropic support as well as mechanical ventilation. An implantable, wearable left ventricular assist device was placed in this patient to allow for ambulation and eventual discharge home. The patient survived 4 months before he developed pneumonia and expired

U.S. Billion-ton Update: Biomass Supply for a Bioenergy and Bioproducts Industry

The Report, Biomass as Feedstock for a Bioenergy and Bioproducts Industry: The Technical Feasibility of a Billion-Ton Annual Supply (generally referred to as the Billion-Ton Study or 2005 BTS), was an estimate of “potential” biomass within the contiguous United States based on numerous assumptions about current and future inventory and production capacity, availability, and technology. In the 2005 BTS, a strategic analysis was undertaken to determine if U.S. agriculture and forest resources have the capability to potentially produce at least one billion dry tons of biomass annually, in a sustainable manner—enough to displace approximately 30% of the country’s present petroleum consumption. To ensure reasonable confidence in the study results, an effort was made to use relatively conservative assumptions. However, for both agriculture and forestry, the resource potential was not restricted by price. That is, all identified biomass was potentially available, even though some potential feedstock would more than likely be too expensive to actually be economically available. In addition to updating the 2005 study, this report attempts to address a number of its shortcomings</p

Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19: A Meta-analysis

IMPORTANCE: Clinical trials assessing the efficacy of IL-6 antagonists in patients hospitalized for COVID-19 have variously reported benefit, no effect, and harm. OBJECTIVE: To estimate the association between administration of IL-6 antagonists compared with usual care or placebo and 28-day all-cause mortality and other outcomes. DATA SOURCES: Trials were identified through systematic searches of electronic databases between October 2020 and January 2021. Searches were not restricted by trial status or language. Additional trials were identified through contact with experts. STUDY SELECTION: Eligible trials randomly assigned patients hospitalized for COVID-19 to a group in whom IL-6 antagonists were administered and to a group in whom neither IL-6 antagonists nor any other immunomodulators except corticosteroids were administered. Among 72 potentially eligible trials, 27 (37.5%) met study selection criteria. DATA EXTRACTION AND SYNTHESIS: In this prospective meta-analysis, risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool. Inconsistency among trial results was assessed using the I(2) statistic. The primary analysis was an inverse variance–weighted fixed-effects meta-analysis of odds ratios (ORs) for 28-day all-cause mortality. MAIN OUTCOMES AND MEASURES: The primary outcome measure was all-cause mortality at 28 days after randomization. There were 9 secondary outcomes including progression to invasive mechanical ventilation or death and risk of secondary infection by 28 days. RESULTS: A total of 10 930 patients (median age, 61 years [range of medians, 52-68 years]; 3560 [33%] were women) participating in 27 trials were included. By 28 days, there were 1407 deaths among 6449 patients randomized to IL-6 antagonists and 1158 deaths among 4481 patients randomized to usual care or placebo (summary OR, 0.86 [95% CI, 0.79-0.95]; P = .003 based on a fixed-effects meta-analysis). This corresponds to an absolute mortality risk of 22% for IL-6 antagonists compared with an assumed mortality risk of 25% for usual care or placebo. The corresponding summary ORs were 0.83 (95% CI, 0.74-0.92; P < .001) for tocilizumab and 1.08 (95% CI, 0.86-1.36; P = .52) for sarilumab. The summary ORs for the association with mortality compared with usual care or placebo in those receiving corticosteroids were 0.77 (95% CI, 0.68-0.87) for tocilizumab and 0.92 (95% CI, 0.61-1.38) for sarilumab. The ORs for the association with progression to invasive mechanical ventilation or death, compared with usual care or placebo, were 0.77 (95% CI, 0.70-0.85) for all IL-6 antagonists, 0.74 (95% CI, 0.66-0.82) for tocilizumab, and 1.00 (95% CI, 0.74-1.34) for sarilumab. Secondary infections by 28 days occurred in 21.9% of patients treated with IL-6 antagonists vs 17.6% of patients treated with usual care or placebo (OR accounting for trial sample sizes, 0.99; 95% CI, 0.85-1.16). CONCLUSIONS AND RELEVANCE: In this prospective meta-analysis of clinical trials of patients hospitalized for COVID-19, administration of IL-6 antagonists, compared with usual care or placebo, was associated with lower 28-day all-cause mortality. TRIAL REGISTRATION: PROSPERO Identifier: CRD4202123015