Bloodstain Pattern Dynamics in Microgravity: Observations of a Pilot Study in the Next Frontier of Forensic Science

As humanity advances into a space-faring species, the risk of injury by multiple means and intentions will follow. Expanding understanding of how forensic science adapts to extraterrestrial environments is a novel and inevitable expansion into the next forensic frontier. This study considers the unique challenges of bloodstain pattern analysis in microgravity environments. Specifically, observation in novel experimentation aboard a parabolic flight research airplane which yielded fluid dynamic behaviors in a microgravity environment that provides practical understanding of Earth-based and off-world bloodstain applications

Surgical Capabilities for Exploration and Colonization Space Flight - An Exploratory Symposium

Identify realistic and achievable pathways for surgical capabilities during exploration and colonization space operations and develop a list of recommendations to the NASA Human Research Program to address challenges to developing surgical capabilities

How much of the intraaortic balloon volume is displaced toward the coronary circulation?

This is a post-print version of the published article. Copyright @ 2010 The American Association for Thoracic Surgery.This article has been made available through the Brunel Open Access Publishing Fund.Objective: During intraaortic balloon inflation, blood volume is displaced toward the heart (Vtip), traveling retrograde in the descending aorta, passing by the arch vessels, reaching the aortic root (Vroot), and eventually perfusing the coronary circulation (Vcor). Vcor leads to coronary flow augmentation, one of the main benefits of the intraaortic balloon pump. The aim of this study was to assess Vroot and Vcor in vivo and in vitro, respectively. Methods: During intraaortic balloon inflation, Vroot was obtained by integrating over time the aortic root flow signals measured in 10 patients with intraaortic balloon assistance frequencies of 1:1 and 1:2. In a mock circulation system, flow measurements were recorded simultaneously upstream of the intraaortic balloon tip and at each of the arch and coronary branches of a silicone aorta during 1:1 and 1:2 intraaortic balloon support. Integration over time of the flow signals during inflation yielded Vcor and the distribution of Vtip. Results: In patients, Vroot was 6.4% ± 4.8% of the intraaortic balloon volume during 1:1 assistance and 10.0% ± 5.0% during 1:2 assistance. In vitro and with an artificial heart simulating the native heart, Vcor was smaller, 3.7% and 3.8%, respectively. The distribution of Vtip in vitro varied, with less volume displaced toward the arch and coronary branches and more volume stored in the compliant aortic wall when the artificial heart was not operating. Conclusion: The blood volume displaced toward the coronary circulation as the result of intraaortic balloon inflation is a small percentage of the nominal intraaortic balloon volume. Although small, this percentage is still a significant fraction of baseline coronary flow.This article is available through the Open Access Publishing Fund

A Comparison Efficacy Study of Commercial Nasopharyngeal Swabs versus a Novel 3D Printed Swab for the Detection of SARS-CoV-2

The large volume of diagnostic tests required by the response to the pandemic of COVID-19 pandemic resulted in a shortage of commercial nasopharyngeal swabs. In an effort to alleviate the shortage, swabs created by 3D printing may be a solution. We designed and produced 3D printed swabs and sought to compare their ability to detect SARS-CoV-2 in patients admitted for COVID-19 or who were suspected of having COVID-19. A total of 30 patients were swabbed with a commercial and printed 3D swab. Results matched in 28 of 31 patients (90%). Two patients were discordant with a positive commercial swab and a negative 3D printed swab and another was discordant because the 3D printed swab was positive and the commercial swab was negative. The sensitivity was 89%, specificity was 92% and Cohen’s kappa coefficient was 0.80. The 3D printed swabs performed acceptably compared to the commercial swab and may be considered for use in lieu of a commercial swab

Minimally Invasive Expeditionary Surgical Care Using Human-Inspired Robots

This technical report serves as an updated collection of subject matter experts on surgical care using human-inspired robotics for human exploration. It is a summary of the Blue Sky Meeting, organized by the Florida Institute for Human and Machine Cognition (IHMC), Pensacola, Florida, and held on October 2-3, 2018. It contains an executive summary, the final report, all of the presentation materials, and an updated reference list

The Viability of Rehydrated Blood in Zero Gravity

Space, the final frontier has been fascinating us for hundreds of years and space travel has only just recently become possible in our species history. The farthest we have traveled in space is the closest object to our home planet, the moon. There are many challenges that come with interplanetary travel that will directly impact the success for the mission to Mars planned to occur around the year 2033. A major problem planning long-duration space flight will be the question on how to deal with emergency situations. What happens if someone gets hurt or needs a blood transfusion? Blood can currently only be stored refrigerated for 42 days at 4 °C (39 °F). This is a serious problem for astronauts because they would only have access to transfusable blood units for the first 42 days of the voyage and would have to spend very valuable energy and space to maintain the blood at 4° C. Our lab has determined a solution to this problem by developing a technique to maintain blood viability despite being in in a dried state at room temperature. However, it is unknown how dried blood powdered will mix with liquids during rehydration in space without gravity to aid in the mixing process. NASA has provided us with funds to test how rehydration of blood will be affected by simulated zero gravity. Rehydration is a gravity mediated process and our laboratory has developed techniques where gravity may not be needed during the rehydration process. We will be testing these rehydration techniques during conditions of microgravity on board of a reduced-gravity aircraft during parabolic flight maneuvers and the results will be discussed. (Supported by NASA-80NSSC18K1664)

Surgical Capabilities for Exploration and Colonization Space Flight - An Exploration Symposium

Surgical capabilities in human space flight, whether on a space-based platform in low Earth orbit or on a long duration planetary exploration mission, will be challenging to conduct for a variety of reasons, some of which will be ameliorated by training, technology, and pre-flight planning. Nevertheless, inherent risks and challenges remain. Early space missions did not have any surgical capability. It was not until NASA's Skylab mission that serious consideration was given to this fundamental medical care capability. Over the past 30 years, subject matter experts have been brought together for discussion on the myriad of challenges and opportunities in this endeavor. The last such meeting was held in 2005 at the NASA Johnson Space Center. As we continue to move forward with human space flight activities for the International Space Station and beyond, the capabilities of information technology, robotics, sensors and imaging have rapidly changed since the last gathering of expertise. In December 2015, through sponsorship of the National Space Biomedical Research Institute (NSBRI), a diverse group of individuals from government, academia, and industry representing three countries gathered at the NSBRI Space 4 Biomedicine facility in Houston, TX. This two day symposia included comprehensive sessions that addressed the challenges that we all face in developing, deploying, and utilizing surgical care capabilities in all human space missions, regardless of mission duration or profile. The symposium benefited from the knowledge and experience of three seasoned NASA physician astronauts, Drs. Jay Buckey, Thomas Marshburn, and Lee Morin. At the end of the first day, the assembled group heard from the crew members about their experiences and their ideas. It is clear that the discussion of surgical capabilities is part of the larger discussion of consideration of advanced healthcare, including critical care, on exploration space missions. This report represents the culmination of the symposium, capturing knowledge, experience, conceptual dialogue, and a narrative that can be used in supporting the development of future programs and potential policy. Each of the presentations that were provided by the guest speakers is included in the appendices. Those presentations that are not included were due to sensitivity of the material or at the request of the speaker. In addition, each speaker was offered an opportunity to provide comments in a 'lightning round' format. All of these comments and speaker abstracts also appear in the appendices. At the conclusion of the second day, a discussion was held that reviewed the priorities that perhaps add value to decision makers. These are also summarized. This report will serve as the final product of this symposium. Additional material may be produced for the peer-reviewed literature

Does conventional intra-aortic balloon pump trigger timing produce optimal hemodynamic effects in vivo?

PURPOSE: The intra-aortic balloon pump (IABP) provides circulatory support through counterpulsation. The hemodynamic effects of the IABP may vary with assisting frequency and depend on IAB inflation/deflation timing. We aimed to assess in vivo the IABP benefits on coronary, aortic, and left ventricular hemodynamics at different assistance frequencies and trigger timings. METHODS: Six healthy, anesthetized, open-chest sheep received IABP support at 5 timing modes (EC, LC, CC, CE, CL, corresponding to early/late/conventional/conventional/conventional inflation and conventional/conventional/conventional/early/late deflation, respectively) with frequency 1:3 and 1:1. Aortic (Qao) and coronary (Qcor) flow, and aortic (Pao) and left ventricular (PLV) pressure were recorded simultaneously, with and without IABP support. Integrating systolic Qao yielded stroke volume (SV). RESULTS: EC at 1:1 produced the lowest end-diastolic Pao (59.5 ± 7.8 mmHg [EC], 63.4 ± 11.1 mmHg [CC]), CC at 1:1 the lowest systolic PLV (69.1 ± 6.5 mmHg [CC], 76.4 ± 6.5 mmHg [control]), CC at 1:1 the highest SV (88.5 ± 34.4 ml [CC], 76.6 ± 31.9 ml [control]) and CC at 1:3 the highest diastolic Qcor (187.2 ± 25.0 ml/min [CC], 149.9 ± 16.6 ml/min [control]). Diastolic Pao augmentation was enhanced by both assistance frequencies alike, and optimal timings were EC for 1:3 (10.4 ± 2.8 mmHg [EC], 6.7 ± 3.8 mmHg [CC]) and CC for 1:1 (10.8 ± 6.7 mmHg [CC], -3.0 ± 3.8 mmHg [control]). CONCLUSIONS: In our experiments, neither a single frequency nor a single inflation/deflation timing, including conventional IAB timing, has shown superiority by uniformly benefiting all studied hemodynamic parameters. A choice of optimal frequency and IAB timing might need to be made based on individual patient hemodynamic needs rather than as a generalized protocol.British Heart Foundation (PG/12/73/29730)