Robotic Habitat Technologies for Minimizing Crew Maintenance Requirements

NASA’s Lunar Gateway aims to be deployed later in the decade and will serve as an outpost orbiting the moon. This habitat will be utilized as a base for lunar operations as well as future missions to Mars. Unlike the International Space Station (ISS), which maintains three to six astronauts at any given time, the Lunar Gateway will be uncrewed for eleven months out of the year. Over 80% of crew time onboard the ISS is dedicated to logistics, repair, and maintenance, leaving minimal time for scientific research and experimentation. In order to maintain Gateway, robotic systems must be implemented to accomplish maintenance and operational tasks. This paper discusses our team’s proposed dexterous robotic system, which will address routine and contingency operational and maintenance tasks on Gateway. The project is experimentally-based, and split into three approaches: cataloging robotic capabilities via robot/taskboard interactions, logistics management of Cargo Transfer Bags (CTBs), and software development of an AprilTag situational development system. This research project utilizes the unique capabilities of the University of Maryland (UMD) Space Systems Laboratory (SSL), which houses various dexterous robotic manipulators, mock-ups of space habitats, and the Neutral Buoyancy Research Facility (NBRF), a 50-foot diameter, 25-foot deep water tank used to simulate microgravity conditions. By incorporating robotic systems into the architecture of the Lunar Gateway, it will allow for the lunar outpost to be continually operated and maintained while uncrewed, and will allow for astronauts, when present, to focus on maximizing scientific discoveries.NASA RASC-AL 202

ROBOTIC TECHNOLOGIES FOR MINIMIZING CREW MAINTENANCE REQUIREMENTS IN SPACE HABITATS

Gemstone Team ASTROThe International Space Station (ISS) is crewed continuously by astronauts conducting scientifc research in microgravity. However, their work is not limited to scientifc research alone; in fact, logistics, maintenance, and repair tasks on the ISS require more than 80% of available crew time, severely limiting opportunities for performing scientifc experiments and technological development. NASA is planning a new project known as Gateway (also referred to as the Lunar Orbital Platform-Gateway). This station will orbit the Moon and be uncrewed for 11 months per year. Astronauts will only be present in the outpost for a limited period of time and will not always be available for continuous repairs and maintenance, as is required for Gateway to operate. Therefore, robotic system(s) are necessary to regularly accomplish these tasks both in the absence and presence of astronauts. Throughout this project, Team ASTRO (Assessment of Space Technologies for Robotic Operations) explored the feasibility of integrating dexterous robotic systems in space habitat architectures to perform routine and contingency operational and maintenance tasks. Ultimately, this allows for astronauts, when present, to focus on exploration and scientifc discoveries. The team conducted this research through three approaches: Gateway component analog taskboard development and end e˙ector assessment, Cargo Transfer Bag (CTB) manipulation and logistics, and AprilTag situational awareness simulation development. Based on analyses and experimental results gained from this research, the team found that robotic systems are feasible alternatives for space habitat operation. Team ASTRO also determined that AprilTags can be used for optimization of the Gateway design to facilitate uncrewed operations and robotic servicing to improve crew productivity when present

Successful Small Intestine Colonization of Adult Mice by Vibrio cholerae Requires Ketamine Anesthesia and Accessory Toxins

Vibrio cholerae colonizes the small intestine of adult C57BL/6 mice. In this study, the physical and genetic parameters that facilitate this colonization were investigated. Successful colonization was found to depend upon anesthesia with ketamine-xylazine and neutralization of stomach acid with sodium bicarbonate, but not streptomycin treatment. A variety of common mouse strains were colonized by O1, O139, and non-O1/non-O139 strains. All combinations of mutants in the genes for hemolysin, the multifunctional, autoprocessing RTX toxin (MARTX), and hemagglutinin/protease were assessed, and it was found that hemolysin and MARTX are each sufficient for colonization after a low dose infection. Overall, this study suggests that, after intragastric inoculation, V. cholerae encounters barriers to infection including an acidic environment and an immediate immune response that is circumvented by sodium bicarbonate and the anti-inflammatory effects of ketamine-xylazine. After initial adherence in the small intestine, the bacteria are subjected to additional clearance mechanisms that are evaded by the independent toxic action of hemolysin or MARTX. Once colonization is established, it is suggested that, in humans, these now persisting bacteria initiate synthesis of the major virulence factors to cause cholera disease. This adult mouse model of intestinal V. cholerae infection, now well-characterized and fully optimized, should serve as a valuable tool for studies of pathogenesis and testing vaccine efficacy

UNBOUND

Featured here, are the extraordinary works of our graduating Fanshawe Design class. This accomplishment is truly a celebration of the three years of passion, hard work, and dedication put forth by our students. It is our greatest hope that family, friends and the fashion industry will enjoy the creative endeavors of these emerging designers from the Fashion Design program at Fanshawe College in London, Ontario.https://first.fanshawec.ca/famd_design_fashiondesign_unbound/1001/thumbnail.jp

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)

Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis. Methods In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability. Findings Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis

Bacterial strains used in this study.

a<p>Sm^R = streptomycin resistant, Km^R = kanamycin resistant.</p

Effect of mouse and <i>V. cholerae</i> strain variation on colonization.

<p>(A) Mouse strains as indicated were inoculated with 1.1×10⁷ CFU El Tor O1 strain P27459. (B) C57BL/6 mice were inoculated with 0.5−1×10⁷ CFU of <i>V. cholerae</i> strain as indicated. (C) Streptomycin treated and non-treated C57BL/6 mice were inoculated with either 2−3×10⁷ or 1.5−3.9×10⁸ CFU of <i>V. cholerae</i> Classical O395. All mice were inoculated with the ABL strategy as described in the text and mice were assessed for colonization of the small intestine 20 hr after inoculation. Values are reported as a Col. Index as described in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0007352#pone-0007352-g001" target="_blank">Fig. legend 1</a>. The number of mice that cleared <i>V. cholerae</i> from the small intestine (<i>n</i>) over the total of mice in the group (<i>n</i>°) is also indicated. Only statistically significant p values calculated by a Mann-Whitney non-parametric t-test comparing medians are shown. P values in panels A and B are compared to El Tor O1 P27459 infection in C57BL/6 mice (Panel B) and in panel C to O395 control at 10⁷ CFU.</p

Inoculation strategy affects successful colonization of C57BL/6 mice.

<p>(A) Prior to inoculation, mice were treated as indicated on the X axis (S-1 mg/ml streptomycin in water; F-restriction of food overnight; A-anesthesia with ketamine-xylazine intraperitoneally at time of inoculation; B-intragastric delivery of sodium bicarbonate, and L-inoculation of bacteria in the logarithmic phase of growth. Control mice (+all) were infected using all five parameters. Mice were then inoculated with 1−5×10⁷ CFU <i>V. cholerae</i> El Tor O1 strain P27459 and colonization of the small intestine assessed after 20 hr. Data are pooled from 3 experiments so the input variation between experiments was normalized by dividing the recovered CFU by the input CFU and data are thereby plotted as a log colonization index with dashed line at 0 indicating that CFU recovered was identical to the input CFU (<i>i</i>). Markers above the dashed line are indicative of growth in the small intestine while markers below indicate clearance. Values below the solid line (<i>d.l.</i>) were below the detection limit of 500 CFU in the small intestine. The number of mice that cleared <i>V. cholerae</i> from the small intestine (<i>n</i>) over the total of mice in the group (<i>n</i>°) is also indicated. The experiment in panel B was performed as above except an additional parameter of anesthesia with inhaled isoflurane (+I) was added and data are pooled from two experiments. Significant and borderline P values are shown compared to control for survival (calculated by a χ2 test) and for colonization (calculated by a Mann-Whitney non-parametric t-test comparing medians).</p