Conceptual design of a fleet of autonomous regolith throwing devices for radiation shielding of lunar habitats

The National Aeronautics and Space Administration (NASA) in conjunction with Universities Space Research Association (USRA) has requested that the feasibility of a fleet of regolith tossing devices designed to cover a lunar habitat for radiation protection be demonstrated. The regolith, or lunar soil, protects the lunar habitat and its inhabitants from radiation. Ideally, the device will operate autonomously in the lunar environment. To prove the feasibility of throwing regolith on the Moon, throwing solutions were compared to traditional, Earth-based methods for moving soil. Various throwing configurations were investigated. A linear throwing motion combined with a spring and motor energizing system proved a superior solution. Three different overall configurations for the lunar device are presented. A single configuration is chosen and critical parameters such as operating procedure, system volume, mass, and power are developed. The report is divided into seven main sections. First, the Introduction section gives background information, defines the project requirements and the design criteria, and presents the methodology used for the completion of this design. Next, the Preliminary Analysis section presents background information on characteristics of lunar habitats and the lunar environment. Then, the Alternate Designs section presents alternate solutions to each of the critical functions of the device. Fourth, a detailed analysis of throwing the regolith is done to demonstrate its feasibility. Then, the three overall design configurations are presented. Next, a configuration is selected and the conceptual design is expanded to include system performance characteristics, size, and mass. Finally, the Conclusions and Recommendations for Future Work section evaluates the design, outlines the next step to be taken in the design process, and suggests possible goals for future design work

Conceptual design of a fleet of autonomous regolith throwing devices for radiation shielding of lunar habitats

This report presents refinements in two areas of the initial design presented in the report entitled 'Conceptual Design of a Fleet of Autonomous Regolith Throwing Devices for Radiation Shielding of Lunar Habitats'. The first section presents an evaluation of the critical areas of the design and presents alternative solutions for these areas. The areas for design refinement are the traction required by the device and the stability of the device when throwing regolith. Several alternative methods are presented to solve these problems. First, the issue of required traction is covered. Next, the design is refined to provide a more stable device. The issue of stability is addressed both by presenting solutions for the configuration chosen for the computer simulation and by presenting two more device configurations. The next section presents the selected solutions. To prevent inadequate traction, the depth of dig-per-pass is reduced. A method combining a dynamic counterweight and an outrigger is chosen to provide a stable device

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London