CultCube: Experiments in autonomous in-orbit cultivation on-board a 12-Units CubeSat platform.

The feasibility and design of the CultCube 12U CubeSat hosting a small Environmental Control and Life Support Systems (ECLSS) for the autonomous cultivation of a small plant in orbit is described. The satellite is aimed at running experiments in fruit plants growing for applications in crewed vehicles for long-term missions in space. CultCube is mainly composed of a pressurized vessel, constituting the outer shell of the ECLSS, and by various environmental controls (water, nutrients, air composition and pressure, light, etc.) aimed at maintaining a survivable habitat for the fruit plants to grow. The plant health status and growth performances is monitored using hyperspectral cameras installed within the vessel, able to sense leaves' chlorophyll content and temperature, and allowing the estimation of plant volume in all its life cycle phases. The paper study case is addressed to the in-orbit experimental cultivation of a dwarf tomato plant (MicroTom), which was modified for enhancing the anti-oxidants production and for growing in stressful environments. While simulated microgravity tests have been passed by the MicroTom plant, the organism behaviour in a real microgravity environment for a full seed-to-seed cycle needs to be tested. The CultCube 12U CubeSat mission presents no particular requirements on the kind of orbit, whereas its minimum significative duration corresponds to one seed-to-seed cycle for the plant, which is 90 days for the paper study case. In the paper, after an introduction on the importance of an autonomous testbed for plant cultivation, in the perspective of the implementation of bioregenerative systems on-board future manned long-term missions, the satellite design and the MicroTom engineered plant for in-orbit growth are described. In addition to the description of the whole set of subsystems, with focus on the payload and its controllers and instrumentation, the system budgets are presented. Finally, the first tests conducted by the authors are briefly reported.

Tratamientos de soporte vital al final de la vida: costos y aspectos éticos. Punto de vista en una unidad de cuidados intensivos basado en la metodología Q / Life-support treatments at end of life: Costs and ethical aspects. Point of view in an intensive care unit based on Q methodology

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Evaluating the Cost and Utility of Mandating Schools to Stock Epinephrine Auto-injectors.

BACKGROUND: The Michigan Legislature mandated that all public schools stock epinephrine auto-injectors (EAIs). A minimal amount is known regarding the incremental value of EAIs in schools. Our primary objective was to describe the frequency of administration of epinephrine for EMS patients with acute allergic reactions in public schools. Our secondary objective was to estimate the cost of mandating public schools to stock EAIs. METHODS: We performed a retrospective cohort study of EMS cases with an impression of allergic reaction and who received epinephrine recorded in the 2014 Michigan EMS Information System (MI-EMSIS). We abstracted patient demographics, incident location by address to identify public schools, source of epinephrine given, and suspected allergen if known. We calculated advanced life support (ALS) response times to assess temporal impact of school EAIs in communities with ALS systems. We estimated the unsubsidized annual procurement cost of this mandate for Michigan public schools (N = 4,039), using range of costs for the required 2 EAIs (adult and pediatric) as estimated by the legislature ($140/each) and recently reported costs for commercial sources ($1,200). Training costs were not included. Descriptive statistics are reported. RESULTS: During this period, there were 1,550,009 EMS cases in the state with 631 receiving non-cardiac arrest epinephrine for presumed anaphylaxis, of which 23 cases were in public schools. Reported allergens were most often food 12 (51.2%), insect stings 4(22.2%) or unknown 7(30.4%). Among these patients, the source for epinephrine used was from the student, 7 (30.4%), EMS 7 (30.4%), school 7(30.4%), and unknown 2(8.7%). A majority (21, 91.3%) of the public school cases occurred in communities with ALS systems and ALS response was relatively rapid (median response 6 minutes, 90 percentile, 13 minutes). The unsubsidized annual cost of Michigan public schools to stock EAIs ranges from $565,460 to $4,846,800. CONCLUSION: In this study, few public school patients received epinephrine for anaphylaxis and the vast majority occurred in communities with rapid ALS response. The direct annual supply cost of the school EAI mandate is substantial.

Development and validation of an experimental life support system for assessing the effects of global climate change and environmental contamination on estuarine and coastal marine benthic communities.

An experimental life support system (ELSS) was constructed to study the interactive effects of multiple stressors on coastal and estuarine benthic communities, specifically perturbations driven by global climate change and anthropogenic environmental contamination. The ELSS allows researchers to control salinity, pH, temperature, ultraviolet radiation (UVR), tidal rhythms and exposure to selected contaminants. Unlike most microcosms previously described, our system enables true independent replication (including randomization). In addition to this, it can be assembled using commercially available materials and equipment, thereby facilitating the replication of identical experimental setups in different geographical locations. Here, we validate the reproducibility and environmental quality of the system by comparing chemical and biological parameters recorded in our ELSS with those prevalent in the natural environment. Water, sediment microbial community and ragworm (the polychaete Hediste diversicolor) samples were obtained from four microcosms after 57 days of operation. In general, average concentrations of dissolved inorganic nutrients (NO3 (-) ; NH4 (+) and PO4 (-3) ) in the water column of the ELSS experimental control units were within the range of concentrations recorded in the natural environment. While some shifts in bacterial community composition were observed between in situ and ELSS sediment samples, the relative abundance of most metabolically active bacterial taxa appeared to be stable. In addition, ELSS operation did not significantly affect survival, oxidative stress and neurological biomarkers of the model organism Hediste diversicolor. The validation data indicate that this system can be used to assess independent or interactive effects of climate change and environmental contamination on benthic communities. Researchers will be able to simulate the effects of these stressors on processes driven by microbial communities, sediment and seawater chemistry and to evaluate potential consequences to sediment toxicity using model organisms such as Hediste diversicolor.

Performance determinants and flexible ICU organisation.

We faced some of the most important aspects of the problem of the appropriateness of ICU resources use, that are the relationship between volume of activity and mortality, the analysis of cost-effectiveness in intensive care medicine, and the monitoring of the human resource use in ICU. For this aim three different surveys were utilized: one at European level, the second at country level and, third, a regional survey. After developing a new measure of volume called ''high-risk volume'', we explored the relationship between outcome and volume, founding that such association was very strong (from 3 to 1719% decrease in ICU/hospital mortality every five extra high-risk patients treated per bed per year), and that an occupancy rate larger than 80% was associated with higher mortality. Therefore, patients in all levels of risk are better treated in high-risk volume ICUs with a reasonable occupancy rate. Analysing cost-effectiveness in intensive care medicine using a national case-mix categorized in different diagnostic groups, we identified brain haemorrhage, ALI/ARDS and surgical unscheduled patients as users a high volume of monetary resources less efficiently, while the scheduled abdominal surgery patients admitted to receive intensive care and patients on the ICU for minor organ support made the best use of the fewer resources spent. Finally, we designed a new approach to measure the rate and appropriateness of nursing resource use in ICU on a daily basis. Testing this approach on a group of general non-specialist ICUs, we found that the method was powerful enough to adequately distinguish between ''over'' and ''under-utilization'' and to identify all the theoretical scenarios of nurse/resource utilization.

The minimal cost of life in space.

The cost of keeping people alive in space is assessed from a theoretical viewpoint and using two actual designs for plant growth systems. While life support is theoretically not very demanding, our ability to implement life support is well below theoretical limits. A theoretical limit has been calculated from requirements and the state of the art for plant growth has been calculated using data from the BIO-Plex PDR and from the Cornell CEA prototype system. The very low efficiency of our current approaches results in a high mission impact, though we can still see how to get a significant reduction in cost of food when compared to supplying it from Earth. Seeing the distribution of costs should allow us to improve our current designs.

Engineering of closed ecological system in space and inter-organismal interactions.

Space agriculture is a concept of synthesis and operation of closed ecological system for controlling living environment and supplying materials in order to sustain life and to meet metabolic needs of space crew. It revitalizes metabolites and other excretion of crew for their recycled usage. It is an advanced concept for life support for long and large scaled manned space missions, where open loop system for materials cycle is not feasible to apply. Several issues, such as cost-benefit analysis with considering benefits of amenity and psychological factors of crew, are discussed in this essay, together with reliability and productivity of biological systems. Studies on plant physiology for inter-organismal interaction contribute to design work for space agriculture, and associate with our engagements to our future, sustainable development of our civilization both on the earth and extending to outer space.

Life support approaches for Mars missions.

Life support approaches for Mars missions are evaluated using an equivalent system mass (ESM) approach, in which all significant costs are converted into mass units. The best approach, as defined by the lowest mission ESM, depends on several mission parameters, notably duration, environment and consequent infrastructure costs, and crew size, as well as the characteristics of the technologies which are available. Generally, for the missions under consideration, physicochemical regeneration is most cost effective. However, bioregeneration is likely to be of use for producing salad crops for any mission, for producing staple crops for medium duration missions, and for most food, air and water regeneration for long missions (durations of a decade). Potential applications of in situ resource utilization need to be considered further.

Electrochemical removal of ammonium ions from a bioreactor effluent.

Ammonium ions are byproducts of the oxidation of nitrogen-containing substances occurring in the initial treatment steps of water recovery systems. Removal of ammonium ions from the effluent stream from 1000 ppm to less than 0.25 ppm is an imperative need as a part of the space life support infrastructure. Drawbacks associated with processes proposed in the past include the generation of a secondary waste, cost, size, and/or the use of consumables that need to be stored or supplied. Lynntech has developed a technology that is based on an innovative, environmentally friendly electrochemical process for the effective removal of ammonium ions. The process does not use consumables except for oxygen gas from air, and does not generate a secondary waste. By controlling operational conditions, the ammonium ions may be transformed to nitrogen gas and/or to nitrate ions. Other advantages of the process include: it is energy efficient, operates at room temperature, and is microgravity compatible. Grant numbers: NAS9-00013.

Computer modeling for advanced life support system analysis.

This article discusses the equivalent mass approach to advanced life support system analysis, describes a computer model developed to use this approach, and presents early results from modeling the NASA JSC BioPlex. The model is built using an object oriented approach and G2, a commercially available modeling package Cost factor equivalencies are given for the Volosin scenarios. Plant data from NASA KSC and Utah State University (USU) are used, together with configuration data from the BioPlex design effort. Initial results focus on the importance of obtaining high plant productivity with a flight-like configuration.

Decision analysis as a life support technology assessment capability.

Applied research and technology development is often characterized by uncertainty, risk, and significant delays before tangible returns are obtained. Decision making regarding which technologies to advance and what resources to devote to them is a challenging but essential task, especially in a resource-constrained environment. In the application of life support technology to future manned space flight, new technology concepts typically are characterized by rough approximations of technology performance, uncertain future flight program needs, and a complex, time-intensive process to develop technology to a flight-ready status. Decision analysis is a quantitative, logic-based discipline that imposes formalism and structure to complex problems confronting a decision maker. It also accounts for the limits of knowledge available at the time a decision is needed. The utility of decision analysis to life support technology R&D was evaluated by applying it to two case studies. The methodology was found to provide useful insight for making technology development resource allocation decisions.

Regenerative life support systems--why do we need them?

Human exploration of the solar system will include missions lasting years at a time. Such missions mandate extensive regeneration of life support consumables with efficient utilization of local planetary resources. As mission durations extend beyond one or two years, regenerable human life support systems which supply food and recycle air, water, and wastes become feasible; resupply of large volumes and masses of food, water, and atmospheric gases become unrealistic. Additionally, reduced dependency on resupply or self sufficiency can be an added benefit to human crews in hostile environments far from the security of Earth. Comparisons of resupply and regeneration will be discussed along with possible scenarios for developing and implementing human life support systems on the Moon and Mars.

A human breathing simulator designed to test the life support system of a hyperbaric tent.

A self contained life support system which can maintain a breathable atmosphere for up to eight hours was recently developed for use with a portable hyperbaric tent. To facilitate further life support system studies, the practicality of a human breathing simulator (HBS), which would remove oxygen and release carbon dioxide at the same rate as a human, was tested. The HBS consists of a cylinder of carbon dioxide bled into the chamber via a flow regulator and a Vanadous bubbler to chemically remove oxygen from the chamber. First experiments show that the HBS works, but that a larger chemical system is needed to remove oxygen at the desired rate. Scale up calculations have been completed.

Guide to ethical decision-making for the critically ill: the three R's and Q.C.

Ethical decision-making for the care of the critically ill and injured has never been more difficult than it is today. Major technologic advances prolong life but often provide questionable benefit in human terms. Both the ethical commitment to the individual patient and the competition for access to expensive and scarce health resources prompt the search for clinically useful and operationally appropriate criteria for decision-making. The mnemonic 3 R's and Q.C. was evolved as a practical tool by which the ethical basis for interventions may be tested. The first tier, the 3 R's, is likely to resolve the vast majority of ethical issues. These are appropriately addressed at the bedside by clinicians who determine whether a proposed intervention is Rational, Redeeming, and Respectful. When the ethical issues cannot be resolved at the bedside on the basis of the 3 R's, a second tier of testing of Quality of Life and Cost (Q.C.) is triggered. This addresses decision-making which is not exclusively or even primarily in the skill domain or authority of most physicians. It calls for assistance by those who represent a broader base of societal involvement including multidisciplinary experts in ethics and law who serve as consultants or who are organized into medical center-wide ethics committees.

Current concepts and future directions of CELSS.

Studies of bioregenerative life support systems for use in space indicate that they are scientifically feasible. Preliminary data suggest that they would provide cost- and weight-saving benefits for low Earth orbit, long duration space platforms. Concepts of such systems include the use of higher plants and/or micro-algae as sources of food, potable water and oxygen, and as sinks for carbon dioxide and metabolic wastes. Recycling of materials within the system will require processing of food organism and crew wastes using microbiological and/or physical chemical techniques. The dynamics of material flow within the system will require monitoring, control, stabilization and maintenance imposed by computers. Future phases of study will continue investigations of higher plant and algal physiology, environmental responses, and control; flight experiments for testing responses of organisms to weightlessness and increased radiation levels; and development of ground-based facilities for the study of recycling within a bioregenerative life support system.

CELSS transportation analysis.

Regenerative life support systems based on the use of biological material have been considered for inclusion in manned spacecraft since the early days of the United States space program. These biological life support systems are currently being developed by NASA in the Controlled Ecological Life Support Systems (CELSS) program. Because of the progress being achieved in the CELSS program, it is time to determine which space missions may profit from use of the developing technology. This paper presents the results of a study that was conducted to estimate where potential transportation cost savings could be anticipated by using CELSS technology for selected future manned space missions. Six representative missions were selected for study from those included in NASA planning studies. The selected mission ranged from a low Earth orbit mission to those associated with asteroids and a Mars sortie. The crew sizes considered varied from four persons to five thousand. Other study parameters included mission duration and life support closure percentages, with the latter ranging from complete resupply of consumable life support materials to 97% closure of the life support system. The paper present the analytical study approach and describes the missions and systems considered, together with the benefits derived from CELSS when applicable.