[The surgically treated gunshot injury. Securing evidence in hospitals without primary participation of police or legal medicine]. / Die operierte Schussverletzung. Schussspurensicherung im klinischen Bereich ohne primäre Beteiligung der Polizei oder der Rechtsmedizin.

Against the background of a problematic reconstruction of a hunting accident, the question arises how such cases can be handled in hospitals and how exhibits can be adequately dealt with. After evaluating a questionnaire on current conditions of securing evidence in cases of surgically treated gunshot wounds from 26 surgical institutions in Mecklenburg-Western Pomerania and in consideration of the certified advanced training in the field of legal medicine, recommendations are given regarding the securing of evidence within the clinical setting without primary involvement of police or legal medicine.

[Effect of systematic information about psychosocial support services during outpatient radiotherapy. A controlled trial]. / Effekte systematischer Informationen über psychosoziale Angebote während der ambulanten Strahlentherapie. Eine kontrollierte Studie.

BACKGROUND: Up to 50 % of all cancer patients require psychosocial support during the course of their disease. However, only a proportion of these patients make use of the existing services. This is partly because patients are unaware that psychosocial support services are available to them. We investigated whether systematically providing printed information concerning psychosocial support can increase the knowledge and usage of these services, as well as health-related self-efficacy. MATERIALS AND METHODS: In a controlled trial, 108 breast cancer patients were assigned alternately to either an intervention- or a control group. At two predefined time points before and during radiotherapy, patients in the intervention group received correspondence informing them about psychosocial services (psycho-oncology, clinical social work and the Cancer Information Service).The control group received no systematic information. Using a standardized questionnaire, all patients were subsequently questioned about their knowledge of psychosocial support services, their perceived self-efficacy and their use of psychosocial support services. RESULTS: We found that systematic provision of information had a positive effect on the knowledge of psychosocial support services (p = 0.042; d = 0.45) and self-efficacy (p = 0.047; d = 0.42). However, no increase in the actual usage of these services was observed (p = 0.661; d = 0.10). CONCLUSION: The systematic provision of information in the form of written correspondence can easily be implemented into clinical routine and is an effective way to increase cancer patients' knowledge of psychosocial support services. Furthermore, providing information about the services had a positive impact on patients' perceived self-efficacy. However, simply making this information available did not increase the usage of psychosocial support services.

Four Fallacies and an Oversight: Searching for Martian Life.

While it is anticipated that future human missions to Mars will increase the amount of biological and organic contamination that might be distributed on that planet, robotic missions continue to grow in capability and complexity, requiring precautions to be taken now to protect Mars, and particularly areas of Mars that might be Special Regions. Such precautionary cleanliness requirements for spacecraft have evolved over the course of the space age, as we have learned more about planetary environments, and are the subject of regular deliberations and decisions sponsored by the Committee on Space Research (COSPAR). COSPAR's planetary protection policy is maintained as an international consensus standard for spacecraft cleanliness that is recognized by the United Nations Committee on the Peaceful Uses of Outer Space. In response to the paper presented in this issue by Fairén et al. (2017), we examine both their concept of evidence for possible life on Mars and their logic in recommending that spacecraft cleanliness requirements be relaxed to access Special Regions "before it is too late." We find that there are shortcomings in their plans to look for evidence of life on Mars, that they do not support their contention that appropriate levels of spacecraft cleanliness are unaffordable, that there are major risks in assuming martian life could be identified by nucleic acid sequence comparison (especially if those sequences are obtained from a Special Region contaminated with Earth life), and that the authors do not justify their contention that exploration with dirty robots, now, is preferable to the possibility that later contamination will be spread by human exploration. We also note that the potential effects of contaminating resources and environments essential to future human occupants of Mars are both significant and not addressed by Fairén et al. (2017). Key Words: Mars-Special Region-Mission-Life detection-Planetary protection. Astrobiology 17, 971-974.

The astrobiology primer: an outline of general knowledge--version 1, 2006.

The Astrobiology Primer has been created as a reference tool for those who are interested in the interdisciplinary field of astrobiology. The field incorporates many diverse research endeavors, but it is our hope that this slim volume will present the reader with all he or she needs to know to become involved and to understand, at least at a fundamental level, the state of the art. Each section includes a brief overview of a topic and a short list of readable and important literature for those interested in deeper knowledge. Because of the great diversity of material, each section was written by a different author with a different expertise. Contributors, authors, and editors are listed at the beginning, along with a list of those chapters and sections for which they were responsible. We are deeply indebted to the NASA Astrobiology Institute (NAI), in particular to Estelle Dodson, David Morrison, Ed Goolish, Krisstina Wilmoth, and Rose Grymes for their continued enthusiasm and support. The Primer came about in large part because of NAI support for graduate student research, collaboration, and inclusion as well as direct funding. We have entitled the Primer version 1 in hope that it will be only the first in a series, whose future volumes will be produced every 3-5 years. This way we can insure that the Primer keeps up with the current state of research. We hope that it will be a great resource for anyone trying to stay abreast of an ever-changing field.

Paradoxical augmented relapse in alcohol-dependent rats during deep-brain stimulation in the nucleus accumbens.

Case reports indicate that deep-brain stimulation in the nucleus accumbens may be beneficial to alcohol-dependent patients. The lack of clinical trials and our limited knowledge of deep-brain stimulation call for translational experiments to validate these reports. To mimic the human situation, we used a chronic-continuous brain-stimulation paradigm targeting the nucleus accumbens and other brain sites in alcohol-dependent rats. To determine the network effects of deep-brain stimulation in alcohol-dependent rats, we combined electrical stimulation of the nucleus accumbens with functional magnetic resonance imaging (fMRI), and studied neurotransmitter levels in nucleus accumbens-stimulated versus sham-stimulated rats. Surprisingly, we report here that electrical stimulation of the nucleus accumbens led to augmented relapse behavior in alcohol-dependent rats. Our associated fMRI data revealed some activated areas, including the medial prefrontal cortex and caudate putamen. However, when we applied stimulation to these areas, relapse behavior was not affected, confirming that the nucleus accumbens is critical for generating this paradoxical effect. Neurochemical analysis of the major activated brain sites of the network revealed that the effect of stimulation may depend on accumbal dopamine levels. This was supported by the finding that brain-stimulation-treated rats exhibited augmented alcohol-induced dopamine release compared with sham-stimulated animals. Our data suggest that deep-brain stimulation in the nucleus accumbens enhances alcohol-liking probably via augmented dopamine release and can thereby promote relapse.

Absorption and metabolism of procaine by the rat small intestine.

The aim of this study was to obtain information about the absorption of procaine in the rat small intestine (Fisher-Parsons preparation). In the range from 0.25-10 mmol.l-1 procaine in the luminal perfusate, much more of the unchanged drug was absorbed in segments of the ileum than of the duodenum and jejunum. Besides procaine, two metabolites, p-aminobenzoic acid (PABA) and acetylated p-aminobenzoic acid (AABA), formed in the intestinal mucosa, appeared in the absorbate. With increasing substrate concentration in the perfusate the PABA in the absorbate increased considerably in all three segments; from 0.75 mmol.l-1 procaine upwards the PABA produced was highest in the jejunum. AABA formed in the mucosa and measured in the absorbate did not increase in the same manner with increasing substrate concentration; in the absorbate of jejunal segments the amount of AABA was significantly higher than in duodenal and ileal segments. Taking into account that in rats the microclimate of the ileum differs considerably from that of the upper part of the small intestine, the marked difference observed in the absorption of procaine between ileal segments on the one side, and duodenal and jejunal segments on the other, can be explained on the basis of the "non-ionic diffusion" theory.

Implementing planetary protection requirements for sample return missions.

NASA is committed to exploring space while avoiding the biological contamination of other solar system bodies and protecting the Earth against potential harm from materials returned from space. NASA's planetary protection program evaluates missions (with external advice from the US National Research Council and others) and imposes particular constraints on individual missions to achieve these objectives. In 1997 the National Research Council's Space Studies Board published the report, Mars Sample Return: Issues and Recommendations, which reported advice to NASA on Mars sample return missions, complementing their 1992 report, The Biological Contamination of Mars Issues and Recommendations. Meanwhile, NASA has requested a new Space Studies Board study to address sample returns from bodies other than Mars. This study recognizes the variety of worlds that have been opened up to NASA and its partners by small, relatively inexpensive, missions of the Discovery class, as well as the reshaping of our ideas about life in the solar system that have been occasioned by the Galileo spacecraft's discovery that an ocean under the ice on Jupiter's moon Europa might, indeed, exist. This paper will report on NASA's planned implementation of planetary protection provisions based on these recent National Research Council recommendations, and will suggest measures for incorporation in the planetary protection policy of COSPAR.

Development of life support requirements for long-term space flight.

When humans move out into the solar system to stay for long durations, the most immediate challenge will be the provision of a life-supporting environment in locations that are naturally devoid of food, air, and water. Life support systems must provide these commodities in all phases of space flight--during intravehicular activity (IVA) and during extra-vehicle activity (EVA). Systems that support human life must provide: overall reliability in the space environment, allowing maintenance and component replacement in space; reduced resupply mass of consumables and spares; for planetary surfaces, the ability to utilize local resources for increased self sufficiency; and the minimized mass power and volume requirements necessary for all space flight systems. This paper will discuss the melding of these technical requirements in such a way as to meet the human needs of space flight.

Planetary Protection Policy (U.S.A.).

Through existing treaty obligations of the United States, NASA is committed to exploring space while avoiding biological contamination of the planets, and to the protection of the Earth against harm from materials returned from space. Because of the similarities between Mars and Earth, plans for the exploration of Mars evoke discussions of these Planetary Protection issues. US Planetary Protection Policy will be focused on the preservation of these goals in an arena that will change with the growth of scientific knowledge about the martian environment. Early opportunities to gain the appropriate data will be used to guide later policy implementation. Because human presence on Mars will result in the end of Earth's separation from the martian environment, it is expected that precursor robotic missions will address critical planetary protection concerns before humans arrive.

Planetary protection policy overview and application to future missions.

The 1967 treaty on the peaceful uses of outer space reflected both concerns associated with the unknown nature of the space environment and the desire of the world scientific community to preserve the pristine nature of celestial objects until such times as they could be studied in an effective manner. Since 1967, NASA has issued policy directives that have adopted the guidelines of COSPAR for protecting the planets from contamination by Earth organisms and for protecting the Earth from the unknown. This paper presents the current status of planetary protection (quarantine) policy within NASA, and a prospectus on how planetary protection and back contamination issues might be addressed in relation to future missions envisioned for development by NASA either independently, or in cooperation with the space agencies of other nations.

Mass balances for a biological life support system simulation model.

Design decisions to aid the development of future space-based biological life support systems (BLSS) can be made with simulation models. Here we develop the biochemical stoichiometry for 1) protein, carbohydrate, fat, fiber, and lignin production in the edible and inedible parts of plants; 2) food consumption and production of organic solids in urine, feces, and wash water by the humans; and 3) operation of the waste processor. Flux values for all components are derived for a steady-state system with wheat as the sole food source. The large-scale dynamics of a materially-closed (BLSS) computer model is described in a companion paper. An extension of this methodology can explore multi-food systems and more complex biochemical dynamics while maintaining whole-system closure as a focus.

A modular BLSS simulation model.

The coordination of material flows in Earth's biosphere is largely made possible by the buffering effect of huge material reservoirs. Without similarly-sized buffers, a bioregenerative life support system (BLSS) for extraterrestrial use will be faced with coordination problems more acute than those in any ecosystem found on earth. A related problem is BLSS design is providing an interface between the various life-support processors, one that will allow for their coordination while still allowing for system expansion. Here we present a modular model of a BLSS that interfaces system processors only with the material storage reservoirs, allowing those reservoirs to act as the principal buffers in the system and thus minimizing difficulties with processor coordination. The modular nature of the model allows independent development of the detailed submodels that exist within the model framework. Using this model, BLSS dynamics were investigated under normal conditions and under various failure modes. Partial and complete failures of various components, such as the waste processor or the plants themselves, drive transient responses in the model system, allowing us to examine the effectiveness of the system reservoirs as buffers. The results from simulations of this sort will help to determine control strategies and BLSS design requirements. An evolved version of this model could be used as an interactive control aid in a future BLSS.

Long-term effects of microgravity and possible countermeasures.

It is well known that long-term exposure to microgravity causes a number of physiological and biochemical changes in humans; among the most significant are: 1) negative calcium balance resulting in the loss of bone; 2) atrophy of antigravity muscles; 3) fluid shifts and decreased plasma volume; and 4) cardiovascular deconditioning that leads to orthostatic intolerance. It is estimated that a mission to Mars may require up to 300 days in a microgravity environment; in the case of an aborted mission, the astronauts may have to remain in reduced gravity for up to three years. Although the Soviet Union has shown that exercise countermeasures appear to be adequate for exposures of up to one year in space, it is questionable whether astronauts could or should have to maintain such regimes for extremely prolonged missions. Therefore, the NASA Life Sciences Division has initiated a program designed to evaluate a number of methods for providing an artificial gravity environment.

A consensus approach to planetary protection requirements: recommendations for Mars lander missions.

Over the last several years, the nature of the surface conditions on the planet Mars, our knowledge of the growth capabilities of Earth organisms under extreme conditions, and future opportunities for Mars exploration have been under extensive review in the United States and elsewhere. As part of these examinations, in 1992 the US Space Studies Board made a series of recommendations to NASA on the requirements that should be implemented on future missions that will explore Mars. In particular, significant changes were recommended in the requirements for Mars landers, changes that significantly alleviated the burden of planetary protection implementation for these missions. In this paper we propose a resolution implementing this new set of recommendations, for adoption by COSPAR at its 30th meeting in Hamburg. We also discuss future directions and study areas for planetary protection, in light of changing plans for Mars exploration.

Transpiration during life cycle in controlled wheat growth.

We use a previously-developed model of wheat growth, which was designed for convenient incorporation into system-level models of advanced space life support systems. We apply the model to data from an experiment that grew wheat under controlled conditions and measured fresh biomass and cumulated transpiration as a function of time. We examine the adequacy of modeling the transpiration as proportional to the inedible biomass and an age factor, which varies during the life cycle. Results indicate that during the main phase of vegetative growth in the first half of the life cycle, the rate of transpiration per unit mass of inedible biomass is more than double the rate during the phase of grain development and maturation during latter half of the life cycle.

Development of countermeasures for medical problems encountered in space flight.

By the turn of this century, long-duration space missions, either in low Earth orbit or for got early planetary missions, will become commonplace. From the physiological standpoint, exposure to the weightless environment results in changes in body function, some of which are adaptive in nature and some of which can be life threatening. Important issues such as environmental health, radiation protection, physical deconditioning, and bone and muscle loss are of concern to life scientists and mission designers. Physical conditioning techniques such as exercise are not sufficient to protect future space travellers. A review of past experience with piloted missions has shown that gradual breakdown in bone and muscle tissue, together with fluid losses, despite a vigorous exercise regimen can ultimately lead to increased evidence of renal stones, musculoskeletal injuries, and bone fractures. Biological effects of radiation can, over long periods of time increase the risk of cancer development. Today, a vigorous program of study on the means to provide a complex exercise regimen to the antigravity muscles and skeleton is under study. Additional evaluation of artificial gravity as a mechanism to counteract bone and muscle deconditioning and cardiovascular asthenia is under study. New radiation methods are being developed. This paper will deal with the results of these studies.

Testing a Mars science outpost in the Antarctic dry valleys.

Field research conducted in the Antarctic has been providing insights about the nature of Mars in the science disciplines of exobiology and geology. Located in the McMurdo Dry Valleys of southern Victoria Land (160 degrees and 164 degrees E longitude and 76 degrees 30' and 78 degrees 30' S latitude), research outposts are inhabited by teams of 4-6 scientists. We propose that the design of these outposts be expanded to enable meaningful tests of many of the systems that will be needed for the successful conduct of exploration activities on Mars. Although there are some important differences between the environment in the Antarctic dry valleys and on Mars, the many similarities and particularly the field science activities, make the dry valleys a useful terrestrial analog to conditions on Mars. Three areas have been identified for testing at a small science outpost in the dry valleys; 1) studying human factors and physiology in an isolated environment; 2) testing emerging technologies (e.g., innovative power management systems, advanced life support facilities including partial bioregenerative life support systems for water recycling and food growth, telerobotics, etc.); and 3) conducting basic scientific research that will enhance our understanding of Mars while contributing to the planning for human exploration. We suggest that an important early result of a Mars habitat program will be the experience gained by interfacing humans and their supporting technology in a remote and stressful environment.

Superior oblique overaction in patients with true Brown's syndrome.

The charts of all patients with the diagnosis of congenital Brown's syndrome seen between July 1983 and June 1984 were examined retrospectively. In the past, overaction of the ipsilateral superior oblique (OAISO) was felt by most authors to be absent or minimal. Our study revealed that separate observers consistently documented the presence of an OAISO in about one-fifth of the selected patients. The presence of OAISO has not been emphasized previously and still remains controversial. We felt that an extremely tight superior oblique might cause an OAISO. We therefore statistically compared its presence to the presence of a downshoot. The presence of an OAISO to abnormal head tilt, abnormal chin position, amblyopia, and abnormal stereo was also compared statistically. Finally, we emphasize a technique of forced ductions that differentiates Brown's syndrome from an inferior oblique palsy, but which also alerts the examiner to the presence of an inferior rectus restriction or other posteriorly located restrictions.

Instrumented personal exercise during long-duration space flights.

This paper reports the results of instrumented personal exercise performed in flight by the Skylab 3 and Skylab 4 crewmen. These data include physiological responses to maximum aerobic exercise on a cycle ergometer at the conclusion of an 84-d exposure to zero-G (Sklyab 4). The bioinstrumentation provided continuous vectorcardiograph heart rate and cycle ergometer work level; minute updates of systolic and diastolic blood pressure, VO-2, V-CO-2, and VE. All Skylab 4 crewmen had higher V-O-2-max (cc/kg/min) at completion of the 84-d earth orbital mission than they had 4 d before launch. Two of these Skylab 4 crewmen, the scientist pilot and pilot, showed high levels of aerobic fitness with V-O-2-max of 54 and 51 cc/kg/min respectively at a heart rate of 185 beats/min and a workload of 286 w.