Author: Dr. Paul ZilbermanMedical Doctor, Anaesthetist, Hadassah Medical Center Jerusalem, Israel
Space is very different, in many aspects. This post does not attempt to address the many changes the human body experiences in space, such as volume modifications in body compartments, fluid shifts, structural configuration in receptor* morphology and, as a consequence, possible variations in pharmacology response, etc. * For the lay reader, a receptor is a special structure on the surface of a cell, for example, that functions as a "receiving point" on which a chemical substance acts in a unique way (like a key – lock mechanism) and a specific reaction is generated (like a muscle contraction) or inhibited (like a cork closing a bottle and blocking the passage of a fluid). These complex structural changes modify many biological reactions, as well as the body’s response to medications. Rather, this post presents some of the technical challenges that an anaesthesiologist may encounter in space. Confined space. On Earth gravity keeps everyone’s feet on the ground. Different pieces of equipment can be repositioned depending on the procedure, machinery can be brought in as needed (XRay scans in orthopaedics, for instance), electric cables can be switched to other convenient wall sockets etc. In a fixed volume space capsule, you don’t have all these possibilities. Everything is measured for maximum volume efficiency. Taking into consideration that anything can and will float if not properly anchored, we can imagine what an “anaesthesia dance” could happen! What equipment? On Earth an anaesthesia workstation is always present in the OR. Depending on its complexity its volume can vary between a medium size fridge to a large double-doored one, just put on its side. You don’t have this amount of deposit in a space cabin, but let’s suppose for one moment that you do - you then need an Anaesthesia Gas Scavenging System (AGSS), which removes the anaesthesia gases that have leaked out or at the end of the procedure. On Earth, these gases are expelled into the atmosphere (there is a lot to talk about this and the greenhouse effects too) and the air currents around any medical facility carry them away. In space you don’t have this. Any gas must be expelled using energy, an active process. Otherwise, the whole cabin will become a big anaesthesia machine with all crew members affected. And, speaking of energy, an anaesthesia workstation is also powered by electricity, which is a limited resource in space, depending on the surface of the solar (or light in general) panels. This energy must be stored and used for other life maintenance systems as well, of which a critical example is the Sabatier reactor that provides oxygen. Regional anaesthesia The simplicity and portability of the necessary equipment makes this type of anesthesia attractive. For peripheral neural blocks all you need is a simple ultrasound machine and dedicated needles. The potential drawbacks are that the technique/s need to be taught on Earth but their “transposition” to space is a bit problematic. If the spinal/epidural anaesthesia is relatively simple to learn, the USG (ultrasound guided) blocks are more challenging. Furthermore, the bodily fluid shift due to the lack of gravity causes many tissues to change their tridimensional appearance, leading to increased difficulty in performing the block.
The cardiovascular responses that accompany spinal/epidural anaesthesia on Earth, in terms of heart rate and blood pressure, are different in space. There may be a lack of reactivity so a certain reduction in blood pressure, for example, might not be compensated. We need to remember that the hostile environment in space, especially radiation, affects not only the human body, but also many sensitive electronic components of medical equipment, leading to possible dysfunction. Monitors can potentially de-calibrate and all the information you receive may become inaccurate. Fluids Preparing and administering a fluid on Earth is routine, however, the lack of gravitation in space poses other challenges: air and fluids do not mix. It is called “lack of buoyancy”. Unless we use special equipment to separate fluids from air nothing can be delivered to the patient. This statement is true also for the anaesthesia vaporiser (a special closed recipient that contains the anaesthesia substance); not only can you not simply fill it the way it would be done on Earth, but even if you could, the anaesthesia liquid that becomes vapour cannot separate from the fluid from which it originates. It just cannot exit the vaporiser. Below is a small example of how liquids behave in space and what happens when a liquid exits a recipient: The same is true for another type of anaesthesia, called TIVA = Total Intra Venous Anaesthesia. This technique uses a dedicated syringe pump that pushes different anaesthesia substances through an intra venous line. It’s a useful technique both in terms of volume and energy expenditure, but again we face the same problems: how to fill the syringe without air bubbles and how to protect the electronics of the syringe pump (in fact a computer in all respects) from the deleterious influences of space radiation!
As you can see, space medicine is a very important topic and many people dream of its future use. Yet, we still have a long way to go! With the advent of intermediary space “stops” and the continuous development of new technologies, every challenge will be solved, sooner or later. Author: Dr. Yohana David Laiser, MD Medical Doctor | Space Exploration Enthusiast | Aspiring Public Health Specialist  The government of Tanzania has set itself a goal to venture into space exploration by launching its first ever Communication Satellite, scheduled for the end of 2023 following similar endeavors by other countries in the region. This daring spirit shown by the government is also reflected by a rising number of space-related activities, establishment of privately owned companies venturing into space exploration, and a germinating stalk of space ecosystem in Tanzania, most notably in the country’s commercial city of Dar es Salaam.
One of record-breaking events to ever happen in Tanzania is the NASA International Space Apps Challenge, which is the largest global hackathon organised by the National Aeronautics and Space Administration (NASA) in the United States of America and partner organisations from all over the world, such as ESA, CSA, JAXA, ISRO and many more. Author: InnovaSpace TeamWorking towards a globally inclusive and diverse network of space professionals, researchers, entrepreneurs, students & enthusiasts - Space Without Borders  Time to catch-up with our colleague from the east, Chris Yuan, who very enthusiastically and capably established the Ursa Minor project in China, under the umbrella of the Planetary Expedition Commander Academy (PECA). It involves the development of new technologies and innovative training courses to encourage and inspire a future generation of space science researchers and astronauts. As previously reported in 2022, Chris and his students learned how to perform the Evetts-Russomano CPR technique underwater on a manikin while diving, as the water simulates the weightlessness that is present in microgravity. This practice now forms part of a larger course, the Ursa Minor Interstellar Expedition Program, giving the opportunity for 12- to 18-year-olds to participate in an underwater space science training camp.
Author: Tobias LeachMedical Student, University of Bristol | iBSc Physiology at King’s College London  The first edition of the InnovaSpace Journal Club was dedicated to a prospective cohort study on jugular venous flow in astronauts aboard the ISS. From this study, the issue of jugular vein thrombus formation arose, which led to some fascinating discussion on how we could possibly manage and mitigate this novel risk to astronaut health. Therefore, I thought it appropriate to use the second edition of the InnovaSpace journal club to cover the issue of bleeding in space. Major Haemorrhage in space – How can it arise? How can it be managed? Should we worry about it?  PAPER PRESENTED & DISCUSSED:  We used a 2019 literature review which evaluated different haemostatic techniques in remote environments and proposed a major haemorrhage protocol for a Mars mission.
The article itself stressed that while the estimated risk for major haemorrhage on a Mars mission was not very high, there were still many possible causes for a big bleed such as trauma and high dose radiation. Additionally, the changes to circulatory physiology observed in microgravity may mean astronauts are less able to cope with even small amounts of blood loss. While the literature search itself left a lot to be desired as only 3 of the 27 papers were randomised controlled trials (RCTs), the results were interesting. Cosmic Conundrum: Unexplained Discovery at Interstellar Meteor Crash Site Sparks Scientific Intrigue18/8/2023
Author: Swapnil K Singh FRSA, IndiaUndergraduate: Astronomy Research & Mechanical Engineering - Astrophysicist of the future! In an extraordinary scientific expedition, researchers embarked on a quest to investigate remnants of the first recognised interstellar meteor, IM1. As they explored the crash site, an astonishing revelation emerged, challenging our understanding of cosmic phenomena and hinting at the possibility of extraterrestrial technology. During their initial examination of the crash site, the team encountered a considerable amount of volcanic dust particles on their magnetic sled. These tiny particles, measuring less than a tenth of a millimetre, were diligently removed from the sled's magnets using a painter's brush. However, it was the presence of a peculiar wire, labelled IS1–2, that truly astonished the researchers. Despite being dragged through the ocean water by the ship Silver Star, the wire remained firmly attached to one of the magnets. The scientists proposed that the volcanic magnetic particles acted as a magnet, effectively holding the wire in place against the force of the ocean current.  An elongated non-magnetic wire from IM1’s site, discovered in the late evening of June 15, 2023 on top of one of the neodymium magnets. Source: https://medium.com/@avi-loeb Driven by curiosity, Ryan Weed and Jeff Wynn conducted an in-depth analysis of the wire's composition. Using an X-ray fluorescence analyser manufactured by Bruker, they compared its composition to known human-made alloys. The results revealed significant peaks in manganese (Mn) and platinum (Pt) on the periodic table. Further investigation unveiled that the wire was composed of a manganese-platinum alloy (MnPt). However, the relative abundance of manganese and platinum in IS1–2 diverged significantly from the composition of MnPt alloys typically used in laboratory non-corroding electrodes. This perplexing deviation suggested the possibility of an origin beyond our world.
Author: Tomas DucaiBiology (microbiology/genetics) graduate, University of Vienna - Space (medicine) enthusiast  "For most people, this is as close to being an astronaut, as you’ll ever get. It’s leaving planet Earth behind and entering an alien world.“ - Mary Frances Emmons - Editor-in-chief Scuba Diving, Sport Diver & The Undersea Journal magazines Mary Frances Emmons puts into words the indescribable atmosphere of scuba diving in which the boundaries become blurred between Earth and the sky above, or at least, to be more precise, the depths of space. It is this mixture of feelings that I want to experience – diving into the element of water, which is essential for life and where physical disabilities may not matter. I have been active in the world of space exploration for over a year now and am truly interested in promoting inclusion in the space sciences and analog space missions. I have been lucky enough to meet a lot of respected people and professionals doing amazing work with great passion in their respective fields, and they have also been keen to help and support me to realize my dreams A particular person who has shaped my dreams in concrete terms is Slovakia’s one and only aquanaut (underwater analog astronaut) and Chief Scientific Officer of the Hydronaut Project (unique underwater lab serving as a research facility for survival training in limited/extreme environments) - Miroslav Rozložník. Miro is an experienced scuba-dive instructor, who I met in Prague at an international analog astronaut community event. He offered to help me experience the unique underwater atmosphere through introducing me to the world of scuba-diving, a truly cherished offer that I gratefully accepted! At the same time, I knew that having a basic introduction to scuba diving may also enhance my chances of being selected as one of the three analog parastronauts for upcoming analog missions at the LunAres analog research station in Poland, especially if underwater mission experiments are being considered. Author: Dr Dolly DaouInternational expert in design business innovation and strategies - International experience in design pedagogy/research, leading philanthropic associations and higher education programs and community projects in Australia, Asia, Europe and in the Middle East. (Visit: https://dollydaou.org/) I was inspired to write this blog in response to a post I saw on social media, where during an interview, one of the attendants asked: Who invented gravity and why do we need it? To the best of the attendant’s knowledge gravity was invented by Isaac Newton. These simple yet complex questions demonstrate the fragility of our knowledge and appreciation of gravity and reveal the inter-connection of these questions to each other. To be clear the reflections on gravity in this blog are not scientific, rather I am exploring the significance of gravity in our everyday as a design researcher. Throughout history the chain reaction of scientific explorations by Aristotle, to Bruno, Galileo, Kepler, Newton, much later Einstein, and then Hawking led to the discovery and adaptation of the theory of gravity. Although Newton could not explain the origin of gravity he did adapt Johannes Kepler’s law of gravitational theory, invented calculus and gave this force its name: gravity. Through this exploration, I open the scope of discussion for other disciplines to examine the power of this invisible force in our universe. Through interior and food design I demonstrate how gravity controls our daily lives from lifting an ordinary object to launching a rocket into space or designing a sustainable food system. We rely on gravitational forces of the planets during our interaction with our environment, especially in the food system gravity plays an integral part in the production, distribution, manufacturing and consumption of food. The images below of the Chinese mountains and Australian ocean show how the food system on our planet Earth is connected through a force that holds everything together called: gravity.  If we understand gravity, we understand the story of creation of the universe, that grounds the human existence and conditions our neurology and physiology. We under-estimated the value of gravity in our everyday, which usually goes un-noticed. The complexity of questioning the origin and benefits of gravity lies in the simplicity of these questions; in the presumption that we should all know the answers. These questions are especially relevant now during our current exploration to the extra-terrestrial inhabitation with lower or zero-gravity environments, which reveal the significance of gravity as a un-negotiable part of our everyday life.  Author: Prof K GanapathyDirector Apollo Telemedicine Networking Foundation, Apollo Tele Health Services | Distinguished Visiting Professor IIT Kanpur | Distinguished Professor The Tamilnadu Dr MGR Medical University | Emeritus Professor National Academy of Medical Sciences  5G is the fifth generation of wireless communication technology, promising faster data transfer speeds, lower latency (round trip latency >10 milliseconds), increased network capacity (1 million devices per sq km), 99.999% network reliability and battery life of up to 10 years for IoT devices. There is considerable hype in the media that deployment of 5G will revolutionize healthcare by enabling new medical applications and improving existing ones. Using Edge computing, 5G Data can be processed closer to where it is generated. IoMT (Internet of Medical Things) devices generate huge amounts of data. Cloud computing can provide the necessary infrastructure to process and analyze this data. Faster transmission of data will enable more efficient storage in the cloud. Accessing more bandwidth and computing resources, and providing infrastructure to enable scalability will now be less problematic. No doubt clarity of images transmitted will be better and the immersive experience in video conferencing will be an all-time high. Mammograms, CT, MRI, and ultrasound images generate large amounts of data. High-speed transfer and processing will save a few minutes. Onboard cameras, camera-based Headgear, and ‘Body Cams’ for paramedics can transmit patient data to hospitals in real-time using ultra-fast and low-latency 5G connected ambulances, with medical equipment, patient monitoring applications and telemetry devices that ensure excellent pre-hospital management. 5G can facilitate real-time control of medical robots, enabling precise and safe interventions in performing complex procedures. 5G enables faster and more efficient data transfer, facilitating clinical trials and drug development, as these require the collection of large amounts of data from multiple sources.  World’s first remote brain surgery using 5G | Original Images: New China TV Author: Lukasz WilczynskiCo-founder European Space Foundation | Originator of the European Rover Challenge project. Experienced dot-connector and communication consultant specialising in technology and innovation.
This interview first featured on the European Space Foundation website
Author: Dr. Paul ZilbermanMedical Doctor, Anaesthetist, Hadassah Medical Center Jerusalem, Israel This article addresses the notion of buoyancy and why drinking beer in space (the ISS usually orbits in the thermosphere), or any carbonated drink for that matter, does not produce the known tingling sensation we can feel in our noses here on Earth. So let’s first briefly consider what is buoyancy? In simple terms, whenever an object is put into a fluid there are several forces that act upon it. The liquid exerts a force from the bottom upwards that tries to push that object up. Then there is the liquid force itself, let’s call it weight, that pushes an object downwards. However, because the liquid pressure increases the deeper you go down into the fluid, there will always be an upwards force bigger than the downward force. This can be explained by looking at the formula for hydrostatic pressure: Hydrostatic pressure = pgh In this formula, p is the density of the liquid, g is the gravitational force (9.81 m/s2) and h is the height of the fluid column measured from the surface. Keeping all the other parameters of the formula constant, the "h" at the bottom of a submerged object will be higher than the one at its top. But we also have here another component: the "g". Well, there is practically no "g" in space, unless we artificially produce it. So, in this case, all the objects inserted or included into a fluid will just stay there. Of course, there are many other factors that play a role here, for example the superficial tension of the fluids etc., however, for the sake of simplicity I am considering here only the buoyancy. So, nothing happens with the CO2 bubbles inside the fluid because they are no lighter than the fluid that surrounds them, perhaps looking something like in this photo:  Image credit: NASA, Public domain This not mixing between the fluid and gases within creates a hard enough life for anyone who would like to enjoy a beer in space (hypothetically, at least as alcohol consumption is not permitted on the ISS), but let's also not forget the cabin temperature of roughly 20 degrees Celsius, which is way too high to enjoy an ice cold beer. If you want to cool it a bit forget leaving it outside too - just take a look at what the temperatures are "outside", unless of course you want to lick your beer like an ice-cream!
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