Clinical Research Directory

Training Non-Anesthesia Personnel to Perform Nerve Blocks in Microgravity

Space exploration is rapidly progressing with multiple upcoming missions planned to the moon and International Space Station, and projected missions to Mars in the early 2030s. Multiple types of injuries and surgical emergencies are possible during space travel. With the rapidly increasing number of travelers, healthcare providers need to refine our plans for responding to surgical emergencies in space. It may not be possible to return injured crew members to earth for medical treatment depending on distance from earth and the severity of the injury. Furthermore, the casualty's physiologic changes in microgravity, and logistical limitations of repatriation make addressing medical emergencies challenging. Pain medications and general anesthesia have side effects that can impact safety in space and have worse side effect profiles when compared to on earth. Regional anesthesia, injecting local anesthetic near to a nerve(s) to create a large area of numbness on the body, has been used for many years for pain management and to allow for surgery in remote settings on earth. Military personnel have used these techniques to provide effective pain control for evacuating wounded soldiers, while maintaining their cognition. For these reasons, regional anesthesia (aka 'nerve block') has been promoted as a viable solution for injured astronauts. Our team has demonstrated that simple nerve blocks are possible in simulated microgravity among trained anesthesia providers. Recognizing that non-physician medical technicians may be integral to future space missions, this study aims to ascertain the feasibility of training such personnel to perform simple nerve blocks in microgravity.

Evaluation and Implementation of Digital Health Ecosystem in Academic Health Center

Mobile health technologies, such as smartwatches, wearable sensors, and digital applications, have the potential to support healthier lifestyles and improve the management of health conditions. These technologies can collect information on physical activity, sleep, heart rate, heart rate variability, respiratory rate, and other health indicators. However, integrating data from these devices into routine health care and electronic health records remains challenging, particularly in primary care settings and remote communities. The purpose of this study is to evaluate the implementation and feasibility of an integrated digital health ecosystem that combines wearable monitoring using smartwatches with a secure digital platform. The ecosystem is designed to collect, transmit, and display health information in a way that may support patients, health care providers, and researchers. Participants will use wearable technologies and complete questionnaires while health-related information is collected through the digital platform. The study will assess the usability, acceptability, interoperability, and feasibility of implementing this technology in real-world settings, including primary care clinics and remote communities. The study will also explore the potential use of wearable-derived physiological data to support the assessment, monitoring, and management of physiological and psychological stress. The knowledge gained from this study may help improve the integration of digital health technologies into routine care, support self-management and preventive health strategies, and facilitate access to health monitoring in underserved environments. Findings may also contribute to the development of digital health solutions for isolated and extreme environments, including future space exploration missions. This research aligns with priorities identified by the Canadian Space Agency to advance technologies that support safe, healthy, and productive human activities in remote and extreme environments on Earth and during future space missions beyond low Earth orbit.

Impact of Energy Density on Energy Intake During Bed Rest

Brief summary: This study is conducted in the context of a 60 days strict bed-rest study with 6° head-down-tilt (HDT) body position. Food intake can be challenging during bed-rest due to loss of appetite and constantly feeling full. The study aims to assess whether or not energy intake varies during a meal when the energy density of a meal is increased by the fat content. This experiment follows a crossover design with repeated measures within subjects. The order of experimental conditions is balanced among participants and sex, and the assignment of orders to participants is randomly. On each test day, participants are provided with breakfast, lunch, and dinner as usual. Across test days, the ED of breakfast (24 participants) or lunch (24 participants) is modified to two levels: the standard level and an increased level (+ 0.42 kcal/g compared to the standard). The meals are adjusted in energy density without noticeable changes in appearance or taste. These meals have identical ingredients, but the macronutrient proportions are modified. Entrées with increased fat content are prepared by incorporating neutral-tasting vegetable oil into the standard recipes. Participants receive their meals and are given the flexibility to eat ad libitum for 45 minutes. To comply with the strict bed rest rules, the next meal will be used for counterbalancing total energy intake over the day if necessary. In case of problems, a nutrient drink could be used to assure the requested total energy intake in order to maintain body weight.The experiments are conducted during 4 campaigns, each campaign consisting of 12 participants.