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- Abdin, A., et al.
(författare)
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Solutions for construction of a lunar base : A proposal to use the spacex starship as a permanent habitat
- 2021
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Ingår i: Proceedings of the International Astronautical Congress, IAC. - : International Astronautical Federation, IAF.
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Konferensbidrag (refereegranskat)abstract
- Returning to the Moon and establishing a permanent human presence is the next step in human space exploration. This necessitates the development of lunar infrastructure up to this task. This contribution presents a framework for rapid, cost-efficient, and supporting construction of a permanent and modular lunar base within the scope of what will be technically and legally feasible today. The proposed concept uses the SpaceX Starship Human Landing System as the foundation for a lunar base. The Starship will be placed horizontally on the lunar surface and transformed into a habitable volume. A workforce of modular rovers will aid astronauts in the construction process, and an array of countermeasures are presented to protect the astronauts from the effects of exposure to radiation, lunar dust, and extended hypogravity. Psychological and psychosocial factors are included to enhance individual well-being and crew dynamics. Physical and cognitive workloads are defined and evaluated to identify effective countermeasures, including specific spacesuit requirements. The proposed construction activities are to be organized as a multi-national public-private partnership to establish an international authority, a concept that has been successful on Earth but has yet to be applied to space activities on a multi-national level. A roadmap incorporating each part of the construction from human and technical perspectives is outlined. Other aspects that are critical to mission success include the cultural significance of the project, legal aspects, budget, financing, and potential future uses of the base. These solutions rely mainly on existing technologies and limited modifications to the lunar lander vehicle, making it a viable solution for the construction of a lunar base in the near future.
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| 2. |
- Abdin, A., et al.
(författare)
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Efficacy of ivabradine in heart failure patients with a high-risk profile (analysis from the SHIFT trial)
- 2023
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Ingår i: Esc Heart Failure. - 2055-5822. ; 10:5, s. 2895-2902
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Tidskriftsartikel (refereegranskat)abstract
- AimsEarly start and patient profile-oriented heart failure (HF) management has been recommended. In this post hoc analysis from the SHIFT trial, we analysed the treatment effects of ivabradine in HF patients with systolic blood pressure (SBP) < 110 mmHg, resting heart rate (RHR) & GE; 75 b.p.m., left ventricular ejection fraction (LVEF) & LE; 25%, New York Heart Association (NYHA) Class III/IV, and their combination. Methods and resultsThe SHIFT trial enrolled 6505 patients (LVEF & LE; 35% and RHR & GE; 70 b.p.m.), randomized to ivabradine or placebo on the background of guideline-defined standard care. Compared with placebo, ivabradine was associated with a similar relative risk reduction of the primary endpoint (cardiovascular death or HF hospitalization) in patients with SBP < 110 and & GE;110 mmHg [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.74-1.08 vs. HR 0.80, 95% CI 0.72-0.89, P interaction = 0.34], LVEF & LE; 25% and >25% (HR 0.85, 95% CI 0.72-1.01 vs. HR 0.80, 95% CI 0.71-0.90, P interaction = 0.53), and NYHA III-IV and II (HR 0.83, 95% CI 0.74-0.94 vs. HR 0.81, 95% CI 0.69-0.94, P interaction = 0.79). The effect was more pronounced in patients with RHR & GE; 75 compared with <75 (HR 0.76, 95% CI 0.68-0.85 vs. HR 0.97, 95% CI 0.81-0.1.16, P interaction = 0.02). When combining these profiling parameters, treatment with ivabradine was also associated with risk reductions comparable with patients with low-risk profiles for the primary endpoint (relative risk reduction 29%), cardiovascular death (11%), HF death (49%), and HF hospitalization (38%; all P values for interaction: 0.40). No safety concerns were observed between study groups. ConclusionsOur analysis shows that RHR reduction with ivabradine is effective and improves clinical outcomes in HF patients across various risk indicators such as low SBP, high RHR, low LVEF, and high NYHA class to a similar extent and without safety concern.
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| 5. |
- Bohm, M., et al.
(författare)
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Time to benefit of heart rate reduction with ivabradine in patients with heart failure and reduced ejection fraction
- 2023
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Ingår i: European Journal of Heart Failure. - 1388-9842. ; 25:8, s. 1429-1435
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Tidskriftsartikel (refereegranskat)abstract
- Aims In the SHIFT (Systolic Heart failure treatment with the I-f inhibitor ivabradine Trial, ISRCTN70429960) study, ivabradine reduced cardiovascular death or heart failure (HF) hospitalizations in patients with HF and reduced ejection fraction (HFrEF) in sinus rhythm and with a heart rate (HR) >= 70 bpm. In this study, we sought to determine the clinical significance of the time durations of HR reduction and the significant treatment effect on outcomes among patients with HFrEF. Methods and results The time to statistically significant reduction of the primary outcome (HF hospitalization and cardiovascular death) and its components, all-cause death, and HF death, were assessed in a post-hoc analysis of the SHIFT trial in the overall population (HR >= 70 bpm) and at HR >= 75 bpm, representing the approved label in many countries. Compared to placebo, the primary outcome and HF hospitalizations were significantly reduced at 102 days, while there was no effect on cardiovascular death, all-cause death, and HF death at HR >= 70 bpm. In the population with a baseline HR >= 75 bpm, a reduction of the primary outcome occurred after 67 days, HF hospitalization after 78 days, cardiovascular death after 169 days, death from HF after 157 days and all-cause death after 169 days. Conclusion Treatment with ivabradine should not be deferred in patients in sinus rhythm with a HR of >= 70 bpm to reduce the primary outcome and HF hospitalizations, in particular in patients with HR >= 75 bpm. At HR >= 75 bpm, the time to risk reduction was shorter for reduction of hospitalization and mortality outcomes in patients with HFrEF after initiation of guideline-directed medication, including beta-blockers at maximally tolerated doses.
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