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2022 | Book

Engineering and Medicine in Extreme Environments


About this book

This book brings together in-depth information on a wide array of bio-engineering topics and their application to enhance human health, performance, comfort, and survival in extreme environments. Contributions from biomedical engineering, information systems, medicine and physiology, and medical engineering are presented in relation to a broad range of harsh and extreme environmental scenarios, including underwater, terrestrial (both natural and man-made), and space travel. Physicians, engineers, and scientists, as well as researchers and graduate students, will find the book to be an invaluable resource.Details effects of extreme environments on human physiology;Presents human-environment interaction in different scenarios;Overview of engineering challenges and problems in extreme environments.

Table of Contents



Chapter 1. The Physiological and Psychological Environment in Humans
It seems to be in the human nature to pursue the extreme while being exposed to extreme environments with sometimes little a priori knowledge about the prevailing conditions. Extreme environments, whether occurring naturally or artificially, are subject to extreme physical forces. These conditions are responsible for triggering specific physiological alterations in the human body to maintain physiological functionality and to ensure survival. The process of physiological maintenance and adaptation can be described from the perspective of homeostasis, allostasis as well as psychological resilience. Each of these terms are mechanisms that regulate a human’s physiology and psychology to enhance health, wellness, performance, and survival. Thus, this chapter explores the boundaries of human capabilities and introduces the fundamental concepts and underlying mechanisms of physiological and psychological responses to extreme environment exposure. These concepts apply uniformly to any kind of environmental stimuli and can be translated and specified for physiological and psychological system responses. Different application scenarios are further explored in the following chapters in the book.
Tobias Cibis, Carolyn McGregorAM
Chapter 2. Wearable Technology in Extreme Environments
Humans need to work in many types of extreme environments where there is a need to stay safe and even to improve performance. Examples include: medical providers treating infectious disease, people responding to other biological or chemical hazards, firefighters, astronauts, pilots, divers, and people working outdoors in extreme hot or cold temperatures. Wearable technology is ubiquitous in the consumer market but is still needed for extreme environments. For these applications, it is particularly challenging to meet requirements to be actionable, accurate, acceptable, integratable, and affordable. To provide insight into these needs and possible solutions and the technology trade-offs involved, several examples are provided. A physiological monitoring example is described for predicting and avoiding heat injury. A cognitive monitoring example is described for estimating cognitive workload, with broader applicability to a variety of conditions, such as cognitive fatigue and depression. Finally, eye tracking is considered as a promising wearable sensing modality with applications for both physiological and cognitive monitoring. Concluding thoughts are offered on the compelling need for wearable technology in the face of pandemics, wildfires, and climate change, but also for global projects that can uplift mankind, such as long-duration spaceflight and missions to Mars.
Brian A. Telfer, Thomas F. Quatieri, Hrishikesh M. Rao, Jeffrey S. Palmer
Chapter 3. Frameworks and Platforms for Extreme Environments Adaptation and Resilience Monitoring
Extreme environments cause physiological and psychological responses that need to be monitored to ensure the preservation of life and mental health in the moment and the prevention or minimization of long-term health and wellness ramifications. Many studies report the higher incidence of several health and mental health conditions within those who work and/or live within extreme environments be they extreme due to the climatic conditions, or extreme due to the nature of the work or sport. Creating engineering and information technology solutions to enable the assessment of the adaptation and resilience response is paramount to supporting the ongoing activities of the human race in extreme environments. This chapter provides an overview of sensing devices, computing systems and platforms along with the information systems frameworks within the context of extreme environments from a generic perspective. These concepts are further explored within the chapters of this book to provide further details for specific extreme natural environments such as space and diving along with extreme working environments such as tactical operations, firefighting and elite sport.
Carolyn McGregorAM, Tobias Cibis


Chapter 4. The Underwater World and Diving Physiology
Although considered relatively safe with modern technology, diving and underwater exploration went through perilous milestones from its practices in the early days. Today there are still a number of risks and health consequences associated with underwater exposure. Diving enforces a number of physiological alterations to the human body. Water clearly has different physical properties compared to the atmospheric conditions the human body is used to, and there are significant physiologic effects of both, pressure and immersion. In order to understand and subsequently investigate any physiological changes due to immersion, a fundamental knowledge of underwater physics is required. The physical laws governing the behaviour of gas under pressure are introduced. Nearly all physiological systems are subjected to changes due to the prevailing underwater physics. In this chapter, we discuss the physiology of immersion, high ambient pressure exposure, and exposure to individual gases. The physiology of immersion focuses on the effects of the diving reflex, respiratory implications and thermal considerations for a diver. While the physiology of high pressure exposure includes the effects of pressure on the volume of gas and air spaces in the human body, the physiology of exposure to individual gases has physiological and neurological consequences due to the narcotic and toxic effects of individual gases.
Michael Bennett AM, Tobias Cibis
Chapter 5. Decompression Modelling and Algorithm
Decompression illness and decompression sickness are pathologies mostly associated with diving incidents, which result from excessive bubble formation from dissolved gas. Great efforts are undertaken to perform research to understand the pathology and fundamental mechanisms, which result from the dynamic effects of compression and decompression. In this chapter, the clinical manifestation of decompression illness including the impact on different physiological systems is presented. Principles in physics, chemistry and biology are investigated that build the base to understand the mechanisms of decompression and bubble kinetics. These principles are then used to derive algorithms and concepts to calculate decompression schedules, which aim to safely step the diver back to the surface. Different approaches are dissected for their general ideas and implementation.
Tobias Cibis
Chapter 6. Biomedical Monitoring in Underwater Environments
The underwater world with its unique environmental conditions not only causes challenges to human physiology but also imposes strict limitations on the operability of sensing devices for biomedical signal collection. The measurement of physiological parameters underwater is gaining interest in order to improve diver’s safety and enable biomedical research. However, the emergent challenges for underwater monitoring technology require innovative concepts in sensing devices. This chapter presents the concepts and applications of multiple approaches to achieve electrophysiological monitoring in underwater settings. A focus will be on the challenges imposed by the underwater environment, a current-based sensing technology for electrophysiological signal sensing, and data science techniques for biomedical analysis and assessment.
Tobias Cibis, Stefan Gradl, Alistair McEwan


Chapter 7. Space as an Extreme Environment—Galactic Adventures: Exploring the Limits of Human Mind and Body, One Planet at a Time
Centuries of human evolution have led to the realization that “the Earth is a very small stage in a vast cosmic arena,” just like the human body continues to be an undiscovered reservoir of limits and possibilities. Over the years, terrestrial medicine has focused on diagnosis and treatment of various medical contingencies, and understanding the mechanisms and triggers of pathogenetic processes. However, it was not until the beginning of human space exploration that humankind was able to shed a light on the specifics of biological processes and the interplay of environmental, psychological and physiological factors. It enabled scientists and researchers to redefine the concept of health and what it truly meant in various terrestrial habitats and in the lower earth orbit. The beginning of space exploration has led to revolutionary discoveries about how the human body functions under the gravitational forces or lack thereof. This chapter will bring the reader on a journey of the brief history of space exploration. It will provide an overview of the effects of the spaceflight environment on human health and wellness, while discovering the incredible abilities of biological systems to adapt to and thrive under various extreme environmental conditions. This chapter will conclude with an overview of health monitoring in space and its various terrestrial applications.
Anastasiia Prysyazhnyuk, Carolyn McGregor AM
Chapter 8. Space as an Extreme Environment: Technical Considerations
Technological and scientific advancements continue to redefine the standards and capabilities of medical care both on Earth and in outer space. Over the last century, the biomedical monitoring has evolved from infantile, oversized equipment to sophisticated portable and wearable devices that have changed the way health monitoring is performed today. This chapter will serve as an introduction to the technological considerations of medical capacity aboard the International Space Station. It will introduce the structural components of the health system aboard the space station, while identifying the technologies that are used to support preventative, diagnostic, and therapeutic care for astronauts while on a mission. It will review the technical specifications that are necessary to acquire and utilize physiological data in a meaningful way. The chapter will conclude with future research directions aimed at enhancement of medical autonomy aboard the spacecraft, as human kind considers deep space exploration and missions of larger distance and duration, where communication with terrestrial control centers will be limited, if at all possible.
Anastasiia Prysyazhnyuk, Carolyn McGregorAM


Chapter 9. Paramilitary and Military Tactical Operations as an Extreme Environment
Tactical Operations is by nature an exposure to the most extreme violent grotesque of societies’ situational possibilities in the widest range of environmental conditions. Although maybe not outer space or the depth of the oceans the hazards are ever real and life threatening. The threat of harm comes from a variety of physical and psychological factors while the repercussion is, at a minimum, life altering. So much so that paramilitary and military personnel spend their careers in constant training. This field has recorded an ever increasing rate of stress, post-traumatic stress disorder (PTSD), and suicides. In this chapter we present a broad introduction to paramilitary and military tactical personnel as an extreme environment. Later in the book a further chapter details opportunities and challenges for engineering, computing and information technology solutions for use with paramilitary and military tactical personnel.
Brendan Bonnis, Carolyn McGregorAM
Chapter 10. Engineering and Information Technology for Paramilitary and Military Tactical Personnel
Paramilitary and military tactical personnel perform various activities utilizing a range of specialized skills. The activities they are required to perform, the load carriage of their ballistic personnel protective equipment and other operation equipment together with the stressors within the operations and the potential for injury death can cause in the moment as well as long-term implications for paramilitary and military tactical personnel. There is great potential to use engineering, computing and information technology to enable individualized and population-based assessment and development of health, wellness, resilience and adaption of paramilitary and military tactical personnel. In this chapter, we present opportunities and challenges for engineering, computing and information technology solutions for use with paramilitary and military tactical personnel.
Carolyn McGregor AM, Brendan Bonnis
Chapter 11. Ultrasound for the Emergency Department and Prehospital Care
Medical ultrasound is one of the most commonly used diagnostic imaging modalities in the practice of medicine. It is portable, low-cost, and capable of real-time image acquisition and visualization. Unlike computed tomography or x-ray, there is no ionizing radiation exposure associated with ultrasound, thus making it a safe imaging choice. Ultrasound has utility in many applications and is used across all levels of care, spanning from the point-of-injury and prehospital care to emergency departments and large medical facilities. Medical ultrasound is particularly well suited for extreme environments due to its portability, small form-factor, ease of use and versatility. In this chapter, we focus on the emergency department and prehospital care settings (including the battlefield), two unique extreme environments where life-threatening physiological complications are often encountered. We will discuss the important role of portable ultrasound in facilitating the diagnosis, triage, and intervention of the common medical conditions in these environments. We will also present the future outlook on how advances in artificial intelligence (AI) can potentially overcome the current limitations of ultrasound, increase the capability of automated assessment, and enable novice users.
Lars A. Gjesteby, Joseph R. Pare, Laura J. Brattain
Chapter 12. Firefighter Personnel and Their Activities in Extreme Environments
Firefighters are exposed to many dangerous and stressful situations when they are deployed to fight structural and wildland fires as well as rescuing victims from vehicular accidents, or other adverse events. When they are deployed, they can be exposed to physical danger as well as extreme heat and/or extreme cold due to fire and environmental conditions, thus making firefighting an extreme environment. This chapter provides an overview of the firefighter profession as an extreme environment including their clothing and equipment, the specific impacts on the human body, and the impact of biological sex and gender together with training and fitness approaches. This situational context information is important in order to understand this profession and the opportunities for engineering and information technology solutions for health, wellness, resilience, and adaption within this population.
F. Michael Williams-Bell, Carolyn McGregor AM
Chapter 13. The Extreme Environments of Elite Sports
This chapter discusses the main characteristics and challenges of the elite sports environment, derived impacts on the athlete’s body and mind, as well as implications of the training process. “Elite Sports” is a common but not well-defined phrase. In this chapter, we refer to the elite sports environment as “the top competitions in a sport (e.g., world championships/series, Olympic Games, etc.) and the training process with the purpose to compete/succeed in competition.” Main characteristics are the search for optimal, on point performance through constantly improving fitness for a specific context of top competition. This implies a high investment of energy and time over a long period. Elite sports competes globally and is in the focus of public attention. Therefore, elite sports is not just extreme in terms of extraordinary physical and mental demands imposed by the movement task but also in respect to the special social and more or less superficial environment in which it takes place. The main challenge of elite sports is to handle physical, psychological, and social stress in the right way. Utilizing it as the motor for the human adaptation capacity in the training process and promoter of optimal performance. High loads of biopsychological stress are needed to optimize fitness. The meaning of the concepts of resilience and antifragility is discussed. Foremost, it is important to balance the stress with sufficient recovery, as well as coping with and minimizing stressors, which are counteracting the adaptive process.
Dino Poimann, Holger Eckhardt, Tobias Cibis, Markus Wirth
Chapter 14. Extended Realities (XRs): How Immersive Technologies Influence Assessment and Training for Extreme Environments
XRs are said to be key drivers for the context-based interaction paradigm and hence will significantly change daily life communication. To efficiently use these technologies for different application areas, it is necessary to understand the underlying fundamentals and characteristics of XRs. This further requires to fully identify existing potentials and limitations. Within this work, the meaning of the term XR is explained by pointing out underlying principles, filtering relevant quality measures, and elaborating important characteristics of corresponding environments. These empirical findings are used to highlight current limitations and future challenges in the area of elite sports as an extreme environment. Furthermore, design considerations and implications are proposed for creating efficient immersive XRs in this area. Finally, a strategic vision for XR in elite sports is presented, by showing long-term potentials and suggesting a research agenda for the field.
Markus Wirth, Wolfgang Mehringer, Stefan Gradl, Bjoern M.Eskofier
Engineering and Medicine in Extreme Environments
Tobias Cibis
Dr. Carolyn McGregor AM
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