- NASA’s moon program mobile launcher rolls back to the launch pad for testing – Spaceflight Now Spaceflight Now
- Mobile Launcher Rolls to Launch Pad for Artemis ll Testing – Artemis NASA Blogs
- Lockheed Martin, NASA working around the clock to finish Artemis II Orion assembly and hold 2024 launch date – NASASpaceFlight.com NASASpaceflight.com
- NASA’s mobile launcher rolls to launch pad for Artemis II testing WKMG News 6 & ClickOrlando
- NASA Is Designing a Larger CubeSat Adapter for the SLS Rocket ExtremeTech
- View Full Coverage on Google News
Tag Archives: pad
Elden Ring Streamer MissMikkaa Simultaneously Defeated Two Malenias With a Dance Pad and a Controller
As if beating Malenia – arguably Elden Ring’s hardest boss – wasn’t a feat enough in itself, Twitch streamer MissMikkaa just beat two Malenias at one time with a controller and a dance pad.
MissMikkaa accomplished this astonishing feat during an “Ultimate Challenge Run,” where she tasked herself with playing “two Elden Rings games simultaneously with different controllers (Dance Pad & PS5 DualSense).” She also had to kill the “bosses on the same try on both game instances.”
You can see a clip of the victory below, and you can click here for the full battle.
2x MALENIA HAS BEEN DEFEATED! After 3 days and 199 tries Malenia is dead in the Ultimate Challenge Run where I play Elden Ring twice simultaneously (with a dance pad & controller). In the beginning I was not even sure if this run was possible. Radagon/Elden Beast is next! pic.twitter.com/cS9VQLvrlE
— MissMikkaa (@MissMikkaa) January 5, 2023
It took her three days and 199 tries, but she prevailed in the end. She plans on taking down Radagon/Elden Beast next, and who knows what other challenges she will come up with in the future.
We spoke to MissMikkaa in November 2022 and she walked us through how she beat Elden Ring entirely with a dance pad, and this was even after she beat Malenia at level 1 with the same dance pad.
Malenia has been one of the toughest challenges in recent memory in the world of video games, and the difficulty of her battle inspired the rise of, alongside MissMikkaa and others, one of Elden Ring’s most legendary players, Let Me Solo Her. This player would appear in players’ games to take down Malenia single-handedly, and we also talked to them about how they became a hero to all.
For more in the world of Elden Ring, check out our chat GinoMachino, the player who beat every single boss without taking a single hit and why we picked Elden Ring as our Game of the year in 2022.
Have a tip for us? Want to discuss a possible story? Please send an email to newstips@ign.com.
Adam Bankhurst is a news writer for IGN. You can follow him on Twitter @AdamBankhurst and on Twitch.
NASA Downplays Launch Pad Damage Caused by SLS Rocket
A scorched platform, fried cameras, broken pipes, and a busted elevator are among the casualties of last week’s launch of NASA’s SLS rocket. Mobile Launcher 1 and Launch Complex 39B at Kennedy Space Center will require repairs, but NASA says they’ll be ready for the next Artemis mission.
Space Launch System, or SLS, blasted off during the early hours of Wednesday, November 16, sending the Orion capsule on a 25.5-day journey to the Moon and back. It was a picture-perfect launch, and NASA has said as much. Preliminary data from the Artemis 1 flight indicates that SLS performed as well as or even exceeded expectations, Mike Sarafin, Artemis 1 mission manager, told reporters yesterday.
SLS’s performance deviations were less than 0.3% across the board, and the rocket missed NASA’s target orbital insertion by just 3 nautical miles, according to Sarafin. He reminded reporters that SLS exerted 8.8 million pounds of thrust at liftoff, and the fact that SLS deviated by 7 feet each second is still “remarkable” in terms of precision. “The results were eye-watering,” he added.
Photojournalists at Kennedy Space Center have been told to not take photos of Launch Complex 39B for security reasons (i.e., ITAR restrictions; NASA says photos of the now-exposed umbilical plates would represent a security violation), and possibly because NASA doesn’t want to promote the fact that its launch tower was damaged.
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During a press briefing on Friday, Sarafin admitted that the mobile launch tower did incur some damage as a result of the launch, which produced temperatures in excess of 3,000 degrees Fahrenheit. “We expected to find damage at the pad, and we are finding damage at the pad,” Sarafin said.
At a press briefing held yesterday, the mission management team offered further details and some visuals that detailed the scope of the damage. In addition to new scorch marks on the tower and missing paint on its deck, a number of pad cameras got burned, and some nitrogen and helium supply lines incurred minor damage. Sarafin said blast doors on the tower’s elevators were torn away by the rocket’s shock wave, so “right now the elevators are inoperable and we need to get those back into service.” All said, the damage “that we did see pertains to really, just a couple of areas,” he said, adding that SLS is largely a “very clean system.”
At the same time, the deluge system “did a great job” and the tail mast service umbilicals were “clean inside,” Sarafin explained. He added that repairs are required, but he’s confident everything will be ready for the crewed Artemis 2 mission in 2024. That might seem like plenty of time, but stacking operations for the sequel mission will likely need to start next year.
The mission management team seemed largely unfazed, and it’s entirely possible that the damage is indeed minimal or at least manageable. It might also be true that NASA is doing its best to downplay any damage induced by its new pride-and-joy. Opinions posted to Twitter varied, with some saying the damage is much worse than NASA is willing to admit, with others saying the damage isn’t a big deal and it’s all part of the engineering process. Indeed, surprises should be expected when launching the world’s most powerful rocket, but if the damage is worse than NASA is leading us to believe, then they should admit it.
Back at the lunar ranch, the uncrewed Orion capsule continues to do its thing. The spacecraft performed a close flyby of the Moon yesterday as it steadily works its way into a distant retrograde orbit around the Moon. Orion will conclude its 25.5-day mission on December 11, when it attempts an atmospheric reentry at Earth and a splashdown in the Pacific Ocean. Artemis 1 is the first of what NASA hopes will be a series of missions to establish a permanent human presence in the lunar environment.
More: What’s Next for the Orion Spacecraft as It Cruises Toward the Moon
NASA Launch Pad Sustained Significant Damage During Artemis Takeoff
“Elevator blast doors were blown right off…”
Damages
It appears that NASA’s Artemis 1 rocket launch pad caught way more damage than expected when it finally took off from Kennedy Space Center last week.
As Reuters space reporter Joey Roulette tweeted, a source within the agency said that damage to the launchpad “exceeded mission management’s expectations,” and per his description, it sounds fairly severe.
“Elevator blast doors were blown right off, various pipes were broken, some large sheets of metal left laying around,” the Reuters reporter noted in response to SpaceNews‘ Jeff Foust, who on Friday summarized a NASA statement conceding that the launchpad’s elevators weren’t working because a “pressure wave” blew off the blast doors.
Trickle Down
The Artemis 1 launch was preceded by a years-long trickle of drama, ranging from the long-delayed development of the Space Launch System that boosted it into space to the craft suffering damage from a hurricane just prior to launch.
Shortly after the launch, NASA acknowledged that debris was seen falling off the rocket, though officials maintain that it caused “no additional risk” to the mission.
In spite of those sanguine claims, however, reporters revealed that NASA seemed very intent on them not photographing the Artemis launch tower — and now, with these preliminary reports about how messed up it seems to have gotten, we may know why.
We don’t yet know how extensive the launch tower damage is, though we have reached out to NASA for comment about it. Luckily, it wasn’t bad enough to preclude the Orion capsule from being successfully launched into space and to begin taking selfies and photos of the Moon, at very least.
The real question? How any of this will affect future launches of the SLS, which is supposed to send American astronauts back to the Moon in just a few years.
More on NASA: NASA Adjusting James Webb Orbit to Get Damaged by Meteorites Less
Watch NASA roll Artemis 1 moon rocket to launch pad early Friday
Update for Nov. 4: See views of NASA’s Artemis 1 moon rocket as it returns to the launch pad 39B at the Kennedy Space Center for a Nov. 14 launch. This video stream comes from Spaceflight Now (opens in new tab).
NASA’s Artemis 1 moon rocket will head back to the launch pad once again early Friday morning (Nov. 4), and you’ll be able to watch the slow-moving action live.
The Artemis 1 stack — a huge Space Launch System (SLS) rocket topped with an Orion spacecraft — is scheduled to roll out from the Vehicle Assembly Building (VAB) at NASA’s Kennedy Space Center (KSC) in Florida at 12:01 a.m. EDT (0401 GMT) on Friday.
Artemis 1 will head toward KSC’s Pad 39B, the jumping-off point for the mission, which is targeting a launch on Nov. 14. The 4-mile (6.4 kilometers) trek, made atop NASA’s giant crawler transporter-2 vehicle, is expected to take about 10 hours.
NASA will livestream at least some of this long journey, if past Artemis 1 rollouts are any guide. Space.com will air that webcast, courtesy of the space agency.
Related: NASA’s Artemis 1 moon mission: Live updates
More: NASA’s Artemis 1 moon mission explained in photos
This will be Artemis 1’s fourth trip from the VAB to Pad 39A. The rocket made the trek in both March and June to conduct prelaunch fueling tests, then went back out again in mid-August for an attempted liftoff.
Glitches foiled planned launch tries in late August and early September, and NASA then returned Artemis 1 to the VAB in late September to shelter from Hurricane Ian.
Mission team members have used this latest stint in the VAB to perform some minor repair and maintenance work, along with a series to tests to ensure that Artemis 1 is ready to fly.
Artemis 1 is the first mission in NASA’s Artemis program, which aims to establish a permanent, sustainable human presence on and around the moon by the late 2020s.
Artemis 1 will be the first flight for the SLS and the second for Orion. It will send the uncrewed capsule on a roughly monthlong shakeout cruise to lunar orbit and back. If all goes well, Artemis 2 will launch astronauts around the moon in 2024 or so, and Artemis 3 will put boots down near the lunar south pole a year or two later.
Mike Wall is the author of “Out There (opens in new tab)” (Grand Central Publishing, 2018; illustrated by Karl Tate), a book about the search for alien life. Follow him on Twitter @michaeldwall (opens in new tab). Follow us on Twitter @Spacedotcom (opens in new tab) or on Facebook (opens in new tab).
Falcon Heavy rocket on the launch pad for one of SpaceX’s most complex missions – Spaceflight Now
The first Falcon Heavy rocket flight since 2019 is scheduled Tuesday to kick off SpaceX’s longest-duration launch mission to date, a roughly six-hour climb into geosynchronous orbit more than 20,000 miles over the equator with a bundle of payloads for the U.S. Space Force. The powerful rocket’s two reusable side boosters will return to Cape Canaveral for landing.
The mission’s high-altitude target orbit means the Falcon Heavy’s upper stage will need to coast for some six hours through the Van Allen radiation belts before reigniting its engine and deploying the Space Force’s satellites.
The long-duration mission required SpaceX to make some changes to the Falcon Heavy rocket. The most visible modification is the addition of gray paint on the outside of the upper stage’s kerosene fuel tank, which will help ensure the fuel does not freeze as the rocket spends hours in the cold environment of space.
The launch, which the Space Force has designated USSF-44, will mark the fourth flight of SpaceX’s Falcon Heavy, the most powerful rocket currently flying. But it is the first Falcon Heavy mission since June 25, 2019, following a series of delays encountered by SpaceX’s customers.
The USSF-44 mission has been delayed about two years from the original schedule of late 2020. The Space Force blamed the delay on satellite-related problems.
The launch will be the first fully operational national security mission to fly on SpaceX’s heavy-lifter. The Falcon Heavy’s most recent launch in June 2019 carried 24 experimental satellites for the military and NASA on the Space Test Program-2, or STP-2, mission. The STP-2 mission was billed as a demonstration flight of the rocket before future launches with more critical national security payloads.
“We’ve worked side-by-side with SpaceX to ensure the Falcon Heavy meets all our requirements and has a successful launch,” said Walt Lauderdale, the Space Force’s mission director for the USSF-44 launch. “This will be the first Falcon Heavy launch in over three years and we’re excited to get these payloads to space. This launch is an important milestone and continues a robust partnership that is cementing a capability that will serve the nation for years to come.”
“This launch culminates years of effort by a dedicated team comprised of mission-focused people from across the U.S. Space Force and SpaceX. The Falcon Heavy is an important element of our overall lift capability, and we’re very excited to be ready for launch,” said Brig. Gen. Stephen Purdy, the Space Force’s program executive officer for assured access to space.
The Space Force has released little information about the satellites launching on the Falcon Heavy rocket.
There are two payloads stacked on top of the other inside the Falcon Heavy’s nose cone. One is called the Shepherd Demonstration, and the other is the Space Force’s second Long Duration Propulsive ESPA, or LDPE 2, spacecraft, itself hosting six payloads — three that will remain attached to the spacecraft and three that will deploy from LPDE 2 to perform their own missions.
The fully assembled Falcon Heavy rocket rolled out to Launch Complex 39A at NASA’s Kennedy Space Center on Monday afternoon, riding a transporter the quarter-mile distance from the hangar to the launch pad. SpaceX teams planned to raise the Falcon Heavy vertical on pad 39A overnight in preparation for liftoff Tuesday during a 30-minute window opening at 9:41 a.m. EDT (1341 GMT).
Forecasters predict a 90% chance of good weather for launch Tuesday, with light winds and scattered clouds predicted. “The primary weather concern will be a rogue Atlantic shower or enhanced cumulus brushing the coast,” the Space Force’s 45th Weather Squadron wrote in an outlook issued Monday.
After receiving its supply if kerosene and liquid oxygen propellants, the Falcon Heavy’s three first stage boosters fire their 27 main engines and throttle up to produce 5.1 million pounds of thrust, around twice the power of any other operational rocket in the world. The rocket will head due east from the launch site, arcing over the Atlantic Ocean before shedding its two side-mounted boosters two-and-a-half minutes into the flight.
The side boosters will pulse their cold gas thrusters and reignite three engines each to reverse course and begin returning to Cape Canaveral Space Force Station for landing at SpaceX’s two recovery zones about 9 miles (15 kilometers) south of pad 39A. The boosters will aim for near-simultaneous vertical landings less than 10 minutes after liftoff.
The core stage, which will throttle back its engines for the first phase of the flight, will fire longer before jettisoning to fall into the Atlantic. It will not be recovered on the USSF-44 mission. An upper stage engine will finish the task of placing the USSF-44 payloads into an equator-hugging geosynchronous orbit some 22,000 miles (36,000 kilometers) above Earth.
The rocket will release the LDPE 2 and Shepherd Demonstration satellites into orbit to conclude the Falcon Heavy launch sequence. The satellites will orbit will orbit in lock-step with Earth’s rotation, a feature that makes geosynchronous orbit a popular location for military communications, early warning, and reconnaissance satellites.
Most satellites heading to geosynchronous orbit get dropped off by their launcher in an egg-shaped transfer orbit. That requires the spacecraft to use its own propulsion resources to circularize at an operational altitude over the equator.
Some launches deploy their satellites directly into geosynchronous orbit. The Atlas 5 and Delta 4 rockets built by United Launch Alliance, a SpaceX rival in the U.S. launch industry, have accomplished this feat before. But the launch Tuesday will be SpaceX’s first attempt to place payloads directly into geosynchronous orbit.
SpaceX tested its long duration coast capability on previous flights, including the Falcon Heavy launch on the STP-2 mission in 2019, which lasted three-and-a-half hours from liftoff through the final burn of the upper stage stage engine. In December 2019, SpaceX performed a long duration six-hour coast experiment on a Falcon 9 rocket upper stage following launch of a resupply mission to the International Space Station.
The Shepherd Demonstration satellite on the USSF-44 mission “hosts payloads that mature technologies and accelerate risk reduction efforts to inform programs of record,” the Space Force said. A military spokesperson said the Shepherd Demonstration satellite carries multiple Space Force payloads, and is based on an “ESPA ring,” a circular structure with attachment ports for experiments and instruments.
The Space Force spokesperson declined to provide additional details on the Shepherd Demonstration mission in response to questions from Spaceflight Now.
The LDPE 2 spacecraft was built by Northrop Grumman, and is similar to the LDPE 1 satellite launched in December 2021 on a ULA Atlas 5 rocket. LDPE 2 hosts six payloads on circumferential ports, apparently similar to the design of the Shepherd Demonstration spacecraft, and has its own propulsion system to maneuver in space. The spacecraft is capable of releasing small satellites into orbit, and a Space Force spokesperson confirmed to Spaceflight Now that three of the LDPE 2 payloads will separate as free flyers in geosynchronous orbit.
One of the small “subsatellites” riding on LDPE 2 is believed to be Tetra 1, a small microsatellite built by Millennium Space Systems, a Boeing subsidiary. Military officials said in a 2020 statement that the Tetra 1 satellite was assigned to launch on the USSF-44 mission, and is designed to “prototype missions and tactics, techniques and procedures in and around geosynchronous Earth orbit.”
The LDPE 2 host spacecraft may also carry two Lockheed Martin CubeSats on a demonstration mission to test maneuvering and navigation capabilities for future small satellites in geosynchronous orbit. The two LINUSS smallsats — short for Lockheed Martin In-space Upgrade Satellite System — were assigned to fly on the USSF-44 mission as of early 2021, according to an orbital debris assessment report published on the Federal Communications Commission’s website.
The LINUSS A1 and A2 satellites, owned by Lockheed Martin and built by Tyvak Nano-Satellite Systems, are designed to separate from the LDPE 2 spacecraft about two months after launch, then perform maneuvers using their miniature propulsion systems. After separating to a distance of several hundred miles from one another, one of the satellites will approach its companion to a range of just 160 feet (about 50 meters).
The demonstrations will test capabilities that could be used in future satellite servicing missions, or on inspector spacecraft that could approach other objects in orbit. the LINUSS mission will also demonstrate on-board high-performance image processing, smallsat propulsion, inertial measurement units, machine vision, 3D-printed components, and reconfigurable flight software, Lockheed Martin said. The company said it developed the LINUSS mission using internal funding.
The LINUSS CubeSats are about 8 inches by 8 inches by 12 inches, and weigh about 47 pounds (21.5 kilograms) at launch.
Spaceflight Now asked the Space Force last week if the Tetra 1 spacecraft and the two LINUSS satellites remain on the USSF-44 mission, and whether they account for the three payloads that will separate from the LDPE 2 spacecraft. A Space Force spokesperson declined to confirm whether the three satellites are still assigned to the USSF-44 launch.
The Space Force says the LDPE program allows the military to more affordably send small and secondary payloads into geosynchronous orbit, helping accelerate the service’s “pivot to new, more resilient space architectures.”
“This capability has broad potential to fill capability gaps in our space systems architecture and provide helpful services for our mission partners with frequent and low-cost access to orbit,” said Brig. Gen. Tim Sejba, Space System’s Command’s program executive officer for space domain awareness and combat power.
“LDPE 2 hosts a variety of payloads that advance technology concerning communications and space weather sensing,” a Space Force spokesperson said.
The next military mission to fly on a Falcon Heavy rocket, named USSF-67, will launch the LDPE 3 spacecraft and a Space Force communications satellite in tandem. That launch is scheduled for January, and will use the same Falcon Heavy side boosters flown on the USSF-44 mission, assuming a successful recovery on the landing zones at Cape Canaveral Space Force Station, the Space Force said.
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Follow Stephen Clark on Twitter: @StephenClark1.
NASA’s Artemis 1 moon rocket ‘on track’ to roll out to pad Friday (Nov. 4)
NASA’s Artemis 1 moon rocket will make another trip to the launch pad on Friday (Nov. 4) ahead of its historic lunar mission.
Artemis 1 is the first mission for NASA’s massive Space Launch System (SLS) megarocket and the second for the Orion spacecraft capsule it will launch to lunar orbit. The rocket has been rolled back to NASA’s Vehicle Assembly Building (VAB) on three previous occasions — once each in April and July following fueling tests, and again in September to shelter from Hurricane Ian.
If all goes according to plan, SLS and Orion will roll back out to Launch Pad 39B at NASA’s Kennedy Space Center in Florida on Friday (Nov. 4), with the 4-mile (6.4 kilometers) journey beginning at 12:01 a.m. EDT (0401 GMT), according to a NASA blog post (opens in new tab) published Friday (Oct. 28). NASA adds that “minor repairs identified through detailed inspections are mostly completed” on the SLS rocket ahead of the next launch window.
Related: NASA’s Artemis 1 moon mission: Live updates
More: NASA’s Artemis 1 moon mission explained in photos
Following the last roll back to the VAB on Sept. 26 to shelter SLS from Hurricane Ian, NASA engineers have been completing testing and repairs on the rocket. “Testing of the reaction control system on the twin solid rocket boosters, as well as the installation of the flight batteries, is complete and those components are ready for flight,” NASA wrote in the blog post.
NASA adds that engineers have also replaced batteries on the rocket’s interim cryogenic propulsion stage (ICPS), which was “powered up for a series of tests to ensure the stage is functioning properly.” Final confidence checks were also completed on the ICPS, the rocket’s second stage that will propel it and the Orion capsule toward the moon once SLS’s solid rocket boosters and core stage have been jettisoned following liftoff and first-stage burn.
There are still several systems that engineers continue to work on, including replacing batteries on the rocket’s core stage and upper section. Testing of the flight termination system, which is designed to destroy the SLS if something goes wrong during launch, will resume next week once the rocket is back at the pad, NASA wrote.
The agency will attempt to launch the Artemis 1 mission no earlier than Nov. 14 at 12:07 a.m. EDT (0407 GMT).
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Symptoms, quality of life important to guide treatment for peripheral artery disease (PAD)
Statement Highlights:
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A new American Heart Association scientific statement provides an updated roadmap for incorporating patient-reported symptoms and quality of life assessments into routine care for people with peripheral artery disease (PAD or clogged leg arteries).
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Patient-reported outcomes measures (PROMs) are systematic and validated ways of asking individuals with PAD to assess their symptoms and to share how their functioning (physical, social and emotional) and their quality of life are affected.
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PROMs have been used as important endpoints for clinical trials evaluating PAD treatments.
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According to the new statement, PROMs may also be used to evaluate the quality of programs providing ongoing care for people with PAD.
Embargoed until 4 a.m. CT / 5 a.m. ET Thursday, October 13, 2022
(NewMediaWire) – October 13, 2022 – DALLAS For the approximately 8.5 million people in the U.S. living with peripheral artery disease (PAD pronounced P-A-D), which is narrowed or clogged arteries in the legs, treatment decisions and criteria for success should be led by their symptoms and self-reported quality of life, according to a new American Heart Association scientific statement published today in the Association’s flagship, peer-reviewed journal Circulation. An American Heart Association scientific statement is an expert analysis of current research and may inform future treatment guidelines.
The statement, “Advancing peripheral artery disease quality of care and outcomes through patient-reported health status assessment,” highlights how managing PAD based on a person’s experience of symptoms can lead to more patient-centered care and outcomes, with a focus on high-value care, compared to relying on clinical measures like the speed of blood flow to the legs or artery diameter.
“The person living with peripheral artery disease is the authority on the impact it has on their daily life. Our treatment must be grounded in their lived experiences and go beyond the clinical measures of how well blood flows through the arteries,” said Vice Chair and lead author of the statement writing group Kim G. Smolderen, Ph.D., a clinical psychologist and an associate professor of medicine and psychiatry and co-director of the Vascular Medicine Outcomes Research (VAMOS) lab at Yale University in New Haven, Connecticut. “We have spent years developing and validating standardized instruments to capture people’s experiences in a reliable and sensitive way. We are now at a point where we can start integrating this information into real-world care, through pilot programs that can develop quality benchmarks for different phenotypes of patients with PAD and the types of treatments they undergo, as seen from their perspective.”
Painful Legs and Other Patient Experiences
While the majority of people living with peripheral artery disease are older than age 40, PAD does occur in younger individuals as well. People with PAD have blockages in the arteries supplying blood to their legs and feet, often creating pain, cramping or weakness when they walk that makes it necessary to stop and rest temporarily until the pain subsides. Some people experience no symptoms; however, many patients might remain pain-free only because they limit their activities. Studies show that their health status and functioning is also impacted. People with severely limited blood flow to the legs (called critical limb ischemia) may experience pain even when resting, fail to heal when they sustain a wound or develop gangrene that may lead to amputation. PAD is also a risk factor for heart attack or stroke.
“All of these manifestations have a tremendous impact on people’s daily functioning and quality of life, with more impact as the severity of the disease increases. Outcomes are also affected by other health conditions common among people with PAD, such as Type 2 diabetes, coronary artery disease, kidney dysfunction or mental health conditions like depression or stress-related disorders,” said Smolderen.
Patient-led Treatment
When the health care team has an increased awareness and recognition of the burden of disease on quality of life, coordination of care for risk factors and patient concerns are at the forefront. The statement advocates for improving and individualizing the care of people with clogged leg arteries by gathering feedback from their experience throughout treatment.
Patient-reported outcomes measures (PROMs) are systematic and validated ways of asking patients directly to assess how their disease impacts their symptoms, their functioning (physical, social and emotional) and their quality of life. Feedback through PROMs can more reliably and objectively assess quality of care for people with PAD.
Key benefits of using PROMs include:
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improving understanding of the patient’s lived experience with PAD;
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improving patient’s self-management of symptoms and medical needs;
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standardizing quality performance benchmarks for practices that care for people with PAD; and
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providing relevant feedback to determine treatment changes or needs.
Engaging patients as the expert on their own experiences calls greater attention to quality-of-life concerns or cardiovascular risk factors, which may help clinicians think beyond a particular intervention. This perspective may lead to conversations that shift treatment or connect patients with other resources such as behavioral health services, wound care or smoking cessation. Patient-centered care may also enhance self-management and shared decision-making between patients and clinicians.
All of these benefits are possible as long as the patient-reported outcomes measures are assessed using tools that the patient understands regardless of literacy level, language barriers and cultural norms. It’s also important that PROMs are conducted by experts who have the qualifications and understanding to administer the tools, interpret the findings and connect patients with additional resources. The statement includes examples of PROMs to measure leg pain and functioning (including walking impairment), PAD-specific health status, general health status and depressive symptoms.
Performance Measures to Improve Quality of Care
PROMs may also become an integral part of assessing whether programs are providing quality care for people with PAD. Spurred by the Centers for Medicare and Medicaid Services and the National Quality Forum, PROMs are increasingly being integrated into definitions of what it means to deliver patient-centered ,high-quality clinical care, and PROMs scores may directly impact reimbursement. To evaluate programs, PROMs are translated into Patient-Reported Outcomes Performance Measures (PRO-PMs).
The use of PRO-PMs has the potential to:
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provide measurable goals for programs to enhance their quality of care;
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encourage the development of training and expertise for health systems to administer, interpret and ethically use PRO-PMs to improve patient care;
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reduce disparities in care and promote health equity; and
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aid in the creation of national standards for quality care.
“This roadmap highlights a paradigm shift that places the patient experience front and center, which is a departure from the status quo. It is provocative to now place the lived experience with the disease at the forefront, engaging people with PAD to provide information that holds health systems and practitioners accountable as to whether high-quality care was delivered, in addition to assessing the safe and effective delivery of current evidence-based treatments,” said Smolderen.
This scientific statement was prepared by the volunteer writing group on behalf of the American Heart Association’s Council on Peripheral Vascular Disease and the Council on Lifestyle and Cardiometabolic Health. The writing group includes a patient advocate and experts in clinical psychology, outcomes research, nursing, cardiology, vascular surgery and vascular medicine. It was important to ensure this statement embodied the interdisciplinary nature of PAD care and the dedication to innovating the vascular space, across vascular specialties. This meant including experts with experience both on the research end with PROs and the clinical experience with PAD, as well as with pioneers in the space of patient reported outcomes for cardiovascular populations and with direct input from patient advocates.
American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.
Co-authors are Chair Carole Decker, Ph.D., R.N.; Olamide Alabi, M.D.; Tracie C. Collins, M.D., M.P.H., M.S.; Bernard P. Dennis, B.A.; Philip P. Goodney, M.D.; Carlos Mena-Hurtado, M.D.; and John A. Spertus, M.D., M.P.H. Authors’ disclosures are listed in the manuscript.
The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers, and the Association’s overall financial information are available here.
Additional Resources:
About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.
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For Media Inquiries: 214-706-1173
Suzette Harris: 214-706-1207; suzette.harris@heart.org
For Public Inquiries: 1-800-AHA-USA1 (242-8721)
heart.org and stroke.org
SpaceX Upgrading Florida Launch Pad in Case of Starship Failure
SpaceX is moving ahead with plans to upgrade a launch pad at Cape Canaveral Space Force Station, which will serve as a backup to the Kennedy Space Center pad the company currently uses to launch cargo and crews to space.
During a press briefing last week, Bill Gerstenmaier, SpaceX’s vice president for build and flight reliability, said that the company is preparing for the upgrades needed for Space Launch Complex 40 (SLC-40) to prepare it for upcoming cargo and crew launches, Space News reported. SpaceX is currently under a commercial crew contract with NASA to shuttle crew and cargo to the International Space Station with its Falcon 9 rocket and Dragon spacecraft.
“We’ve already started the work to begin the preparations for pad 40. We’ve ordered some hardware, put some contracts into place,” Gerstenmaier said during the briefing. At first, the company will only launch cargo missions from SLC-40, but it plans to add crew missions later. “It gives us some flexibility to move some things off 39A, which helps us balance launches off both pads,” Gerstenmaier added.
SLC-40 has been under lease to SpaceX from the United States Air Force since 2007; the Air Force previously used the launch pad at Cape Canaveral to launch its Titan III and IV rockets, which it did from 1965 to 2005. SpaceX is leasing Launch Complex 39A (LC-39A) from NASA’s Kennedy Space Center, and it uses the facility to launch crew and cargo missions to the ISS. The private space company is also working towards the inaugural launch of its super heavy-lift Starship rocket from its launch facility in Boca Chica, Texas, with company CEO Elon Musk recently claiming that it could fly as early as November.
The company eventually plans to launch the megarocket from Kennedy Space Center. NASA selected Starship to land humans on the Moon by late 2025 as part of the space agency’s Artemis 3 mission. To that end, SpaceX is building a massive Starship launch tower a few hundred feet away from pad 39A’s launch tower. The massive 1,000-foot-tall (300-meter) launch tower is nearing completion, with its sixth and seventh sections added this summer. But the thought of having Starship anywhere near pad 39A is apparently making NASA a bit nervous, particularly when it comes to SpaceX’s ongoing commercial crew obligations.
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For you see, SpaceX has a history of its prototype rockets exploding on the pad. In 2016, SpaceX’s Falcon 9 rocket exploded on its Cape Canaveral launch pad, resulting in significant damage that took more than a year to repair. Other shenanigans at the launch pad include an eight second static fire test of a Starship prototype that ended in a brush fire, in an incident from last month.
As Reuters reported in June, NASA officials told SpaceX that a Starship explosion near LC-39A could cut off the space agency’s only means of launching astronauts to the ISS, hence its desire for a backup launch pad. Accordingly, SpaceX will upgrade the pad at Cape Canaveral, but Gerstenmaier says the company won’t bring Starship to Kennedy until it’s ready for prime time. Starship is currently undergoing tests in Boca Chica in advance of the megarocket’s first orbital test. “Our intent is to bring Starship to 39A after we have a reliable vehicle. We’ll do a series of tests in Boca [Chica] to makes sure the vehicle is ready to go. When we think we have a good and reliable vehicle, we’ll bring it to 39A,” Gerstenmaier said during the briefing.
Starship is a fully reusable, super heavy-lift launch vehicle designed to carry supplies and passengers to Earth orbit, the Moon, and possibly even further destinations like Mars. That’s all fine and well, but NASA is probably right to be a bit wary about having this rocket on its property.
More: SpaceX’s Starship Rocket Tower in Florida Is Taking Shape
SpaceX rolls rocket to pad ahead of Crew-5 astronaut launch (photos)
The hardware that will fly SpaceX’s next astronaut mission for NASA is poised and ready for liftoff.
The Crew-5 mission is scheduled to launch at noon EDT (1600 GMT) on Wednesday (Oct. 5) from Pad 39A at NASA’s Kennedy Space Center (KSC) in Florida, and team members have been checking off boxes in the leadup.
On Saturday (Oct. 1), for example, the four Crew-5 astronauts — NASA’s Nicole Mann and Josh Cassada, Japan’s Koichi Wakata and Russian cosmonaut Anna Kikina — arrived at KSC from NASA’s Johnson Space Center in Houston.
Related: SpaceX Crew-5 astronauts ready for historic mission
That same day, the Falcon 9 rocket and Dragon capsule that will fly Crew-5 were rolled out to Pad 39A from SpaceX‘s processing facility at KSC. The Falcon 9 is jarringly white and clean by SpaceX standards; Elon Musk’s company is famous for landing and reflying boosters, which get soot-blackened during their trips back to Earth. But Crew-5 will be the first mission for this particular Falcon 9 first stage.
On Sunday (Oct. 2), SpaceX performed a “static fire” test of the Falcon 9, lighting up the first stage’s nine Merlin engines briefly in a standard preflight trial. SpaceX, NASA and the Crew-5 astronauts also “completed a full rehearsal of launch day activities” on Sunday, SpaceX said via Twitter (opens in new tab).
Crew-5 will send Mann, Cassada, Wakata and Kikina to the International Space Station for a five-month stay. The mission will make history in multiple ways. For instance, Kikina will become the first cosmonaut ever to fly on a SpaceX mission to orbit. And Mann will become the first Native American woman to reach the final frontier.
NASA and SpaceX had been targeting today (Oct. 3) for Crew-5’s liftoff, but Hurricane Ian pushed things back by two days.
The storm’s impact on the timeline for NASA’s Artemis 1 moon mission was much more dramatic. NASA had been targeting Sept. 27 for the launch of Artemis 1, which will lift off from KSC’s Pad 39B. But the Artemis 1 team rolled Artemis 1 off the pad last week to protect it from Ian and is now eyeing a launch in mid-November.
Mike Wall is the author of “Out There (opens in new tab)” (Grand Central Publishing, 2018; illustrated by Karl Tate), a book about the search for alien life. Follow him on Twitter @michaeldwall (opens in new tab). Follow us on Twitter @Spacedotcom (opens in new tab) or on Facebook (opens in new tab).