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Ashot Sargsyan

Publications and source records attributed to Ashot Sargsyan.

Autonomous Medical Officer Support (AMOS) Software Technology Demonstrations on the International Space Station (ISS)

Performance of medical procedures in spaceflight beyond low Earth orbit (LEO) requires novel solutions to replace real-time ground support because as distance from Earth increases, communication latencies increase, hampering remote guidance. The Autonomous Medical Officer Support Software (AMOS) Technology Demonstrations on the International Space Station (ISS) trialed a novel software tool that shifts the emphasis from preflight training and real-time remote guidance (current ISS paradigm) to a new standard of multi-dimensional in-flight just-in-time (JIT) instruction. The AMOS platform is a skill management tool for all mission phases and currently features comprehensive training and guidance modules for urinary bladder and renal ultrasound examinations. Variability in Subject anatomy, Operator experience, and Operator receptiveness to instruction during autonomous exams are persistent but manageable limitations. Here we report the first successful demonstrations of autonomous imaging activities in the operational setting of spaceflight, validating this autonomous guidance proof of concept.

Douglas Ebert

Noninvasive Indicators of Intracranial Pressure Before, During, and After Long-Duration Spaceflight

Weightlessness induces a cephalad shift of blood and cerebrospinal fluid that may increase intracranial pressure (ICP) during spaceflight, while lower body negative pressure (LBNP) may provide an opportunity to caudally redistribute fluids and lower ICP. To investigate the effects of spaceflight and LBNP on noninvasive indicators of ICP (nICP), we studied thirteen crewmembers before and after spaceflight in seated, supine, and 15° head-down tilt postures, and at ~45 and ~150 days of spaceflight with and without 25 mmHg LBNP. We used 4 techniques to quantify nICP: cerebral and cochlear fluid pressure (CCFP), otoacoustic emissions (OAE), ultrasound measures of optic nerve sheath diameter (ONSD), and ultrasound-based internal jugular vein pressure (IJVp). On flight day 45, two nICP measures were lower than preflight supine posture (CCFP: mean difference -98.5 -nl [CI: -190.8 to -6.1 -nl], p = 0.037]; OAE: -19.7 degrees [CI: -10.4 to -29.1 degrees], p < 0.001), but not significantly different from preflight seated measures. Conversely, ONSD was not different than any preflight posture, whereas IJVp was significantly greater than preflight seated measures (14.3 mmHg [CI: 10.1 to 18.5mmHg], p < 0.001), but not significantly different than preflight supine measures. During spaceflight, acute LBNP application did not cause a significant change in nICP indicators. These data suggest that during spaceflight nICP is not elevated above values observed in the seated posture on Earth. Invasive measures would be needed to provide absolute ICP values and more precise indications of ICP change during various phases of spaceflight.

Jessica V. Jasien

Intracranial Effects of Microgravity: A Prospective Longitudinal MRI Study

Purpose of Research: To investigate the intracranial effects of microgravity by measuring combined changes in intracranial volumetric parameters, pituitary morphologic structure, and aqueductal cerebrospinal fluid (CSF) hydrodynamics relative to spaceflight and to establish a comprehensive model of recovery after return to Earth.

Larry A Kramer

Fluid Shifts Study

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Steven Laurie

Surveillance for Jugular Venous Thrombosis in Long-Duration Space Flight: Findings From Twenty-Eight U.S. Astronauts

BACKGROUND: Given the high incidence of internal jugular vein (IJV) flow anomalies aboard the International Space Station and a case of thrombosis, the National Aeronautics and Space Administration (NASA) instituted an occupational surveillance program to evaluate astronauts for venous thromboembolism (VTE). Current findings of the program are presented. METHODS: NASA astronauts undergo pre- and in-flight VTE surveillance examinations using a standardized vascular ultrasound protocol, which includes evaluation for bilateral IJV compressibility, filling, flow, and spontaneous echo contrast (SEC). RESULTS: Twenty-eight NASA astronauts had terrestrial baseline examinations and at least one in-flight imaging session. The reduction of in-flight peak IJV flow speeds was significant and more pronounced on the left. Comparing the first in-flight measurement to the terrestrial baseline, peak flow speeds were reduced from 90.1±41.9 cm/s (average ±SD) to 62.1±31.6 cm/s on the right and from 76.9±41.8 cm/s to 26.8±18.2 cm/s on the left. Seven astronauts showed stagnant or retrograde flow in the left IJV. Fourteen developed appreciable SEC in the left IJV (7 greater than mild); none developed significant right-sided SEC. All IJVs were fully compressible and free from thrombi. DISCUSSION: Bilateral IJV flow speed reduction is observed in microgravity, possibly due to the multitude of available flow redistribution paths for cranial drainage. In a subset of astronauts, significant flow anomalies develop that may facilitate thrombus formation through changes in blood viscosity and speed, especially if combined with other thrombogenic factors. These findings warrant attention to the interplay between individual vascular configurations and the dynamic properties of blood as a non-Newtonian fluid in the reduced-shear flow environment of microgravity.

Ashot Sargsyan