Engineering topics
Laurie, S. S.
Publications and source records attributed to Laurie, S. S..
Autonomous Diagnostic Imaging Performed by Untrained Operators using Augmented Reality as a Form of "Just-in-Time" Training
We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.
Gradient Compression Garments as a Countermeasure to Post-Space Flight Orthostatic Intolerance: Potential Interactions with the Maximum Absorbency Garment
Astronauts and cosmonauts may experience symptoms of orthostatic intolerance during re-entry, landing, and for several days post-landing following short- and long-duration spaceflight. Presyncopal symptoms have been documented in approximately 20% of short-duration and greater than 60% of long-duration flyers on landing day specifically during 5-10 min of controlled (no countermeasures employed at the time of testing) stand tests or 80 deg head-up tilt tests. Current operational countermeasures to orthostatic intolerance include fluid loading prior to and whole body cooling during re-entry as well as compression garments that are worn during and for up to several days after landing. While both NASA and the Russian space program have utilized compression garments to protect astronauts and cosmonauts traveling on their respective vehicles, a "next-generation" gradient compression garment (GCG) has been developed and tested in collaboration with a commercial partner to support future space flight missions. Unlike previous compression garments used operationally by NASA that provide a single level of compression across only the calves, thighs, and lower abdomen, the GCG provides continuous coverage from the feet to below the pectoral muscles in a gradient fashion (from approximately 55 mm Hg at the feet to approximately 16 mmHg across the abdomen). The efficacy of the GCG has been demonstrated previously after a 14-d bed rest study without other countermeasures and after short-duration Space Shuttle missions. Currently the GCG is being tested during a stand test following long-duration missions (~6 months) to the International Space Station. While results to date have been promising, interactions of the GCG with other space suit components have not been examined. Specifically, it is unknown whether wearing the GCG over NASA's Maximum Absorbency Garment (MAG; absorbent briefs worn for the collection of urine and feces while suited during re-entry and landing) will interfere with the effectiveness of the GCG or conversely whether the GCG will reduce the fluid absorption capabilities of the MAG. Methods: This operational, directed study, will (1) determine whether the effectiveness of the GCG is affected by the MAG with regard to cardiovascular responses to head-up tilt, the standard orthostatic intolerance test employed for astronauts and bed rest subjects; (2) determine whether the effectiveness of the MAG is compromised by the GCG tested by injecting a standard fluid volume (950 ml in 3 separate simulated "urine voids") at a standardized rate (30 ml/sec); and (3) determine whether comfort is affected by wearing the MAG under the GCG using a standardized questionnaire. Results from this study will guide future development and operational use of the GCG and MAG to maximize crew health, safety, and comfort.
Fluid Shifts
Introduction. NASA's Human Research Program is focused on addressing health risks associated with long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but now more than 50 percent of ISS astronauts have experienced more profound, chronic changes with objective structural findings such as optic disc edema, globe flattening and choroidal folds. These structural and functional changes are referred to as the visual impairment and intracranial pressure (VIIP) syndrome. Development of VIIP symptoms may be related to elevated intracranial pressure (ICP) secondary to spaceflight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration spaceflight and to determine if a relation exists with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as any VIIP-related effects of those shifts, are predicted by the crewmember's pre-flight status and responses to acute hemodynamic manipulations, specifically posture changes and lower body negative pressure. Methods. We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, and calcaneus tissue thickness (by ultrasound); (3) vascular dimensions by ultrasound (jugular veins, cerebral and carotid arteries, vertebral arteries and veins, portal vein); (4) vascular dynamics by MRI (head/neck blood flow, cerebrospinal fluid pulsatility); (5) ocular measures (optical coherence tomography; intraocular pressure; 2-dimensional ultrasound including optic nerve sheath diameter, globe flattening, and retina-choroid thickness; Doppler ultrasound of ophthalmic and retinal arteries and veins); (6) cardiac variables by ultrasound (inferior vena cava, tricuspid flow and tissue Doppler, pulmonic valve, stroke volume, right heart dimensions and function, four-chamber views); and (7) ICP measures (tympanic membrane displacement, otoacoustic emissions). Pre- and post-flight, acute head-down tilt will induce cephalad fluid shifts, whereas lower body negative pressure will oppose these shifts. Controlled Mueller maneuvers will manipulate cardiovascular variables. Through interventions applied before, during, and after flight, we intend to fully evaluate the relationship between fluid shifts and the VIIP syndrome. Discussion. Ten subjects have consented to participate in this experiment, including the recent One-Year Mission crewmembers, who have recently completed R plus180 testing; all other subjects have completed pre-flight testing. Preliminary results from the One-Year Mission crewmembers will be presented, including measures of ocular structure and function, vascular dimensions, fluid distribution, and non-invasive estimates of intracranial pressure.
Effects of Spaceflight on Venous and Arterial Compliance
The visual impairment and intracranial pressure (VIIP) syndrome is a spaceflight-associated set of symptoms affecting more than 50% of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures (e.g. optic disc edema, choroidal folds, and globe flattening) and is hypothesized to be related to elevated intracranial pressure secondary to a cephalad fluid shift. However, ocular symptoms have not been replicated in subjects completing prolonged bed rest, a well-accepted spaceflight analog. Altered vascular compliance along with spaceflight factors such as diet, radiation exposure, or environmental factors may cause alterations in the cardiovascular system that contribute to the manifestation of ocular changes. Loss of visual acuity could be a significant threat to crew health and performance during and after an exploration mission and may have implications for years post-flight. The overall objective of this project is to determine if spaceflight alters vascular compliance and whether such an adaptation is related to the incidence of VIIP. This objective will be met by completing three separate but related projects.
Field Test: Results from the One Year Mission
The One Year Mission was designed to aid in determining the effect that extending the duration on orbit aboard the International Space Station (ISS) would have on a number of biological and physiological systems. Two crewmembers were selected to participate in this endeavor, one U.S. On-Orbit Segment (USOS) astronaut and one Russian cosmonaut. The Neuroscience and Cardiovascular and Vision Laboratories at the Johnson Space Center and the Sensory-Motor and Countermeasures Division within the Institute for Biomedical Problems were selected to investigate vestibular, sensorimotor and cardiovascular function with the two long-duration crewmembers using the established methodology developed for the Field Test (FT).
Pilot Field Test: Use of a Compression Garment During a Stand Test After Long-Duration Space Flight
Orthostatic intolerance (OI) is a concern for astronauts returning from long-duration space flight. One countermeasure that has been used to protect against OI after short-duration bed rest and space flight is the use of lower body and abdominal compression garments. However, since the end of the Space Shuttle era we have not been able to test crewmembers during the first 24 hours after landing on Earth. NASA's Pilot Field Test provided us the opportunity to test cardiovascular responses of crewmembers wearing the Russian Kentavr compression garment during a stand test at multiple time points throughout the first 24 hours after landing. HYPOTHESIS We hypothesized that the Kentavr compression garment would prevent an increase in heart rate (HR) >15 bpm during a 3.5-min stand test. METHODS: The Pilot Field Test was conducted up to 3 times during the first 24 hours after crewmembers returned to Earth: (1) either in a tent adjacent to the Soyuz landing site in Kazakhstan (approx.1 hr) or after transportation to the Karaganda airport (approx. 4 hr); (2) during a refueling stop in Scotland (approx.12 hr); and (3) upon return to NASA Johnson Space Center (JSC) (approx.24 hr). We measured HR and arterial pressure (finger photoplethysmography) for 2 min while the crewmember was prone and throughout 3.5 min of quiet standing. Eleven crewmembers consented to participate; however, 2 felt too ill to start the test and 1 stopped 30 sec into the stand portion of the test. Of the remaining 8 crewmembers, 2 did not wear the Russian Kentavr compression garment. Because of inclement weather at the landing site, 5 crewmembers were flown by helicopter to the Karaganda airport before initial testing and received intravenous saline before completing the stand test. One of these crewmembers wore only the portion of the Russian Kentavr compression garment that covered the lower leg and thus lacked thigh and abdominal compression. All crewmembers continued wearing the Russian Kentavr compression garment during the second testing session in Scotland, but none wore it during testing at JSC. RESULTS: The mean Delta HR from the supine to standing position in the 8 crewmembers measured pre-flight or 60 days after return from long-duration space flight was 9.8 bpm. During the first few hours after landing from long-duration space flight, the mean Delta HR of the 6 crewmembers who wore the Russian Kentavr compression garment in Kazakhstan or Karaganda was +14 bpm and the change in mean arterial pressure (Delta MAP) was +0.8 mmHg, while the 2 crewmembers who did not wear the Russian Kentavr compression garment had a Delta HR of +38 bpm and a Delta MAP of +1.1 mmHg. In Scotland, 4 crewmembers wore the Russian Kentavr compression garment and had a Delta HR of +7.4 bpm while the 3 crewmembers who did not wear it had a Delta HR of +25.0 bpm. Seven crewmembers were tested upon return to JSC approx. 24 hr after landing, but none wore the Russian Kentavr compression garment and their Delta HR was 16.0 bpm. CONCLUSIONS: These are the first stand-test data to be collected from long-duration crewmembers during the first 24 hr of re-adaptation to gravity on Earth. The Delta HR measured in crewmembers who completed the stand-test while wearing Kentavr within the first approx.4 hours after returning to Earth was only slightly elevated from pre-flight Delta HR, while the few subjects who did not wear the Russian Kentavr compression garment had a much larger increase in HR in order to maintain arterial pressure throughout 3.5-min of standing. These data demonstrate the effectiveness of a compression garment in preventing large increases in HR during a 3.5 min stand test after long-duration space flight. However, the fact that three crewmembers were too ill to complete the test or was not able to complete 3.5 min of standing despite wearing the Russian Kentavr compression garment indicates that wearing a compression garment does not resolve all problems crewmembers face during the period of re-adaptation immediately after return to Earth's gravity.
Effect of 1% Inspired CO2 During Head-Down Tilt on Ocular Structures, Cerebral Blood Flow, and Visual Acuity in Healthy Human Subjects
The cephalad fluid shift induced by microgravity has been hypothesized to elevate intracranial pressure (ICP) and contribute to the development of the visual impairment/intracranial pressure (VIIP) syndrome experienced by many astronauts during and after long-duration space flight. In addition, elevated ambient partial pressure of carbon dioxide (PCO2) on the International Space Station (ISS) has also been hypothesized to contribute to the development of VIIP. We seek to determine if an acute, mild CO2 exposure, similar to that occurring on the ISS, combined with the cephalad fluid shift induced by head-down tilt will induce ophthalmic and ICP changes consistent with the VIIP syndrome.
Effects of Spaceflight on Venous and Arterial Compliance
The visual impairment and intracranial pressure (VIIP) syndrome is a spaceflight-associated medical condition consisting of a constellation of symptoms affecting less than 70% of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures and is hypothesized to be related to elevated intracranial pressure secondary to spaceflight-induced cephalad fluid shifts, although other space flight factors (e.g., diet, environmental factors) may contribute. Loss of visual acuity could be a significant threat to crew health and performance during and after an exploration mission and may have implications for years postflight.
Pilot Field Test: The Ability to Ambulate Following Landing as Assessed with Seat Egress, Walk and Obstacle Testing
To date, changes in functional performance have been systematically studied after short-duration space flight. As important as the postflight functional changes have been, full functional recovery has never been investigated or established for long-duration flights. The Pilot Field Test (PFT) experiment, conducted with participation of ISS crewmembers traveling on Soyuz expeditions 34S - 41S, is comprised of several tasks designed to study the recovery of sensorimotor abilities of astronauts during the first 24 hours after landing and beyond. The objective of the Seat Egress - Walk and Obstacle Test, developed by NASA's Russian collaborators at the Institute for Biomedical Problems, is to address this gap in knowledge. This will allow us to characterize the ability of crewmembers to perform critical mission requirements that they will be expected to perform after an unassisted landing following 6 to 12 months in microgravity.
Sensorimotor Results from the Joint NASA and Russian Pilot Field Test
Testing of crew responses following long-duration flights has not previously been possible until a minimum of 24 hours after landing. As a result, it has not been possible to estimate the nonlinear trend of the early (<24 hours) recovery process, nor has it been possible to accurately assess the full impact of the decrements associated with long-duration flight. To overcome these limitations, both the Russian and U.S. programs have implemented testing at the Soyuz landing site. This research effort has been identified as the Field Test (FT). For operational reasons the FT has been divided into two phases: the full FT and a preliminary pilot version (PFT) of the FT that is reduced in both length and scope. The PFT has now been completed with the landing of the crew of International Space Station Increment 42/43 (Soyuz expedition 41S). RESEARCH: The primary goal of this research was to determine functional abilities associated with long-duration space flight crews beginning as soon after landing as possible (< 2 hours) with an additional two follow-up measurement sessions within 24 hours after landing. This study goal has both sensorimotor and cardiovascular elements. The PFT represented a initial evaluation of the feasibility of testing in the field and was comprised of a jointly agreed upon subset of tests drawn from the full FT and relied heavily on Russia's Institute of Biomedical Problems Sensory-Motor and Countermeasures Department for content and implementation. Data from the PFT was collected following several ISS missions. Testing on the U.S. side has included: (1) a sit-to-stand test, (2) recovery from a fall stand test where the crewmember begins in the prone position on the ground and then stands for 3.5 minutes while cardiovascular performance and postural ataxia data are acquired, and (3) a tandem heel-to-toe walk test to determine changes in the central locomotor program. Video, cardiovascular parameters (heart rate and blood pressure), data from body-worn inertial sensors, and severity of postflight motion sickness were collected during each test session. In addition our Russian investigators have made measurements associated with: (a) obstacle avoidance, (b) muscle compliance, (c) postural adjustments to perturbations (pushes) applied to the subject's chest area and (d) center of mass measurements made across most test objectives with insoles inserted into the subjects' shoes. Data from 18 subjects have been obtained for a majority of the PFT objectives. SUMMARY: The increased level of functional deficit observed in the crewmembers tested with the PFT objectives has been typically greater than previously observed when measurements were collected after the 2 hr window. Significant improvement in crew performance was observed within 24 hours, but full recovery appears to require 6 to 16 days. Clearly measureable performance parameters such as ability to perform a seat egress, recovery from a fall or the ability to see clearly when walking, and related physiologic data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the variability among crewmembers for exploration missions where the crew will be unassisted after landing. Overall, these early functional and related physiologic measurements will allow the estimation of nonlinear sensorimotor and cardiovascular recovery trends that have not been previously captured.
Pilot Field Test: Results of Tandem Walk Performance Following Long-Duration Spaceflight
Coordinated locomotion has proven to be challenging for many astronauts following long duration spaceflight. As NASA's vision for spaceflight points toward interplanetary travel and missions to distant objects, astronauts will not have assistance once they land. Thus, it is vital to develop a knowledge base from which operational guidelines can be written that define when astronauts can be expected to safely perform certain tasks. Data obtained during the Field Test experiment will add important insight to this knowledge base. Specifically, we aim to develop a recovery timeline of functional sensorimotor performance during the first 24 hours and several days after landing. A forerunner of the full Field Test study, the Pilot Field Test (PFT) comprised a subset of the tasks and measurements to be included in the ultimate set.
Field Test: Results of Tandem Walk Performance Following Long-Duration Spaceflight
BACKGROUND: Coordinated locomotion has proven to be challenging for many astronauts following long duration spaceflight. As NASA's vision for spaceflight points toward interplanetary travel, we must prepare for unassisted landings, where crewmembers may need to perform mission critical tasks within minutes of landing. Thus, it is vital to develop a knowledge base from which operational guidelines can be written that define when astronauts can be expected to safely perform certain tasks. Data obtained during the Field Test experiment (FT) will add important insight to this knowledge base. Specifically, we aim to develop a recovery timeline of functional sensorimotor performance during the first 24 hours and several days after landing. METHODS: FT is an ongoing study of 30 long-duration ISS crewmembers. Thus far, 9 have completed the full FT (5 U.S. Orbital Segment [USOS] astronauts and 4 Russian cosmonauts) and 4 more consented and launching within the next year. This is in addition to the eighteen crewmembers that participated in the pilot FT (11 USOS and 7 Russian crewmembers). The FT is conducted three times preflight and three times during the first 24 hours after landing. All crewmembers were tested in Kazakhstan in either the medical tent at the Soyuz landing site (~one hour post-landing), or at the airport (~four hours post-landing). The USOS crewmembers were also tested at the refueling stop (~12 hours post-landing) and at the NASA Johnson Space Center (~24 hours post-landing) and a final session 7 days post-landing. Crewmembers are instrumented with 9 inertial measurement unit sensors that measure acceleration and angular displacement (APDM's Emerald Sensors) and foot pressure-sensing insoles that measure force, acceleration, and center of pressure (Moticon GmbH, Munich, Germany) along with heart rate and blood pressure recording instrumentation. The FT consists of 12 tasks, but here we will focus on the most challenging task, the Tandem Walk, which was also performed as part of pilot FT. To perform the Tandem Walk, subjects begin with their feet together, their arms crossed at their chest and eyes closed. When ready, they brought one foot forward and touched the heel of their foot to their toe, repeating with the other foot, and continuing for about 10 steps. Three trials were collected with the eyes closed and a fourth trial was collected with eyes open. There are four metrics which are used to determine the performance level of the Tandem Walk. The first is percent correct steps. For a step to be counted as correct, the foot could not touch the ground while bringing it forward (no side stepping), eyes must stay closed during the eyes closed trials, the heel and toe should be touching, or almost touching (no large gaps) and there shouldn't be more than a three second pause between steps. Three judges score each step and the median of the three scores is kept. The second metric is the average step speed, or the number of steps/time to complete them. Thirdly, the root mean squared (RMS) error in the resultant trunk acceleration is used to determine the amount of upper body instability observed during the task. Finally, the RMS error of the mediolateral center of pressure as measured by the Moticon insoles is used to determine the mediolateral instability at the foot level. These four parameters are combined into a new overall Tandem Walk Parameter. RESULTS: Preliminary results show that crewmembers perform the Tandem Walk significantly worse the first 24 hours after landing as compared to their baseline performance. We find that each of the four performance metrics is significantly worse immediately after landing. We will present the results of tandem walk performance during the FT thus far. We will also combine these with the 18 crewmembers that participated in the pilot FT, concentrating on the level of performance and recovery rate. CONCLUSION: The Tandem Walk data collected as part of the FT experiment will provide invaluable information on the performance capabilities of astronauts during the first 24 hours after returning from long-duration spaceflight that can be used in planning future Mars, or other deep-space missions with unassisted landings. FT will determine the average sensorimotor recovery timeline and inform return-to-duty guidelines for unassisted landings.
NASA's Functional Task Test: Providing Information for an Integrated Countermeasure System
Exposure to the microgravity conditions of spaceflight causes astronauts to experience alterations in multiple physiological systems. These physiological changes include sensorimotor disturbances, cardiovascular deconditioning, and loss of muscle mass and strength. Some or all of these changes might affect the ability of crewmembers to perform critical mission tasks immediately after landing on a planetary surface. The goals of the Functional Task Test (FTT) study were to determine the effects of spaceflight on functional tests that are representative of critical exploration mission tasks and to identify the key physiological factors that contribute to decrements in performance. The FTT was comprised of seven functional tests and a corresponding set of interdisciplinary physiological measures targeting the sensorimotor, cardiovascular and muscular changes associated with exposure to spaceflight. Both Shuttle and ISS crewmembers participated in this study. Additionally, we conducted a supporting study using the FTT protocol on subjects before and after 70 days of 6 head-down bed rest. The bed rest analog allowed us to investigate the impact of body unloading in isolation on both functional tasks and on the underlying physiological factors that lead to decrements in performance, and then to compare them with the results obtained in our spaceflight study. Spaceflight data were collected on three sessions before flight, on landing day (Shuttle only) and 1, 6 and 30 days after landing. Bed rest subjects were tested three times before bed rest and immediately after getting up from bed rest as well as 1, 6, and 12 days after reambulation. We have shown that for Shuttle, ISS and bed rest subjects, functional tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. These changes in functional performance were paralleled by similar decrements in sensorimotor tests designed to specifically assess postural equilibrium and dynamic gait control. Bed rest subjects experienced similar deficits both in functional tests with balance challenges and in sensorimotor tests designed to evaluate postural and gait control as spaceflight subjects indicating that body support unloading experienced during spaceflight plays a central role in post-flight alteration of functional task performance. To determine how differences in body-support loading experienced during in-flight treadmill exercise affect postflight functional performance, the loading history for each subject during in-flight treadmill (T2) exercise was correlated with postflight measures of performance. ISS crewmembers who walked on the treadmill with higher pull-down loads had enhanced post-flight performance on tests requiring mobility. Taken together the spaceflight and bed rest data point to the importance of supplementing inflight exercise countermeasures with balance and sensorimotor adaptability training. These data also support the notion that inflight treadmill exercise performed with higher body loading provides sensorimotor benefits leading to improved performance on functional tasks that require dynamic postural stability and mobility.
Effects of Mild Hypercapnia During Head-Down Bed Rest on Ocular Structures, Cerebral Blood Flow, aud Visual Acuity in Healthy Human Subjects
The cephalad fluid shift induced by microgravity has been hypothesized to cause an elevation in intracranial pressure (ICP) and contribute to the development of the Visual Impairment/Intracranial Pressure (VIIP) syndrome, as experienced by some astronauts during long-duration space flight. Elevated ambient partial pressure of carbon dioxide (PCO2) on ISS may also raise ICP and contribute to VIIP development. We seek to determine if the combination of mild CO2 exposure, similar to that occurring on the International Space Station, with the cephalad fluid shift induced by head-down tilt, will induce ophthalmic and cerebral blood flow changes similar to those described in the VIIP syndrome. We hypothesize that mild hypercapnia in the head-down tilt position will increase choroidal blood volume and cerebral blood flow, raise intraocular pressure (IOP), and transiently reduce visual acuity as compared to the seated or the head-down tilt position without elevated CO2, respectively.