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Otto, C.

Publications and source records attributed to Otto, C..

10 records
All sourcesNASA NTRSDOE OSTI
NASA NTRS2018

Integration of Optical Coherence Tomography Scan Patterns to Augment Clinical Data Suite

Vision changes identified in long duration spaceflight astronauts has led Space Medicine at NASA to adopt a more comprehensive clinical monitoring protocol. Optical Coherence Tomography (OCT) was recently implemented at NASA, including on board the International Space Station in 2013. NASA is collaborating with Heidelberg Engineering to increase the fidelity of the current OCT data set by integrating the traditional circumpapillary OCT image with radial and horizontal block images at the optic nerve head. The retinal nerve fiber layer was segmented by two experienced individuals. Intra-rater (N=4 subjects and 70 images) and inter-rater (N=4 subjects and 221 images) agreement was performed. The results of this analysis and the potential benefits will be presented.

Mason, S.↗
NASA NTRS2015

Prospective Observational Study of Ocular Health in ISS Crews - The Ocular Health Study

The Visual Impairment Intracranial Pressure (VIIP) syndrome is currently NASA's number one human space flight risk. The syndrome, which is related to microgravity exposure, manifests with changes in visual acuity (hyperopic shifts, scotomas), changes in eye structure (optic disc edema, choroidal folds, cotton wool spots, globe flattening, and dilated optic nerve sheaths), and in some cases with documented increased intracranial pressure (ICP) postflight. While the eye appears to be the main affected end organ of this syndrome, the ocular effects are thought to be related to underlying changes in the vascular system and the central nervous system. The leading hypotheses for the development of VIIP involve microgravity-induced head-ward fluid shifts along with a loss of gravity-assisted drainage of venous blood from the brain, leading to cephalic congestion, decreased CSF resorption and increased ICP. Since 70% of ISS crewmembers have manifested clinical signs or symptoms of the VIIP syndrome, it is assumed that the majority have some degree of ICP elevation in-flight compared to the ground. Prolonged elevations of ICP can cause long-term reduced visual acuity and loss of peripheral visual fields, and have been reported to cause mild cognitive impairment in the analog terrestrial population of Idiopathic Intracranial Hypertension (IIH). These potentially irreversible health consequences underscore the importance of identifying the factors that lead to this syndrome and mitigating them.

Otto, C.↗
NASA NTRS2011

Factors Impacting Habitable Volume Requirements: Results from the 2011 Habitable Volume Workshop

This report documents the results of the Habitable Volume Workshop held April 18-21, 2011 in Houston, TX at the Center for Advanced Space Studies-Universities Space Research Association. The workshop was convened by NASA to examine the factors that feed into understanding minimum habitable volume requirements for long duration space missions. While there have been confinement studies and analogs that have provided the basis for the guidance found in current habitability standards, determining the adequacy of the volume for future long duration exploration missions is a more complicated endeavor. It was determined that an improved understanding of the relationship between behavioral and psychosocial stressors, available habitable and net habitable volume, and interior layouts was needed to judge the adequacy of long duration habitat designs. The workshop brought together a multi-disciplinary group of experts from the medical and behavioral sciences, spaceflight, human habitability disciplines and design professionals. These subject matter experts identified the most salient design-related stressors anticipated for a long duration exploration mission. The selected stressors were based on scientific evidence, as well as personal experiences from spaceflight and analogs. They were organized into eight major categories: allocation of space; workspace; general and individual control of environment; sensory deprivation; social monotony; crew composition; physical and medical issues; and contingency readiness. Mitigation strategies for the identified stressors and their subsequent impact to habitat design were identified. Recommendations for future research to address the stressors and mitigating design impacts are presented.

Simon, M.↗
NASA NTRS2011

Designing Medical Support for a Near-Earth Asteroid Mission

This panel will discuss the design of medical support for a mission to a near-Earth asteroid (NEA) from a variety of perspectives. The panelists will discuss the proposed parameters for a NEA mission, the NEA medical condition list, recommendations from the NASA telemedicine workshop, an overview of the Exploration Medical System Demonstration planned for the International Space Station, use of predictive models for mission planning, and mission-related concerns for behavioral health and performance. This panel is intended to make the audience aware of the multitude of factors influencing medical support during a NEA mission.

Watkins, S. D.↗
NASA NTRS2011

Telemedicine in Space Flight - Summary of a NASA Workshop

The Exploration Medical Capability Element of the Human Research Program at NASA Johnson Space Center hosted the Telemedicine Workshop in January 2011 to discuss the medical operational concept for a crewed mission to a near-Earth asteroid (NEA) and to identify areas for future work and collaboration. With the increased likelihood of a medical incident on a long duration exploration mission to a near-Earth asteroid, as well as the fact that there will likely be limited medical capabilities and resources available to diagnose and treat medical conditions, it is anticipated that a more structured use of telemedicine will become highly desirable. The workshop was convened to solicit expert opinion on current telemedicine practices and on medical care in remote environments. Workshop Objectives: The workshop brought together leaders in telemedicine and remote medicine from The University of Texas Medical Branch, Henry Ford Hospital, Ontario Telemedicine Network, U.S. Army Institute of Surgical Research, University of Miami, American Telemedicine Association, Doctors Without Borders, and the Pan American Health Organization. The primary objectives of the workshop were to document the medical operations concept for a crewed mission to a NEA, to determine gaps between current capabilities and the capabilities outlined in the operations concept, to identify research required to close these gaps, and to discuss potential collaborations with external-to-NASA organizations with similar challenges. Summary of Discussions and Conclusions: The discussions held during the workshop and the conclusions reached by the workshop participants were grouped into seven categories: Crew Medical Officers, Patient Area in Spacecraft, Training, Electronic Medical Records, Intelligent Care Systems, Consultation Protocols, Prophylactic Surgical Procedures, and Data Prioritization. The key points discussed under each category will be presented.

Barsten, K. N.↗
NASA NTRS2010

Visual Impairment/Intracranial Pressure Risk Assessment

Since 2006 there have been 6 reported cases of altered visual acuity and intracranial pressure (ICP) in long duration astronauts. In order to document this risk and develop an integrated approach to its mitigation, the NASA Space Life Sciences Directorate (SLSD) and Human Research Program (HRP) have chosen to use the Human System Risk Board (HSRB) and the risk management analysis tool (RMAT). The HSRB is the venue in which the stakeholders and customers discuss and vet the evidence and the RMAT is the tool that facilitates documentation and comparison of the evidence across mission profiles as well as identification of risk factors, and documentation of mitigation strategies. This process allows for information to be brought forward and dispositioned so that it may be properly incorporated into the RMAT and contribute to the design of the research and mitigation plans. The evidence thus far has resulted in the identification of a visual impairment/intracranial pressure (VIIP) project team, updating of both short and long duration medical requirements designed to assess visual acuity, and a research plan to characterize this issue further. In order to understand this issue more completely, a plan to develop an Accelerated Research Collaboration (ARC) has been approved by the HSRB. The ARC is a novel research model pioneered by the Myelin Repair Foundation. It is a patient centered research model that brings together researchers and clinicians, under the guidance of a scientific advisory panel, to collaborate and produce results much quickly than accomplished through traditional research models. The data and evidence from the updated medical requirements and the VIIP ARC will be reviewed at the HSRB on a regular basis. Each review package presented to the HSRB will include an assessment and recommendation with respect to continuation of research, countermeasure development, occupational surveillance modalities, selection criteria, etc. This process will determine the course of the VIIP project and ultimately how SLSD and HRP mitigate this emerging human health and performance risk.

Fogarty, Jennifer A.↗
NASA NTRS2010

Visual Impairment and Intracranial Hypertension: An Emerging Spaceflight Risk

What is the risk? Given that astronauts exposed to microgravity experience a cephalad fluid shift, and that both symptomatic and asymptomatic astronauts have exhibited optic nerve sheath edema on MRI, there is a high probability that all astronauts have some degree of increased intracranial pressure (ICP; intracranial hypertension), and that those susceptible (via eye architecture, anatomy, narrow optic disc) have a high likelihood of developing papilledema (optic disc edema, globe flattening), choroidal folds, and/or hyperopic shifts and that the degree of edema may determine long-term or permanent vision impairment or loss. Back to back panels on this topic have been developed to address this emerging risk. The first panel will focus on the 6 clinical cases with emphasis on ophthalmic findings and imaging techniques used pre-, in-, and post-flight. The second panel will discuss the operational mitigation and medical requirements, the potential role of CO2 on ISS, and the research approach being developed. In total these back to back panels will explore what is known about this risk, what has been done immediately to address it, and how an integrated research model is being developed.

Fogarty, Jennifer A.↗