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S M C Lee

Publications and source records attributed to S M C Lee.

Mitigating Headward Fluid Shifts with Venoconstrictive Thigh Cuffs during Spaceflight

Venoconstrictive thigh cuffs (VTC) are a mechanical countermeasure capable of attenuating the spaceflight induced headward fluid shift, and thus may be a viable spaceflight associated neuro-ocular syndrome (SANS) countermeasure. Crewmembers can use VTC to mitigate the headward fluid shift to aid in adapting to spaceflight. However, data are needed to determine if VTC affect ocular structures. PURPOSE The purpose of this study is to determine the efficacy of long duration use of VTC application to mitigate the spaceflight-induced headward fluid shift. We hypothesize that a VTC countermeasure will temporarily reverse the headward fluid shift and attenuate spaceflight-induced changes of internal jugular vein (IJV) cross-sectional area, IJV pressure, stroke volume, cardiac output, intraocular pressure (IOP), and optic nerve head and retinal morphology. METHODS This study will evaluate the effectiveness of VTC countermeasure application on the headward fluid shift, as well as cardiovascular and ocular variables. VTC during spaceflight will be worn for an extended duration (up to 6 hours) with data collected at three time points (30 minutes, 3 hours, and 6 hours) to characterize the temporal profile of key fluid shift outcome measures of the vascular fluid shift, IOP, and ocular structure changes. Ten astronauts will be recruited to participate and will be studied before and during approximately 180-day International Space Station (ISS) spaceflight missions. Baseline data collection will occur approximately 90-days before launch (Figure). Preflight, each leg of the crewmember will be measured to determine the VTC cuff size and a cuff fit check session will occur prior to the preflight baseline ground imaging to verify the appropriate fit measured via a surface contact pressure. Prior to donning the VTC, baseline measures without VTC will be collected seated, supine, and supine followed by data collection with the VTC. The baseline data collection will include ultrasound (IJV area and pressure, stroke volume and cardiac output), brachial blood pressure and heart rate, optical coherence tomography (OCT) imaging (total retinal thickness and choroid thickness), and IOP. An inflight cuff fit check session, same as the preflight fit check, will occur prior to VTC use on ISS. The inflight VTC experiment will be conducted early (FD45) and late (R-45) to determine if mission duration affects VTC fit and the efficacy of fluid redistribution. A system usability scale comfort questionnaire will be included in each VTC session to capture feedback from crewmembers regarding the comfort and usability of the VTC. SCIENTIFIC & MISSION IMPACT Results will narrow knowledge gaps described in the Human Research Roadmap to mitigate the headward fluid shift during spaceflight and help NASA to 1) determine the efficacy of extended use VTC application to mitigate the spaceflight-induced headward fluid shift and 2) further the understanding of the use of VTC on vascular fluid shifts, IOP, and ocular structure during spaceflight. Supported by NASA Human Research Program Directed Research. Figure. Detailed Testing Schedule. Baseline data collection at L-90 will be performed in a randomized order of position.

J V Jasien↗

Standard Measures During Spaceflight

The key goal of the Spaceflight Standard Measures project is to ensure that a set of measures, representing the Human Research Program’s key risks and acquired with minimal impact on time and resources, is consistently captured from crewmembers through the end of the International Space Station (ISS) Program. Data collected under the Spaceflight Standard Measures project include assessments of sleep/wake cycles, cognition, immune status and function, general blood and urine chemistry (urine is collected only before flight and after landing), microbiome composition (gastrointestinal tract, saliva, and body surface), cardiovascular structure and function (carotid intima-media thickness, orthostatic responses), sensorimotor function, and team processes. Data is collected once or twice before the flight (180 and 90 days before launch), twice during the 6-month missions (fight day 30 and 30 days before return to Earth) with the exception of actigraphy, which is recorded continuously during the mission, and during two-week periods before and after the mission. In this presentation, we will review the data collected to date on twelve ISS crew members. These data are placed in the NASA Life Sciences Data Archive and are available for occupational surveillance (using non-identifiable data) Institutional Review Board-approved data sharing requests, and retrospective data requests. This data repository enables high-level monitoring of the effectiveness of countermeasures and meaningful interpretation of health and performance outcomes for various mission durations. The knowledge gained from this project informs and supports future hypothesis-driven research that will enable the success of planetary missions.

G R Clement↗

Characterization of Jugular Venous Blood Flow During Acute Fluid Shifts

INTRODUCTION Exposure to weightlessness induces a headward fluid shift and redistribution of fluids, resulting in increased internal jugular vein (IJV) cross-sectional area and altered IJV blood flow dynamics including stasis and retrograde flow. These findings may contribute to various risks of spaceflight, including thrombosis or other risks affected by cerebral venous blood flow. To date, our understanding of the cerebral venous outflow dynamics is limited to the left IJV assessed ~45and ~150days into spaceflight. Therefore, it is unknown how quickly the alterations in venous blood flow dynamics change as a result of weightlessness. The purpose of this study is to determine 1) if venous stasis is an immediate effect of weightlessness, and therefore a risk for short-duration missions, and 2) the effect of weightlessness on brachiocephalic venous flow. METHODS In this study, we will determine the effects of acute weightlessness during parabolic flight on right and left IJV cross-sectional area, as well as blood flow dynamics through the IJV and brachiocephalic veins in 12 healthy subjects. Baseline ultrasound images will be obtained on the ground prior to the parabolic flight in the seated and supine postures to determine normal changes in blood flow with posture-induced fluid shifts in a 1genvironment. Subjects will then undergo parabolic flight withrepeated,~20 second exposure to 0g. Each data collection session will include 2D ultrasonography to quantify IJV cross-sectional area and Doppler ultrasonography to characterize venous blood flow patterns in the IJV and brachiocephalic veins. RESULTS Data collection for this study is planned to take place in October, 2021.CONCLUSIONS This study will characterize the immediate venous response in the left and right IJV and brachiocephalic veins upon entry into weightlessness. The results from this parabolic flight study will be compared with previous data from International Space Station crewmembers collectedafter~45 and ~150 days into spaceflight to provide a more complete understanding of the temporal profile of changes in venous blood flow dynamics during weightlessness and whether these findings develop in veins other than the left IJV. Supported by the NASA Human Research Program.

K Marshall-Bowman↗

Indices of Cardiovascular Disease Risk in Astronauts After Long-Duration Spaceflight in Low Earth Orbit

Current human spaceflight missions consist primarily of 4-6 month stays onboard the International Space Station (ISS), but in the future will include longer missions to the Moon and Mars. These missions will expose astronauts to increased risk of oxidative and inflammatory damage from a variety of sources (e.g., galactic cosmic radiation, psychological stress, reduced physical activity). Earth-based evidence suggests that increased oxidative stress and inflammation accelerates development of cardiovascular disease, but it is unclear if the spaceflight environment increases this risk in astronauts.

S M C Lee↗

Characterization of Jugular Venous Blood Flow During Acute Fluid Shifts

INTRODUCTION Exposure to weightlessness induces a headward fluid shift and redistribution of fluids, resulting in increased internal jugular vein (IJV) cross-sectional area and altered IJV blood flow dynamics, including stasis and retrograde flow. These findings may contribute to various risks of spaceflight, including thrombosis or other risks affected by cerebral venous blood flow. To date, our understanding of the cerebral venous outflow dynamics in weightlessness is limited to the left IJV assessed ~45 and ~150 days into spaceflight. Therefore, it is unknown how quickly the alterations in venous blood flow dynamics change as a result of weightlessness. The purpose of this study is to determine 1) if venous stasis is an immediate effect of weightlessness and therefore a risk for short-duration missions and 2) the effect of weightlessness on brachiocephalic venous flow. METHODS In this study, we investigated the effects of acute weightlessness during parabolic flight on the right and left IJV in 12 healthy subjects. Baseline ultrasound images were obtained on the ground (1g) in the seated and supine postures and during 0g parabolic flight. Each data collection session included 2D ultrasonography to quantify IJV cross-sectional area and Doppler ultrasonography to characterize venous blood flow patterns in the bilateral IJVs. RESULTS There was a similar pattern of response in the left and right IJV area across postures and g-levels. IJV area increased from seated to supine by 0.74 mm2 (95% CI: 0.56 to 0.91 mm2, p<.001) and increased further during weightlessness by 0.29 mm2 (95% CI: 0.11 to 0.47 mm2, p=.0015). IJV Doppler images revealed stagnant flow in the left IJV in one subject during 0g exposure that was not present during any imaging on the ground; the right IJV continued to show pulsatile, nominal flow patterns in both 0g and 1g. CONCLUSIONS This study characterized the immediate effect of the weightlessness-induced headward fluid shift on venous parameters in the left and right IJV. The left IJV appears to be more susceptible to flow alterations, including stagnant flow, during both short and long-duration exposure to weightlessness that may contribute to the risk of thrombosis inflight.

K Marshall-Goebel↗

Standard Measures During Spaceflight

The goal of the Spaceflight Standard Measures project is to ensure that a set of measures, representing the Human Research Program’s key risks and acquired with minimal impact on time and resources, is consistently captured from crewmembers through the end of the International Space Station (ISS) Program. Data collected under the Spaceflight Standard Measures project include assessments of sleep/wake cycles, cognition, immune status and function, general blood and urine chemistry (urine is collected only before flight and after landing), microbiome composition (gastrointestinal tract, saliva, and body surface), cardiovascular structure and function (carotid intima-media thickness, orthostatic responses), sensorimotor function, sleep quality, and team processes. Data is collected once or twice before the flight (180 and 90 days before launch), twice during the 6-month missions (flight day 30 and 30 days before return to Earth) with the exception of actigraphy, which is recorded during two-week periods before, during, and after the mission. In this presentation, we will review the data collected to date on 31 ISS crewmembers. These data are placed in the NASA Life Sciences Portal (NLSP) and are available for occupational surveillance (using non-identifiable data), Institutional Review Board-approved data sharing requests, and retrospective data requests. This data repository enables high-level monitoring of the effectiveness of countermeasures and meaningful interpretation of health and performance outcomes for various mission durations. The knowledge gained from this project informs and supports future hypothesis-driven research that will enable the success of planetary missions.

G R Clement↗