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NASA NTRS2000

A Miniature Mars Ascent Vehicle

Launch of payloads from the surface of the Mars is a central element in any Sample Return program, and represents one of the most important objectives of NASA planetary science and Human Exploration and Development of Space (HEDS) programs. Analysis of these samples in the sophisticated laboratories of Earth will give vastly more scientific as well as HEDS-relevant engineering and space-medicine knowledge of those bodies than can be performed from any feasible near-term miniaturized instruments. What is proposed here is a launch system with no moving parts of any kind: no gyroscope, no accelerometers, no control surfaces, and no thrust vector control.

B. H. Wilcox↗

NASA NTRS2006

Recommendations from NASA's Operational and Research Musculoskeletal Summit

Introduction: Continuously evolving medical standards of care, limited crew training time, and the inherent constraints of space flight necessitate regular revisions of the mission medical support infrastructure and methodology. A three-day Operational and Research Musculoskeletal Summit was held to review NASA s current strategy for preflight health maintenance and injury screening, risk mitigation for musculoskeletal injuries or syndromes, treatment methods during flight, and research topics to mitigate risks to astronaut health. The Summit also undertook consideration of the best evidence-based terrestrial musculoskeletal practices to recommend their adaptation for use in space. Methods: The types and frequencies of musculoskeletal injuries sustained by short- and long-duration astronauts were obtained from the Longitudinal Study of Astronaut Health. The Summit panel was comprised of experts from the clinical and research communities, as well as representatives from NASA Headquarters, the Astronaut corps, and the offices of JSC Medical Operations, JSC Human Adaptation and Countermeasures, Glenn Research Center Human Research, and Astronaut Strength Conditioning and Rehabilitation. Before the summit, panelists participated in a Web-based review of NASA s Space Medical Conditions List (SMCL). Results: The Summit generated seventy-five operational and research recommendations to the NASA Office of Space Medicine, including changes to the SMCL and to the musculoskeletal section of the ISS debrief questionnaire. From these recommendations, seven were assigned highest value and priority, and could be immediately adopted for the exploration architecture. Discussion: Optimized exercise and conditioning to improve performance and forestall musculoskeletal damage on orbit were the primary area of focus. Special attention was paid to exercise timing and muscle group specificity. The panel s recommendations are currently in various stages of consideration or integration into the ISS and Exploration programs. This effort serves to enhance the on-orbit system so comprehensive treatment can be delivered in a more effective and standardized manner.

Jones, J. A.↗

NASA NTRS2006

WIse-2005: Combined Aerobic and Resistive Exercise May Help Mitigate Bone Loss During 60-D Simulated Microgravity in Women

Exercise can attenuate bone loss associated with disuse during bed rest (BR), an analog of space flight. Previous studies have examined the efficacy of aerobic or resistive exercise countermeasures, but not in combination. We sought to determine the effect of a combined resistive and aerobic exercise regimen on bone metabolism during BR. After a 20-d ambulatory adaptation to confinement and diet, 16 women participated in a 60-d head-down-tilt BR. Control subjects (CN, n=8) performed no countermeasures. Exercise subjects, (EX, n=8) participated in exercise alternating daily between supine treadmill exercise within lower body negative pressure and resistive fly-wheel exercise (6-d wk(sup -1)). In the last week of BR, bone resorption was greater (p less than 79 plus or minus 44%, mean plus or minus SD) and EX groups (64 50%). N-telopeptide also increased (CN: 51 plus or minus 34%; EX: 43 plus or minus 56%). However, bone-specific alkaline phosphatase, a bone formation marker, tended to be higher in EX (26 plus or minus 18%) than in CN (8 plus or minus 33%) groups. The combination of resistive and aerobic exercise does not prevent bone resorption, but may promote formation, potentially mitigating the net bone loss associated with simulated microgravity. This study was supported by CNES, CSA, ESA, NASA, and NASA grant NNJ04HF71G to ARH. MEDES (French Institute for Space Medicine and Physiology) organized the study.

Smith, Scott M.↗

NASA NTRS2007

Translational Research in Space Exploration

This viewgraph presentation reviews NASA's role in medical translational research, and the importance in research for space exploration. The application of medical research for space exploration translates to health care in space medicine, and on earth.

Iyengar, M. Sriram↗

NASA NTRS2006

ISS Utilization for Exploration-Class Missions

Exercise countermeasures are the most commonly utilized approach for maintaining the health and performance of astronauts during spaceflight missions. However, International Space Station (ISS) exercise countermeasure hardware reliability and prescriptions are not at a point of departure to support exploration-class missions. The JSC Exercise Countermeasures Project (ECP) plans to use ISS as a research and hardware evaluation platform to define and validate improved exercise hardware, prescriptions, and monitoring strategies to support crewmember operations on the Moon and Mars. The ECP will partner with JSC's Space Medicine Division to standardize elements of ISS exercise prescriptions to better understand their efficacy and to propose modified prescriptions for implementation that may be used in the crew exploration vehicle and/or lunar habitat. In addition, evaluations of the ISS treadmill harness will be conducted to define and improve fit and function, and assess the next generation medical monitoring devices such as the portable unit for metabolic analysis and the muscle atrophy research and exercise system for completion of periodic fitness evaluations during lunar and Mars travel. Finally, biomechanical data from ISS crew exercise sessions will be obtained to better understand loading and restraint systems, and identify the physiologic requirements during ISS extravehicular activities that may be analogous to extended excursions from the lunar habitat. It is essential to optimize exercise prescriptions, hardware, and monitoring strategies for exploration initiatives using ISS as a platform before the planned retirement of the Shuttle in 2010 and the declining NASA emphasis on ISS to maximize knowledge before embarking on travel to the Moon and Mars.

FIncke, R.↗

NASA NTRS2005

Introduction and Mission Response Team (MRT)

On February 1, 2003 the Space Shuttle Columbia, returning to Earth with a crew of seven astronauts, disintegrated along a track extending from California to Louisiana. Observers on the ground filmed breakup of the spacecraft. Debris fell along a 567 statute mile track from Littlefield, Texas to Fort Polk, Louisiana; the largest ever recorded debris field. At the time of the accident the National Aeronautics and Space Administration (NASA) flight surgeon on-duty at the Mission Control Center (MCC) in Houston, Texas initiated the medical contingency response. The DOD surgeon at Patrick Air Force Base was notified, NASA medical personnel were recalled and the services of Armed Forces Institute of Pathology (AFIP) were requested. Subsequent to the accident the NASA flight surgeons that had supported the crew on orbit now provided medical support to the crewmember s families. Federal Emergency Management Agency (FEMA), the National Transportation Safety Board (NTSB), the Federal Bureau of Investigation (FBI) and numerous other federal, state and local agencies along with the citizens of Texas and Louisiana responded to the disaster. Search and recovery was managed from a Disaster Field Office (DFO) established in Lufkin, Texas. Mishap Investigation Team (MIT) medical operations were managed from Barksdale Air Force Base, Louisiana. Accident investigation teams (Columbia Accident Investigation Task Force (CAITF) and Columbia Accident Investigation Board (CAIB)) appointed immediately after the disaster included current and former authorities in space medicine. In August 2003, the CAIB concluded its investigation and released its findings in a report published in February 2004.

Pool, Sam↗

NASA NTRS2005

Mishap Investigation Team (MIT) - Barksdale AFB, Louisiana

The Shuttle Program is organized to support a Shuttle mishap using the resources of the MIT. The afternoon of Feb. 1, 2003, the MIT deployed to Barksdale AFB. This location became the investigative center and interim storage location for crewmembers received from the Lufkin Disaster Field Office (DFO). Working under the leadership of the MIT Lead, the medical team executed a short-term plan that included search, recovery, and identification including coordination with the Armed Forces Institute of Pathology Temporary operations was set up at Barksdale Air Force Base for two weeks. During this time, coordination with the DFO field recovery teams, AFIP personnel, and the crew surgeons was on going. In addition, the crewmember families and NASA management were updated daily. The medical team also dealt with public reports and questions concerning biological and chemical hazards, which were coordinated with SPACEHAB, Inc., Kennedy Space Center (KSC) Medical Operations and the Johnson Space Center (JSC) Space Medicine office. After operations at Barksdale were concluded the medical team transitioned back to Houston and a long-term search, recovery and identification plan was developed.

Stepaniak, Philip↗

NASA NTRS2010

Assessment of Prone Positioning of Restrained, Seated Crewmembers in a Post Landing Stable 2 Orion Configuration

During the Orion landing and recovery subsystem design review, June 2009, it was noted that the human system and various vehicle systems, the environmental control and life support (ECLSS) and guidance, navigation and control (GN&C) systems for example, are negatively affected by Orion assuming a stable 2 (upside down; Figure A) configuration post landing. The stable 2 configuration is predicted to occur about 50% of the time based on Apollo landing data and modeling of the current capsule. The stable 2 configuration will be countered by an active up-righting system (crew module up-righting system; CMUS). Post landing balloons will deploy and inflate causing the vehicle to assume or maintain the stable 1 (up-right; Figure B) configuration. During the design review it was proposed that the up-righting system could be capable of righting the vehicle within 60 seconds. However, this time limit posed a series of constraints on the design which made it less robust than desired. The landing and recovery subsystem team requested an analysis of Orion vehicle systems as well as the human system with regard to the effect of stable 2 in order to determine if an up-righting response time greater than 60 seconds could be tolerated. The following report focuses on the assessment of the human system in the posture assumed when Orion is in the stable 2 configuration. Stable 2 will place suited, seated, and restrained crewmembers in a prone (facedown), head-up position for a period of time dependent on the functionality of the up-righting systems, ability of the crew to release themselves from the seat and restraints, and/or time to arrival of rescue forces. Given that the Orion seat and restraint system design is not complete and therefore, not available for evaluation, Space Medicine assessed how long a healthy but deconditioned crewmember could stay in this prone, restrained position and the physiological consequences of this posture by researching terrestrial analogs and considered the known physiological alterations and deconditioning experienced by long duration crewmembers.

Barr, Yael↗

NASA NTRS2010

Musculoskeletal Changes, Injuries and Rehabilitation Associated with Spaceflight

The in-flight musculoskeletal database provides the foundation for directing operationally-relevant research in space medicine. This effort will enable medical operations to develop medical kits, training programs, and preventive medicine strategies for future CxP missions: a) Quantify medications and medical supplies for next-generation spacecraft. b) Objective data for engineers to determine weight requirements. Flight surgeons can make specific recommendations to astronauts based on injury data, such as emphasizing hand protection while in-flight. EVA and spacecraft engineers can examine evidence-based data on injuries and design countermeasures to help prevent them.

Scheuring, Richard A.↗

NASA NTRS2010

Atrial Arrhythmia Summit: Post Summit Report

The Atrial Arrhythmia Summit brought together nationally and internationally recognized experts in cardiology, electrophysiology, exercise physiology, and space medicine in an effort to elucidate the mechanisms, risk factors, and management of atrial arrhythmias in the unique occupational cohort of the U.S. astronaut corps.

Barr, Yael↗

NASA NTRS2010

Concept of Operations Evaluation for Mitigating Space Flight-Relevant Medical Issues in a Planetary Habitat

Introduction: Analogue environments assist the NASA Human Research Program (HRP) in developing capabilities to mitigate high risk issues to crew health and performance for space exploration. The Habitat Demonstration Unit (HDU) is an analogue habitat used to assess space-related products for planetary missions. The Exploration Medical Capability (ExMC) element at the NASA Johnson Space Center (JSC) was tasked with developing planetary-relevant medical scenarios to evaluate the concept of operations for mitigating medical issues in such an environment. Methods: Two medical scenarios were conducted within the simulated planetary habitat with the crew executing two space flight-relevant procedures: Eye Examination with a corneal injury and Skin Laceration. Remote guidance for the crew was provided by a flight surgeon (FS) stationed at a console outside of the habitat. Audio and video data were collected to capture the communication between the crew and the FS, as well as the movements of the crew executing the procedures. Questionnaire data regarding procedure content and remote guidance performance also were collected from the crew immediately after the sessions. Results: Preliminary review of the audio, video, and questionnaire data from the two scenarios conducted within the HDU indicate that remote guidance techniques from an FS on console can help crew members within a planetary habitat mitigate planetary-relevant medical issues. The content and format of the procedures were considered concise and intuitive, respectively. Discussion: Overall, the preliminary data from the evaluation suggest that use of remote guidance techniques by a FS can help HDU crew execute space exploration-relevant medical procedures within a habitat relevant to planetary missions, however further evaluations will be needed to implement this strategy into the complete concept of operations for conducting general space medicine within similar environments

Barsten, Kristina↗

NASA NTRS2011

Integration and Cooperation in the Next Golden Age of Human Space Flight Data Repositories: Tools for Retrospective Analysis and Future Planning

As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health Repository (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future research studies.

Thomas, D.↗

NASA NTRS2010

Visual Impairment and Intracranial Hypertension: An Emerging Spaceflight Risk

During recent long duration missions to the International Space Station (ISS) crewmembers have reported changes in visual acuity or visual field defects. Exams in the postflight period revealed changes to the visual system and elevated intracranial pressures. As a result, NASA Space Medicine has added a number of tests to be performed in the preflight, inflight and postflight periods for ISS and shuttle missions with the goal of determining the processes at work and any potential mitigation strategies. This discussion will acquaint you with the changes that NASA has made to its medical requirements in order to address the microgravity induced intracranial hypertension and associated visual changes. Key personnel have been assembled to provide you information on this topic. Educational Objectives: Provide an overview of the current Medical Operations requirements and the mitigation steps taken to operationally address the issue.

Taddeo, Terrance A.↗

NASA NTRS2010

Cold Stowage Flight Systems

The International Space Station (ISS) provides a test bed for researchers to perform science experiments in a variety of fields, including human research, life sciences, and space medicine. Many of the experiments being conducted today require science samples to be stored and transported in a temperature controlled environment. NASA provides several systems which aide researchers in preserving their science. On orbit systems provided by NASA include the Minus Eighty Laboratory freezer for ISS (MELFI), Microgravity Experiment Research Locker Incubator (MERLIN), and Glacier. These freezers use different technologies to provide rapid cooling and cold stowage at different temperature levels on board ISS. Systems available to researchers during transportation to and from ISS are MERLIN, Glacier, and Coldbag. Coldbag is a passive cold stowage system that uses phase change materials. Details of these current technologies will be provided along with operational experience gained to date. With shuttle retirement looming, NASA has protected the capability to provide a temperature controlled environment during transportation to and from the ISS with the use of Glacier and Coldbags, which are compatible with future commercial vehicles including SpaceX's Dragon Capsule, and Orbital s Cygnus vehicle. This paper will discuss the capability of the current cold stowage hardware and how it may continue to support NASA s mission on ISS and in future exploration missions.

Campana, Sharon↗

NASA NTRS2011

NASA Life Sciences Data Repositories: Tools for Retrospective Analysis and Future Planning

As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future research studies.

Thomas, D.↗

NASA NTRS2011

Cold Stowage Flight Systems

The International Space Station (ISS) provides a test bed for researchers to perform science experiments in a variety of fields, including human research, life sciences, and space medicine. Many of the experiments being conducted today require science samples to be stored and transported in a temperature controlled environment. NASA provides several systems which aid researchers in preserving their science. On orbit systems provided by NASA include the Minus Eighty Laboratory freezer for ISS (MELFI), Microgravity Experiment Research Locker Incubator (MERLIN), and Glacier. These freezers use different technologies to provide rapid cooling and cold stowage at different temperature levels on board ISS. Systems available to researchers during transportation to and from ISS are MERLIN, Glacier, and Coldbag. Coldbag is a passive cold stowage system that uses phase change materials to maintain temperature. Details of these current technologies are provided along with operational experience gained to date. This paper discusses the capability of the current cold stowage hardware and how it may continue to support NASA s mission on ISS and in future exploration missions.

Campana, Sharon E.↗

NASA NTRS2004

Creating a Scenario Suitable for Multiple Caregivers

The HPS can be utilized for the training of a wide variety of caregivers, ranging from physicians to laypeople. Methods: A single scenario was developed and adapted for a number of clinical scenarios and operational environments, ranging from in-flight to the immediate postflight timeline. In this way, different caregivers, from astronauts to search and rescue forces to specialty-boarded physicians, could make use of a single clinical situation. Five crew medical officer analogs and sixty anesthesia residents, serving as flight surgeon analogs, and, were briefed on space medicine and physiology, then were exposed to the scenario and asked to manage the patient as if they were part of the in-flight or recovery team. Results: Basic themes, such as crisis resource management, were standard across the student audiences. Discussion: A single clinical script can easily be adapted for multiple uses.

Doerr, Harold↗

NASA NTRS2004

Code Blue on Orbit: Treating Cardiac Arrest on the ISS

As a result of the Columbia tragedy on February 1,2003, the International Space Station (ISS) crew size has been temporarily reduced from three to two. This change forces adaptations in many operational procedures used by the crew, including medical protocols which were designed for scenarios involving one casualty and two caregivers. The Office of Space Medicine directed that the procedure for the resuscitation of a crewmember in cardiac arrest be rewritten for use by a single care provider. Methods: Adaptation of this procedure made use of current American Heart Association Advanced Cardiac Life Support (ACLS) procedures and reflects necessary compromises between the realities of the operational environment and prompt provision of medical care. Results: Numerous changes were incorporated due to the diminution in available personnel, including substitution of endotracheal rather than intravenous delivery of drugs, more rapid defibrillation, addition of a precordial thump, removal of transcutaneous pacing, streamlining of procedural steps, and clarification of termination criteria. Discussion: The on-orbit care available to the ISS crewmembers is constrained by numerous factors, including crew medical training, minimal medical assets, limited air/ground communication , and a single caregiver for the foreseeable future. All of these combine to make a successful resuscitation unlikely, however, this procedure must ultimately deal with not only the patient's welfare, but also that of the caregiver, the mission, and the program.

Bacal, Kira↗