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Human System Risk Management for Space Flight

This brief abstract reviews the development of the current day approach to human system risk management for space flight and the development of the critical components of this process over the past few years. The human system risk management process now provides a comprehensive assessment of each human system risk by design reference mission (DRM) and is evaluated not only for mission success but also for long‐term health impacts for the astronauts. The discipline of bioastronautics is the study of the biological and medical effects of space flight on humans. In 1997, the Space Life Sciences Directorate (SLSD) initiated the Bioastronautics Roadmap (Roadmap) as the "Critical Path Roadmap", and in 1998 participation in the roadmap was expanded to include the National Space Biomedical Research Institute (NSBRI) and the external community. A total of 55 risks and 250 questions were identified and prioritized and in 2000, the Roadmap was base-lined and put under configuration control. The Roadmap took into account several major advisory committee reviews including the Institute of Medicine (IOM) "Safe Passage: Astronaut care for Exploration Missions", 2001. Subsequently, three collaborating organizations at NASA HQ (Chief Health and Medical Officer, Office of Space Flight and Office of Biological & Physical Research), published the Bioastronautics Strategy in 2003, that identified the human as a "critical subsystem of space flight" and noted that "tolerance limits and safe operating bands must be established" to enable human space flight. These offices also requested a review by the IOM of the Roadmap and that review was published in October 2005 as "A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA's Bioastronautics Roadmap", that noted several strengths and weaknesses of the Roadmap and made several recommendations. In parallel with the development of the Roadmap, the Office of the Chief Health and Medical Officer (OCHMO) began a process in 2004 of evaluating the tolerance limits and safe operating bands called for in the Bioastronautics Strategy. Over the next several years, the concept of the "operating bands" were turned into Space Flight Human System Standards (SFHSS), developed by the technical resources of the SLSD at the NASA Johnson Space Center (JSC). These standards were developed and reviewed at the SLSD and then presented to the OCHMO for acceptance. The first set of standards was published in 2007 as the NASA‐STD‐3001, Volume 1, Crew Health that elaborated standards for several physiological areas such as cardiovascular, musculoskeletal, radiation exposure and nutrition. Volume 2, Human Factors, Habitability and Human Health was published in 2011, along with development guidance in the Human Integration Design Handbook (HIDH). Taken together, the SFHSS Volumes 1 and 2, and the HIDH replaced the NASA‐STD‐3000 with new standards and revisions of the older document. Three other changes were also taking place that facilitated the development of the human system risk management approach. In 2005, the life sciences research and development portfolio underwent a comprehensive review through the Exploration Systems Architecture Study (ESAS) that resulted in the reformulation of the Bioastronautics Program into Human Research Program (HRP) that was focused on appropriate mitigation results for high priority human health risks. The baseline HRP budget was established in August 2005. In addition, the OCHMO formulated the Health and Medical Technical Authority (HMTA) in 2006 that established the position of the Chief Medical Officer (CMO) at the NASA JSC along with other key technical disciplines, and the OCHMO became the responsible office for the SFHSS as noted above. The final change was the establishment in 2008 of the Human System Risk Board (HSRB), chaired by the CMO with representation from the HRP, SLSD management and technical experts. The HSRB then began to review all human system risks, established a comprehensive risk management and configuration management plan and data sharing policy. These major developments of standards, the HRP, the HMTA and a forum for review of human system risks (HSRB) facilitated the integration of human research, medical operations, systems engineering and many other disciplines in the comprehensive review of human system risks. The HSRB began a comprehensive review of all potential inflight medical conditions and events and over the course of several reviews consolidated the number of human system risks to 30 where the greatest emphasis is placed for investing program dollars for risk mitigation. The HSRB considers all available evidence from human research, medical operations and occupational surveillance in assessing the risks for appropriate mitigation and future work. All applicable DRMs (low earth orbit 6 and 12 months, deep space sortie for 30 days and 1 year, a one year lunar mission, and a planetary mission for 3 years) are considered as human system risks are modified by the hazards associated with space flight such as microgravity, exposure to radiation, distance from the earth, isolation and a closed environment. Each risk has a summary assessment representing the state of knowledge/evidence base for that risk, the available risk mitigations, traceability to the SFHSS and program requirements, and future work required. These data then can drive coordinated budgets across the HRP, the International Space Station, Crew Health and Safety and Advanced Exploration System budgets. These risk assessments were completed for 6 DRMs in December of 2014 and serve as the baseline for which subsequent research and technology development and crew health care portfolios can be assessed. The HSRB will review each risk at least annually and especially when new information is available that must be considered for effective risk mitigation. The current status of each risk can be reported to program management for operations, budget reviews and general oversight of the human system risk management program.

Davis, Jeffrey↗

Genomics Study of Effect of Redox-Active Metalloporphyrin on Murine Retina During Spaceflight

Astronauts returning from spaceflight have experienced eye problems, which may decrease retinal performance and lead to long-term effects on visual acuity. This study leverages the collected data from spaceflown murine retinas that were treated with redox-active metalloporphyrin (BuOE) to mitigate spaceflight-induced changes. 10-week-old adult C57BL/6 male mice (n=5 in each of BuOE treated and saline control groups) were flown on Space-X 24 to the ISS national lab, kept in low earth orbit for 35 days and returned to Earth alive. Our analysis of RNA-sequencing data generated from subsequent murine retina tissues uncovered genes, pathways, and epigenetic modifications consistent with therapeutic potential of BuOE. For spaceflown murine samples, the treatment group show differentially expressed genes relative to saline controls that reached significance (adjusted p-value < 0.05) and included genes Gpx3 and Crhbp, which are related to protection against cell oxidative damage and cellular response to organonitrogen compounds. Ranked fold-changes from the same contrast were used for gene set enrichment analysis, which showed biological processes reaching significance (adjusted p-value < 0.05) including glutathione metabolic processes and cellular response to xenobiotic stimulus. The findings from this investigation have the potential to provide valuable insights into the molecular mechanisms underlying conditions like spaceflight associated neuro-ocular syndrome and assess the effectiveness of BuOE as a countermeasure for astronauts experiencing neuro-ophthalmic abnormalities, which can lead to long-term effects on visual acuity.

Machine Learning↗

Genomics Study of Effect of Redox-Active Metalloporphyrin on Murine Retina During Spaceflight

Astronauts returning from spaceflight have experienced eye problems, which may decrease retinal performance and lead to long-term effects on visual acuity. This study leverages the collected data from spaceflown murine retinas that were treated with redox-active metalloporphyrin (BuOE) to mitigate spaceflight-induced changes. 10-week-old adult C57BL/6 male mice (n=5 in each of BuOE treated and saline control groups) were flown on Space-X 24 to the ISS national lab, kept in low earth orbit for 35 days and returned to Earth alive. Our analysis of RNA-sequencing data generated from subsequent murine retina tissues uncovered genes, pathways, and epigenetic modifications consistent with therapeutic potential of BuOE. For spaceflown murine samples, the treatment group show differentially expressed genes relative to saline controls that reached significance (adjusted p-value < 0.05) and included genes Gpx3 and Crhbp, which are related to protection against cell oxidative damage and cellular response to organonitrogen compounds. Ranked fold-changes from the same contrast were used for gene set enrichment analysis, which showed biological processes reaching significance (adjusted p-value < 0.05) including glutathione metabolic processes and cellular response to xenobiotic stimulus. The findings from this investigation have the potential to provide valuable insights into the molecular mechanisms underlying conditions like spaceflight associated neuro-ocular syndrome and assess the effectiveness of BuOE as a countermeasure for astronauts experiencing neuro-ophthalmic abnormalities, which can lead to long-term effects on visual acuity.

Machine Learning↗

Influence of Microgravity on Arterial Baroreflex Responses Triggered by Valsalva's Maneuver

When astronauts return to Earth and stand upright, their heart rates may speed inordinately, their blood pressures may fall, and some returning astronauts may even faint. Since physiological adjustments to standing are mediated importantly by pressure-regulating reflexes (baroreflexes), we studied involuntary (or autonomic) nerve and blood pressure responses of astronauts to four, 15-second periods of 15- and 30-mmHg straining (Valsalva'.~ maneuver). We measured the electrocardiogram, finger blood pressure, respiration, and muscle sympathetic nerve activity in four healthy male astronauts before and during the 16-day Neurolab Space Shuttle mission. We found that although microgravity provoked major autonomic changes, no astronaut experienced fainting symptoms after the mission. Blood pressure fell more during straining in space than on Earth (the average reduction of systolic pressure with 30-mmHg straining was 49 mmHg during and 27 mmHg before the mission). However, the increases of muscle sympathetic nerve activity that were triggered by straining were also larger in space than on Earth. As a result, the gain of the sympathetic baroreflex, taken as the total sympathetic nerve response divided by the maximum pressure reduction during straining, was the same in space as on Earth. In contrast, heart rate changes, which are mediated by changes of vagus nerve activity, were smaller in space. This and earlier research suggest that exposure to microgravity augments blood pressure and sympathetic adjustments to Valsalva straining and differentially reduces vagal, but not sympathetic baroreflex responsiveness. The changes that we documented can be explained economically as a consequence of the blood volume reduction that occurs in space.

Eckberg, Dwain L.↗

Potential Use of In Situ Material Composites such as Regolith/Polyethylene for Shielding Space Radiation

NASA has an extensive program for studying materials and methods for the shielding of astronauts to reduce the effects of space radiation when on the surfaces of the Moon and Mars, especially in the use of in situ materials native to the destination reducing the expense of materials transport. The most studied material from the Moon is Lunar regolith and has been shown to be as efficient as aluminum for shielding purposes (1). The addition of hydrogenous materials such as polyethylene should increase shielding effectiveness and provide mechanical properties necessary of structural materials (2). The neutron radiation shielding effectiveness of polyethylene/regolith stimulant (JSC-1A) composites were studied using confluent human fibroblast cell cultures exposed to a beam of high-energy spallation neutrons at the 30deg-left beam line (ICE house) at the Los Alamos Neutron Science Center. At this angle, the radiation spectrum mimics the energy spectrum of secondary neutrons generated in the upper atmosphere and encountered when aboard spacecraft and high-altitude aircraft. Cell samples were exposed in series either directly to the neutron beam, within a habitat created using regolith composite blocks, or behind 25 g/sq cm of loose regolith bulk material. In another experiment, cells were also exposed in series directly to the neutron beam in T-25 flasks completely filled with either media or water up to a depth of 20 cm to test shielding effectiveness versus depth and investigate the possible influence of secondary particle generation. All samples were sent directly back to JSC for sub-culturing and micronucleus analysis. This presentation is of work performed in collaboration with the NASA sponsored Center for Radiation Engineering and Science for Space Exploration (CRESSE) at Prairie View A&M.

Theriot, Corey A.↗

HZETRN Radiation Transport Validation Using Balloon-Based Experimental Data

The deterministic radiation transport code HZETRN (High charge (Z) and Energy TRaNsport) was developed by NASA to study the effects of cosmic radiation on astronauts and instrumentation shielded by various materials. This work presents an analysis of computed differential flux from HZETRN compared with measurement data from three balloon-based experiments over a range of atmospheric depths, particle types, and energies. Model uncertainties were quantified using an interval-based validation metric that takes into account measurement uncertainty both in the flux and the energy at which it was measured. Average uncertainty metrics were computed for the entire dataset as well as subsets of the measurements (by experiment, particle type, energy, etc.) to reveal any specific trends of systematic over- or under-prediction by HZETRN. The distribution of individual model uncertainties was also investigated to study the range and dispersion of errors beyond just single scalar and interval metrics. The differential fluxes from HZETRN were generally well-correlated with balloon-based measurements; the median relative model difference across the entire dataset was determined to be 30%. The distribution of model uncertainties, however, revealed that the range of errors was relatively broad, with approximately 30% of the uncertainties exceeding ± 40%. The distribution also indicated that HZETRN systematically under-predicts the measurement dataset as a whole, with approximately 80% of the relative uncertainties having negative values. Instances of systematic bias for subsets of the data were also observed, including a significant underestimation of alpha particles and protons for energies below 2.5 GeV/u. Muons were found to be systematically over-predicted at atmospheric depths deeper than 50 g/cm(sup 2) but under-predicted for shallower depths. Furthermore, a systematic under-prediction of alpha particles and protons was observed below the geomagnetic cutoff, suggesting that improvements to the light ion production cross sections in HZETRN should be investigated.

James E Warner↗

Long Duration Head-Down Tilt Bed Rest Studies: Safety Considerations Regarding Vision Health

Visual symptoms reported in astronauts returning from long duration missions in low Earth orbit, including hyperopic shift, choroidal folds, globe flattening and papilledema, are thought to be related to fluid shifts within the body due to microgravity exposure. Because of this possible relation to fluid shifts, safety considerations have been raised regarding the ocular health of head-down tilt (HDT) bed rest subjects. HDT is a widely used ground ]based analog that simulates physiological changes of spaceflight, including fluid shifts. Thus, vision monitoring has been performed in bed rest subjects in order to evaluate the safety of HDT with respect to vision health. Here we report ocular outcomes in 9 healthy subjects (age range: 27-48 years; Male/Female ratio: 8/1) completing bed rest Campaign 11, an integrated, multidisciplinary 70-day 6 degrees HDT bed rest study. Vision examinations were performed on a weekly basis, and consisted of office-based (2 pre- and 2 post-bed rest) and in-bed testing. The experimental design was a repeated measures design, with measurements for both eyes taken for each subject at each planned time point. Findings for the following tests were all reported as normal in each testing session for every subject: modified Amsler grid, red dot test, confrontational visual fields, color vision and fundus photography. Overall, no statistically significant differences were observed for any of the measures, except for both near and far visual acuity, which increased during the course of the study. This difference is not considered clinically relevant as may result from the effect of learning. Intraocular pressure results suggest a small increase at the beginning of the bed rest phase (p=0.059) and lesser increase at post-bed rest with respect to baseline (p=0.046). These preliminary results provide the basis for further analyses that will include correlations between intraocular pressure change pre- and post-bed rest, and optical coherence tomography measurements of the retina.

Cromwell, Ronita L.↗

Exploration Helmet Permanent Anti-Fog Study

For the current Extravehicular Mobility Unit (EMU) spacesuit, an astronaut applies an antifog solution to the interior of the helmet bubble before each EVA. However, the anti-fog solution has been reported to cause eye discomfort during at least seven EMU EVAs when the anti-fog solution contacted the crew member’s eyes. During STS-100, astronaut Chris Hadfield reported the eye irritation temporarily blinded him during his spacewalk. In addition, the wipe on anti-fog solution is a consumable that needs to be accounted for and a supply launched for missions. To solve this, NASA has tested different permanent anti-fog coatings. However, major issues have arisen with Human in the Loop (HITL) testing with the coatings. Cleaning and removing Valsalva devices which use pressure sensitive adhesives have been challenges to avoid damaging the permanent anti-fog coating. Due to these issues, further investigation is being completed evaluating two solvent based anti-fog solutions: Exxene’s HCF-100 and FSI’s Visgard 106-94. Each coating will be evaluated on polycarbonate samples for application consistency, steam cycles (mimicking breath cycles), cleaning durability, haze, and light transmission. This study will determine if either coating is a viable option to pursue as a permanent anti-fog for spacesuit helmet applications.

spacesuit↗

Exploration Helmet Permanent Anti-Fog Study

For the current Extravehicular Mobility Unit (EMU) spacesuit, an astronaut applies an antifog solution to the interior of the helmet bubble before each EVA. However, the anti-fog solution has been reported to cause eye discomfort during at least seven EMU EVAs when the anti-fog solution contacted the crew member’s eyes. During STS-100, astronaut Chris Hadfield reported the eye irritation temporarily blinded him during his spacewalk. In addition, the wipe on anti-fog solution is a consumable that needs to be accounted for and a supply launched for missions. To solve this, NASA has tested different permanent anti-fog coatings. However, major issues have arisen with Human in the Loop (HITL) testing with the coatings. Cleaning and removing Valsalva devices which use pressure sensitive adhesives have been challenges to avoid damaging the permanent anti-fog coating. Due to these issues, further investigation is being completed evaluating two solvent based anti-fog solutions: Exxene’s HCF-100 and FSI’s Visgard 106-94. Each coating will be evaluated on polycarbonate samples for application consistency, steam cycles (mimicking breath cycles), cleaning durability, haze, and light transmission. This study will determine if either coating is a viable option to pursue as a permanent anti-fog for spacesuit helmet applications.

spacesuit↗

Radiation Risk Assessment of the Individual Astronaut: A Complement to Radiation Interests at the NIH

Predicting human risks following exposure to space radiation is uncertain in part because of unpredictable distribution of high-LET and low-dose-derived damage amongst cells in tissues, unknown synergistic effects of microgravity upon gene- and protein-expression, and inadequately modeled processing of radiation-induced damage within cells to produce rare and late-appearing malignant cancers. Furthermore, estimation of risks of radiogenic outcome within small numbers of astronauts is not possible using classic epidemiologic study. It therefore seems useful to develop strategies of risk-assessment based upon large datasets acquired from correlated biological models useful for resolving radiogenic risk-assessment for irradiated individuals. In this regard, it is suggested that sensitive cellular biodosimeters that simultaneously report 1) the quantity of absorbed dose after exposure to ionizing radiation, 2) the quality of radiation delivering that dose, and 3) the biomolecular risk of malignant transformation be developed in order to resolve these NASA-specific challenges. Multiparametric cellular biodosimeters could be developed using analyses of gene-expression and protein-expression whereby large datasets of cellular response to radiation-induced damage are analyzed for markers predictive for acute response as well as cancer-risk. A new paradigm is accordingly addressed wherein genomic and proteomic datasets are registered and interrogated in order to provide statistically significant dose-dependent risk estimation in individual astronauts. This evaluation of the individual for assessment of radiogenic outcomes connects to NIH program in that such a paradigm also supports assignment of a given patient to a specific therapy, the diagnosis of response of that patient to therapy, and the prediction of risks accumulated by that patient during therapy - such as risks incurred by scatter and neutrons produced during high-energy Intensity-Modulated Radiation Therapy. Value of assessment of radiogenic outcome for individuals exposed to radiation is suggested to be common to both NASA and NIH.

Richmond, Robert C.↗

Astronaut Clothing for Exploration Missions

Astronaut clothes for exploration missions beyond low Earth orbit need to satisfy several challenges not met by the currently-used mostly-cotton clothing. A laundering system is not expected to be available, and thus soiled garments must be trashed. Jettisoning waste does not seem feasible at this time. The cabin oxygen concentration is expected to be higher than standard, and thus fabrics must better resist ignition and burning. Fabrics need to be identified that reduce logistical mass, that can be worn longer before disposal, that are at least as comfortable as cotton, and that resist ignition or that char immediately after ignition. Human factors and psychology indicate that crew well-being and morale require a variety of colors and styles to accommodate personal identity and preferences. Over the past four years, the Logistics Reduction Project under NASA's Advanced Exploration Systems Program has sponsored the Advanced Clothing System Task to conduct several ground studies and one ISS study. These studies have evaluated length of wear and personal preferences of commercially-available exercise- and routine-wear garments made from several fabrics (cotton, polyester, Merino wool, and modacrylic), woven and knitted. Note that Merino wool and modacrylic char like cotton in ambient air, while polyester unacceptably melts. This paper focuses on the two components of an International Space Station study, onboard and on the ground, with astronauts and cosmonauts. Fabrics were randomized to participants. Length of wear was assessed by statistical survival analysis, and preference by exact binomial confidence limits. Merino wool and modacrylic t-shirts were worn longer on average than polyester t-shirts. Interestingly, self-assessed preferences were inconsistent with length-of-wear behavior, as polyester was preferred to Merino wool and modacrylic.

Poritz, Darwin H.↗

Vestibular plasticity following orbital spaceflight: recovery from postflight postural instability

Results of previous studies suggested that the vestibular mediated postural instability observed in astronauts upon return to earth from orbital spaceflight may be exacerbated by an increased weighting of visual inputs for spatial orientation and control of movement. This study was performed to better understand the roles of visual and somatosensory contributions to recovery of normal sensori-motor postural control in returning astronauts. Preflight and postflight, 23 astronaut volunteers were presented randomly with three trials of six sensory organization test (SOT) conditions in the EquiTest system test battery. Sagittal plane center-of-gravity (COG) excursions computed from ground reaction forces were significantly higher on landing day than preflight for those test conditions presenting sway-referenced visual and/or somatosensory orientation cues. The ratio of summed peak-to-peak COG sway amplitudes on the two sway-referenced vision tests (SOTs 3 + 6) compared to the two eyes closed tests (SOTs 2 + 5) was increased on landing day, indicating an increased reliance on visual orientation cues for postural control. The ratio of peak-to-peak COG excursions on sway-referenced surfaces (SOTs 4, 5 & 6) to an earth fixed support surfaces (SOTs 1, 2 & 3) increased even more after landing suggesting primary reliance on somatosensory orientation cues for recovery of postflight postural stability. Readaptation to sway-referenced support surfaces took longer than readaptation to sway-referenced vision. The increased reliance on visual and somatosensory inputs disappeared in all astronauts 4-8 days following return to earth.

NASA Program Space Physiology and Countermeasures↗

Astronaut Risk Levels During Crew Module (CM) Land Landing

The NASA Engineering Safety Center (NESC) is investigating the merits of water and land landings for the crew exploration vehicle (CEV). The merits of these two options are being studied in terms of cost and risk to the astronauts, vehicle, support personnel, and general public. The objective of the present work is to determine the astronaut dynamic response index (DRI), which measures injury risks. Risks are determined for a range of vertical and horizontal landing velocities. A structural model of the crew module (CM) is developed and computational simulations are performed using a transient dynamic simulation analysis code (LS-DYNA) to determine acceleration profiles. Landing acceleration profiles are input in a human factors model that determines astronaut risk levels. Details of the modeling approach, the resulting accelerations, and astronaut risk levels are provided.

Lawrence, Charles↗

Increased Rates of Hip and Spine Fractures in Astronauts are Associated with Longer Spaceflight Durations

Given the accelerated declines in bone mineral density reported in US astronauts serving on the International Space Station, there is a possibility that a prolonged exposure to spaceflight could put astronauts at increased fracture risk during subsequent planetary explorations or after return to Earth. To date, there have been no fractures in astronauts during spaceflight. Recently-reported data from a flight study suggested that intake of the bisphosphonate alendronate combined with resistive exercise (on the Advanced Resistive Exercise Device – ARED) preserved more astronauts at their preflight skeletal status after a ~6-mos spaceflight than with ARED exercise alone. However, there is low acceptance of alendronate, or the recommended zoledronic acid, to suppress in-flight bone loss largely due to concern for unintended medication side effects and a perceived absence of astronaut fractures that can be directly attributable to spaceflight exposure. Hence, a recent survey of all astronaut fractures was analyzed to assess whether the rate of postflight fractures could be associated with extended spaceflight exposures. The fracture survey was of 262 astronauts across 8433.6 person-years (PY) and grouped according to previous exposure to a “Long Duration (LD)” spaceflight (3 mos or greater, but typically 6-mos). The number of fractures was modeled using count regression adjusting for i) the repeated measures within individuals across the groups, ii) the differing length of surveillance for each individual and iii) age at start of surveillance for each of the groups. Astronaut Group by Spaceflight Exposure #Individuals PY Covered No Exposure to Spaceflight 262 1882.7 No Exposure to LD spaceflight “Non-LD” 232 6121.3 Exposure to LD spaceflight 42 429.6 Analysis revealed an increased rate of hip and spine fractures for surveillance periods compared between LD Exposure and Non-LD Exposure: Hip – Relative Rate: 3.4 (95%CI: 1.0, 12.0); Spine– Relative Rate: 3.4 (95%CI: 1.0, 11.6). For all other skeletal sites, rates of fracture were similar for LD and Non-LD exposures. Data comparisons were conducted between groups of astronauts to preclude the interpretation of greater physical activity in astronauts as a contributing factor to fracture rates. This analysis of fracture data is the first report associating postflight hip and spine fractures in astronauts with exposure to extended duration spaceflights. Further analyses integrating co-morbidities for bone loss are planned.

skeleton↗

Magnetic Resonance Imaging (MRI) to Assess Changes to Trabecular Microarchitecture (Trb µArch) of the Hip

BACKGROUND . Calculated loss rates in trabecular (Trb) volumetric bone mineral density (vBMD), in astronauts after return from 6-month long-duration (LD) spaceflight, are rapid relative to menopause-induced loss rates and could contribute to the observed lack of recovery. Perforations in the Trb bony struts, skeletal fragility and fractures [5] have been associated with the rapid rate of bone loss in women due to menopause. The more rapid loss rate observed in astronauts could be inducing similar, irreversible losses of trabecular connectivity as seen in cadaver studies of female skeletons. These changes are not detectable by DXA technology and would not be discovered in astronauts during scheduled, triennial DXA testing for primary osteoporosis. High-resolution-peripheral quantitative computed tomography (HR-pQCT) of the lower leg have detected losses in Trb vBMD (vBMD) and changes in Trb microarchitecture (µArch) in astronauts immediately following routine 6-month spaceflights and continuing in some individuals for 1 or more years postflight with no signs of recovery. Resolution of these microarchitectural changes by whole body QCT, especially in the deeply embedded hip bone, is prohibitive due to excessive and unsafe radiation exposures. While HR-pQCT has sufficient resolution to study Trb µArch at safe and lower radiation exposure testing is restricted only to the lower leg and wrist. Hence, a technology to detect detrimental changes to Trb µArch in astronauts, especially of the hip, is needed to inform type and timing of countermeasures to irreversible deficits (preflight, inflight and postflight). METHODS . This HRP-funded study (2023-2027) will verify the sensitivity of a protocol for MRI scanning (on a 3T Siemens Vida) to detect changes to hip Trb µArch in persons following spinal cord injury (SCI); skeletal immobilization below the spinal lesion will serve as an analog for non-weight-bearing during spaceflight. The study period has been extended by 1 yr due to delayed Richmond IRB approval in Y1. A 3T MRI protocol will characterize serial changes in hip Trb µArch in SCI patients from time of admission at the Richmond VA Medical Center to their scheduled annual exam 12-months later. SCI patients with age, sex, and physical characteristics like ISS astronauts will be consented. The ability of 3T MRI hip scan to discriminate loss of trabecular connectivity subjects with SCI will be compared to age- and sex-matched ambulatory controls. A comparison between HR-pQCT and MRI measurements at the ankle (distal tibia) of study subjects will also be performed. A modified DXA scan analysis (3D-Shaper) will also be verified as a potential method for monitoring concurrent changes in hip Trb bone over 12-month. SIGNIFICANCE . Deliverables: a surveillance method for assessing for irreversible losses of connectivity and how skeletal changes after LD spaceflight(s) would modify the terrestrial risk of primary osteoporosis.

Spinal Cord Injury↗

Magnetic Resonance Imaging (MRI) to Assess Changes to Trabecular Microarchitecture (Trb µArch) of the Hip

BACKGROUND . Calculated loss rates in trabecular (Trb) volumetric bone mineral density (vBMD), in astronauts after return from 6-month long-duration (LD) spaceflight, are rapid relative to menopause-induced loss rates and could contribute to the observed lack of recovery. Perforations in the Trb bony struts, skeletal fragility and fractures [5] have been associated with the rapid rate of bone loss in women due to menopause. The more rapid loss rate observed in astronauts could be inducing similar, irreversible losses of trabecular connectivity as seen in cadaver studies of female skeletons. These changes are not detectable by DXA technology and would not be discovered in astronauts during scheduled, triennial DXA testing for primary osteoporosis. High-resolution-peripheral quantitative computed tomography (HR-pQCT) of the lower leg have detected losses in Trb vBMD (vBMD) and changes in Trb microarchitecture (µArch) in astronauts immediately following routine 6-month spaceflights and continuing in some individuals for 1 or more years postflight with no signs of recovery. Resolution of these microarchitectural changes by whole body QCT, especially in the deeply embedded hip bone, is prohibitive due to excessive and unsafe radiation exposures. While HR-pQCT has sufficient resolution to study Trb µArch at safe and lower radiation exposure testing is restricted only to the lower leg and wrist. Hence, a technology to detect detrimental changes to Trb µArch in astronauts, especially of the hip, is needed to inform type and timing of countermeasures to irreversible deficits (preflight, inflight and postflight). METHODS . This HRP-funded study (2023-2027) will verify the sensitivity of a protocol for MRI scanning (on a 3T Siemens Vida) to detect changes to hip Trb µArch in persons following spinal cord injury (SCI); skeletal immobilization below the spinal lesion will serve as an analog for non-weight-bearing during spaceflight. The study period has been extended by 1 yr due to delayed Richmond IRB approval in Y1. A 3T MRI protocol will characterize serial changes in hip Trb µArch in SCI patients from time of admission at the Richmond VA Medical Center to their scheduled annual exam 12-months later. SCI patients with age, sex, and physical characteristics like ISS astronauts will be consented. The ability of 3T MRI hip scan to discriminate loss of trabecular connectivity subjects with SCI will be compared to age- and sex-matched ambulatory controls. A comparison between HR-pQCT and MRI measurements at the ankle (distal tibia) of study subjects will also be performed. A modified DXA scan analysis (3D-Shaper) will also be verified as a potential method for monitoring concurrent changes in hip Trb bone over 12-month. SIGNIFICANCE . Deliverables: a surveillance method for assessing for irreversible losses of connectivity and how skeletal changes after LD spaceflight(s) would modify the terrestrial risk of primary osteoporosis.

Risk Surveillance↗

Exploration Helmet Permanent Anti-fog Study

For the current Extravehicular Mobility Unit (EMU) spacesuit, an astronaut applies an anti-fog solution to the interior of the helmet bubble before each EVA. However, the anti-fog solution has been reported to cause eye discomfort during at least seven EMU EVAs when the anti-fog solution contacted the crew member’s eyes. During STS-100, astronaut Chris Hadfield reported the eye irritation temporarily blinded him during his spacewalk. In addition, the wipe on anti-fog solution is a consumable that needs to be accounted for and a supply launched for missions. To solve this, the Exploration EMU (xEMU) pressure bubble investigated using a permanent anti-fog coating during Design Verification and Test (DVT) human in the loop (HITL) events. Chosen for previous use in Constellation Space Suit develop, HTAF-601, a water based permanent anti-fog solution, was tested. However, major issues have arisen with further HITL testing with the coating. Cleaning the helmet has been a challenge to avoid damaging the permanent anti-fog coating. NASA has completed a set of different methods for cleaning the anti-fog to try to document a preferred method. It was found isopropyl alcohol (IPA) cannot be used to clean the interior of the helmet because it will strip and delaminate the permanent anti-fog coating. Even with using a very gentle cleaning method of flushing with distilled or DI water and dabbing at facial oils, the permanent anti-fog starts to delaminate consistently after 50 hours manned pressurized time (MPT). Finally, the HTAF-601 coating is being discontinued by the vendor. Due to these issues, further investigation is being completed evaluating two solvent based anti-fog solutions: Exxene’s HCF-100 and FSI’s Visgard 106-94. Each coating will be evaluated on polycarbonate samples for application consistency, steam cycles (mimicking breath cycles), cleaning durability, haze, and light transmission. This study will determine if either coating is a viable option to pursue as a permanent anti-fog for spacesuit helmet applications.

spacesuit↗