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NASA NTRS2014

Bone Metabolism on ISS Missions

Spaceflight-induced bone loss is associated with increased bone resorption (1, 2), and either unchanged or decreased rates of bone formation. Resistive exercise had been proposed as a countermeasure, and data from bed rest supported this concept (3). An interim resistive exercise device (iRED) was flown for early ISS crews. Unfortunately, the iRED provided no greater bone protection than on missions where only aerobic and muscular endurance exercises were available (4, 5). In 2008, the Advanced Resistive Exercise Device (ARED), a more robust device with much greater resistance capability, (6, 7) was launched to the ISS. Astronauts who had access to ARED, coupled with adequate energy intake and vitamin D status, returned from ISS missions with bone mineral densities virtually unchanged from preflight (7). Bone biochemical markers showed that while the resistive exercise and adequate energy consumption did not mitigate the increased bone resorption, bone formation was increased (7, 8). The typical drop in circulating parathyroid hormone did not occur in ARED crewmembers. In 2014, an updated look at the densitometry data was published. This study confirmed the initial findings with a much larger set of data. In 42 astronauts (33 male, 9 female), the bone mineral density response to flight was the same for men and women (9), and those with access to the ARED did not have the typical decrease in bone mineral density that was observed in early ISS crewmembers with access to the iRED (Figure 1) (7). Biochemical markers of bone formation and resorption responded similarly in men and women. These data are encouraging, and represent the first in-flight evidence in the history of human space flight that diet and exercise can maintain bone mineral density on long-duration missions. However, the maintenance of bone mineral density through bone remodeling, that is, increases in both resorption and formation, may yield a bone with strength characteristics different from those that existed before space flight. Studies to assess bone strength after flight are underway at NASA, to better understand the results of bone remodeling. Studies are also underway to evaluate optimized exercise protocols and nutritional countermeasures. Regardless, there is clear evidence of progress being made to protect bone during spaceflight.

Smith, S. M.↗

NASA NTRS1992

Dome cities for extreme environments

Extreme environments whether they be the frigid nights of the polar regions, the burning sands of the desert, or the harsh environment of space pose interesting challenges to the architect, the engineer, and the constructor in their efforts to create habitats for mankind. In space, the goals are to provide radiation protection while also providing an aesthetic living environment for long duration missions. Because of the need to provide both radiation protection and options for expansion of base facilities, a unique structural system which separates the radiation protection systems from the pressure envelope of the habitats was created. The system uses cable networks in a tensioned structural system, which supports the lunar regolith used for shielding above the facilities. The system is modular, easily expandable, and simple to construct. Additional innovations include the use of rock melting perpetrators for piles and anchoring deadmen, and various sized craters to provide side shielding. The reflective properties of the fabric used in the membrane are utilized to provide diffuse illumination. The use of craters along with the suspended shielding allows the dome to be utilized in fashions similar to those proposed by various designers unaware of the Moon's hostile radiation environment. Additional topics addressed deal with construction techniques for large domes, i.e., on the order of 100's to 1000's of meters, thermal control, the integration of tertiary water treatment schemes with architectural design, human factors, and its implications for the design of habitats for long term use in extreme environments.

Leonard, Raymond S.↗

NASA NTRS2014

Numerical Modeling of Ocular Dysfunction in Space

Upon introduction to microgravity, the near-loss of hydrostatic pressure causes a marked cephalic (headward) shift of fluid in an astronaut's body. The fluid shift, along with other factors of spaceflight, induces a cascade of interdependent physiological responses which occur at varying time scales. Long-duration missions carry an increased risk for the development of the Visual Impairment and Intracranial Pressure (VIIP) syndrome, a spectrum of ophthalmic changes including posterior globe flattening, choroidal folds, distension of the optic nerve sheath, kinking of the optic nerve and potentially permanent degradation of visual function. In the cases of VIIP found to date, the initial onset of symptoms occurred after several weeks to several months of spaceflight, by which time the gross bodily fluid distribution is well established. We are developing a suite of numerical models to simulate the effects of fluid shift on the cardiovascular, central nervous and ocular systems. These models calculate the modified mean volumes, flow rates and pressures that are characteristic of the altered quasi-homeostatic state in microgravity, including intracranial and intraocular pressures. The results of the lumped models provide initial and boundary data to a 3D finite element biomechanics simulation of the globe, optic nerve head and retrobulbar subarachnoid space. The integrated set of models will be used to investigate the evolution of the biomechanical stress state in the ocular tissues due to long-term exposure to microgravity.

intraocular pressure↗

NASA NTRS2019

Inserting New Technologies into Human-Computer Interfaces for Future Lunar and Mars Missions

Plans call for human cislunar operations and lunar surface access, to prepare for eventual Mars missions. NASA will also develop new opportunities in lunar orbit that provide the foundation and act as a gateway for human exploration deeper into the solar system. Current human spaceflight is complex and requires as many as fifty people to support the International Space Station (ISS) Mission Control Center (MCC) in Houston, Texas. These flight controllers in the front and back rooms of the MCC, serve as an extra pair of eyes overseeing the numerous station systems. Deep space missions - to the moon, Mars, and beyond - will be more complex and place challenging mission constraints on the crew. As the round-trip communication delays increase in deep space exploration, more on-board systems autonomy and functionality will be needed to maintain and control the vehicle. These mission constraints will change the Earth-based ground control approach and will demand efficient and effective human-computer interfaces (HCI) to control a highly complex vehicle or habitat system. All of this necessitates a different approach to designing and developing spacecraft and habitats. In the beginning of new human spaceflight programs, focus is typically on launch vehicle and uncrewed spacecraft design and development. The reasoning behind this focus to enable flight testing of an integrated launch vehicle and spacecraft system to ensure it will be safe enough to allow humans on board. This is an essential process for new spacecraft, however, the practical effect is a lack of funding for the spacecraft’s human interfaces development. It can be many years before the human interface development begins, putting it late in the spacecraft lifecycle, when almost all other spacecraft systems and subsystems are already in place. This forces the usage of existing and proven technologies for the HCI interfaces. We posit that putting the human first in a spacecraft design process will yield a more effective spacecraft for exploration and long duration missions. NASA Human Research Program (HRP) has identified inadequate HCI as a risk for future missions. New tools and procedures to aid the crew in operating a complex spacecraft will be required. This paper discusses ongoing activities in the development of the next generation HCI components and systems, and a new approach toward human interfaces for spacecraft.

Salazar, George A.↗

NASA NTRS2018

EcAMSat: Small Satellite to Examine E. coli's Response in Microgravity to the Antibiotic Gentamicin

We have successfully flown the EcAMSat (Escherichia coli Antimicrobial Satellite) free-flyer mission. This was a 6U small satellite that autonomously conducted an experiment in low Earth orbit to explore the impact of the space environment on antibiotic resistance in uropathogenic E. coli (UPEC) and the role a particular sigma factor plays in the response. After being held in stasis during transport to orbit, two strainsâ€ a wildtype UPEC and an isogenic mutant with a deleted gene that encodes a sigma factorâ€ were grown to stationary phase in a fluidic card inside EcAMSat's payload, then incubated with three concentrations of the antibiotic gentamicin. The payload then administered alamarBlueÂ®, a redox indicator, into all wells of the fluidic card. The cells were then incubated for 144 hours and metabolic activity was measured optically using the payloads' LED and detector system. Data were then telemetered to the ground and compared to a control experiment conducted in an identical satellite in a lab. The results of this experiment will help us better understand important therapeutic targets for treating bacterial infections on Earth and in space. Such targets are particularly relevant to deep-space and long-duration missions where crew may be more susceptible to infection and treatments for them may work differently.

antibiotic↗

NASA NTRS2009

Kinematic and EMG Comparison of Gait in Normal and Microgravity

Astronauts regularly perform treadmill locomotion as a part of their exercise prescription while onboard the International Space Station. Although locomotive exercise has been shown to be beneficial for bone, muscle, and cardiovascular health, astronauts return to Earth after long duration missions with net losses in all three areas [1]. These losses might be partially explained by fundamental differences in locomotive performance between normal gravity (NG) and microgravity (MG) environments. During locomotive exercise in MG, the subject must wear a waist and shoulder harness that is attached to elastomer bungees. The bungees are attached to the treadmill, and provide forces that are intended to replace gravity. However, unlike gravity, which provides a constant force upon all body parts, the bungees provide a spring force only to the harness. Therefore, subjects are subjected to two fundamental differences in MG: 1) forces returning the subject to the treadmill are not constant, and 2) forces are only applied to the axial skeleton at the waist and shoulders. The effectiveness of the exercise may also be affected by the magnitude of the gravity replacement load. Historically, astronauts have difficulty performing treadmill exercise with loads that approach body weight (BW) due to comfort and inherent stiffness in the bungee system. Although locomotion can be executed in MG, the unique requirements could result in performance differences as compared to NG. These differences may help to explain why long term training effects of treadmill exercise may differ from those found in NG. The purpose of this investigation was to compare locomotion in NG and MG to determine if kinematic or muscular activation pattern differences occur between gravitational environments.

DeWitt, John K.↗

NASA NTRS2018

EcAMSat: A Small Satellite Flown to Explore the Role a Sigma Factor Plays in E. coli's Response to the Antibiotic Gentamicin

We have successfully flown the EcAMSat (Escherichia coli Antimicrobial Satellite) free-flyer mission. This was a 6U (six unit - CubeSat) small satellite that autonomously conducted an experiment in low Earth orbit to explore the impact of the space environment on antibiotic resistance in uropathogenic E. coli (UPEC) and the role a particular sigma factor plays in the response. After being held in stasis during transport to orbit, two strains - a wildtype UPEC and an isogenic mutant with a deleted gene that encodes a sigma factor - were grown to stationary phase in a fluidic card inside EcAMSat's payload, then incubated with three concentrations of the antibiotic gentamicin. The payload then administered alamarBlue (registered trademark), a redox indicator, into all wells of the fluidic card. The cells were then incubated for 144 hours and metabolic activity was measured optically using the payloads' LED (Light-Emitting Diode) and detector system. Data were then telemetered to the ground and compared to a control experiment conducted in an identical satellite in a lab. The results of this experiment will help us better understand important therapeutic targets for treating bacterial infections on Earth and in space. Such targets are particularly relevant to deep-space and long-duration missions where crew may be more susceptible to infection and treatments for them may work differently.

small satellite↗

NASA NTRS2004

Implementation of ALARA radiation protection on the ISS through polyethylene shielding augmentation of the Service Module Crew Quarters

With 5-7 month long duration missions at 51.6 degrees inclination in Low Earth Orbit, the ionizing radiation levels to which International Space Station (ISS) crewmembers are exposed will be the highest planned occupational exposures in the world. Even with the expectation that regulatory dose limits will not be exceeded during a single tour of duty aboard the ISS, the "as low as reasonably achievable" (ALARA) precept requires that radiological risks be minimized when possible through a dose optimization process. Judicious placement of efficient shielding materials in locations where crewmembers sleep, rest, or work is an important means for implementing ALARA for spaceflight. Polyethylene (CnHn) is a relatively inexpensive, stable, and, with a low atomic number, an effective shielding material that has been certified for use aboard the ISS. Several designs for placement of slabs or walls of polyethylene have been evaluated for radiation exposure reduction in the Crew Quarters (CQ) of the Zvezda (Star) Service Module. Optimization of shield designs relies on accurate characterization of the expected primary and secondary particle environment and modeling of the predicted radiobiological responses of critical organs and tissues. Results of the studies shown herein indicate that 20% or more reduction in equivalent dose to the CQ occupant is achievable. These results suggest that shielding design and risk analysis are necessary measures for reducing long-term radiological risks to ISS inhabitants and for meeting legal ALARA requirements. Verification of shield concepts requires results from specific designs to be compared with onboard dosimetry. c2004 COSPAR. Published by Elsevier Ltd. All rights reserved.

NASA Center JSC↗

NASA NTRS2020

VEG-04: The Effects of Light Quality on Mizuna Mustard Growth, Nutritional Composition, and Organoleptic Acceptability for a Space Diet

Growing fresh, nutritious, palatable produce for crew consumption during spaceflight may provide health-promoting, bioavailable nutrients and enhance the astronaut dietary experience as we move toward longer-duration missions. Tending plants may also serve as a countermeasure for crew psychological stresses associated with spaceflight. However, requirements to support consistent growth of a variety of high quality, nutritious crops under spaceflight environmental conditions remain unclear. This study explores the potential to grow crops for consumption on the International Space Station (ISS) using the Veggie vegetable-production system. VEG-04A and B were two flight tests conducted in 2019 with the leafy green crop mizuna mustard. Mizuna was grown in two Veggie chambers simultaneously, with the chambers set to different red-to-blue light formulations; one Veggie was programmed as "red-rich" and the second as "blue-rich." Light quality is known to impact plant growth, nutrition, microbiology, and organoleptic characteristics on Earth, and the Veggie flight tests examined how these impacts might differ in microgravity. VEG-04A, a 35-day growth test with a single harvest, was initiated in June and harvested in July 2019. At harvest, the astronauts froze half of the edible plant tissue to return to Earth and weighed the remaining half using the Mass Measurement Device (MMD). Weighed samples were then cleaned with produce-sanitizing wipes, and consenting crew members participated in organoleptic evaluation of the fresh produce. The remaining sanitized produce was available for crew consumption as desired. Frozen flight samples were returned at the end of August for microbial and chemical analyses to assess food safety and nutritional quality. No pathogens were detected on VEG-04A flight or ground control samples. On average, bacterial and fungal counts were significantly lower on ground control samples than flight samples. VEG-04B, a 56-day test with multiple harvests from the same plants, assessed sustained productivity. VEG-04B was initiated in October 2019 with three harvests at four, six, and eight weeks after initiation. Challenges with the watering program occurred early during VEG-04A, and several plants failed to survive in both the flight and ground control operations. Thus, prior to VEG-04B, an extra test was conducted to tailor water timing and volumes. This test determined that mizuna grew best if the wicks inside the plant pillow were allowed to dry after plants germinated, reducing persistent water around the stem. The wicks changed from being a conduit for water out of the plant pillow to being a conduit for air into the root zone. This test allowed a fine tuning of methods for VEG-04B. It is our hope that these tests on ISS will help mitigate the risk of an inadequate food supply for long-duration missions by adding fresh vegetables to the crew diet. This research was co-funded by the Human Research Program and Space Biology (MTL#1075) in the ILSRA 2015 NRA call.

Massa, Gioia D.↗

NASA NTRS2019

Scale-Up of the Carbon Dioxide Removal by Ionic Liquid Sorbent (CDRILS) System

The Carbon Dioxide Removal by Ionic Liquid Sorbent (CDRILS) system is designed for efficient, safe and reliable carbon dioxide (CO2) removal from cabin air on long-duration missions to the Moon, deep space, and Mars. CDRILS integrates an ionic liquid sorbent with hollow fiber membrane contactors for rapid CO2 removal and recovery. The liquid-based system provides continuous CO2 delivery, which avoids complicated valve networks to switch between absorbing and desorbing beds and enables simpler integration to the Sabatier without the need for the CO2 Management System (CMS). Ionic liquids are particularly desirable as liquid absorbents for space applications since they are non-volatile, non-odorous, and have high oxidative stability. The hollow fiber membrane contactors offer both high contact area and rigorous containment between the gas and liquid phases in a microgravity environment. Scale-up of the CDRILS technology has presented a series of fascinating challenges, since the interaction between hollow fiber properties, ionic liquid properties and performance is complex. Properties measured with lab-scale hollow fiber contactors are used to estimate the performance of contactors that are similar in scale to flight-scale demonstrations. To accomplish this, component and system models have been built to relate the key scrubber and stripper design and operating variables with performance, and experiments directed to validate the models have been performed. System size, weight and power are determined by component selection, arrangement, and operating conditions. Reliability will be extremely important for any long-range mission and depends on the stability of the ionic liquids and hollow fiber contactors. We report on our continuing long term stability experiments for the ionic liquid and contactor materials and our investigation of the physical properties of additional ionic liquids.

Yates, Stephen F.↗

NASA NTRS2007

Bisphosphonate Treatment: Risk Management in Long Duration Spaceflight

Bisphosphonates are a class of pharmaceuticals used to treat diverse bone disorders such as osteoporosis, Paget's disease, and multiple myeloma. They constitute a class of drugs which adhere to bony surfaces and interfere with the resorptive activity of osteoclasts. They also represent a potential countermeasure towards the loss of bone mass experienced by astronauts during spaceflight. Recently, the medical literature has revealed cases of osteonecrosis of the jaw in individuals receiving intravenous bisphosphonate therapy with a smaller number of cases occurring in individuals receiving the oral form of the medication. Risk management for long duration missions requires consideration of mission success and lifetime health care of astronauts. We performed MEDLINE and PubMed searches (1966 December 2006) using the following keywords: osteonecrosis, jaw, bisphosphonates. Additional references were obtained from the citations of the retrieved articles. Injectable bisphosphonates such as pamidronate and zoledronic acid have been highlighted recently in the literature due to a possible link with osteonecrosis of the jaw. The mechanism of action remains unclear but may be linked to physiologic microdamage in the jawbones resulting from suppression of bone metabolism. The most predisposing factors appear to be the type and dose of bisphosphonate used, a history of dental surgery, trauma, and/or dental infection. In addition, patients diagnosed with a malignancy such as breast cancer or multiple myeloma, who have been on intravenous bisphosphonate therapy for several months seem to be at increased risk. The use of oral bisphosphonates appears to place patients more at risk from acute events such as gastrointestinal tract injury or perforation. Although some studies report little to no increase in GI events compared to placebo, we must remember that in microgravity, astronauts may be unable to comply with medication instructions. They may have difficulty remaining upright for the required 30-45 minutes post-ingestion. We are currently unaware if this inability to comply with instructions on the package insert may lead to an increased risk for GI events. There is a potential long-term complication that resides with both forms of bisphosphonate therapy. In order to repair normally occurring physiologic microdamage to bone, both osteoclastic resorption and osteoblastic bone deposition must be functional. Controversy exists in the literature regarding whether prolonged use of bisphosphonates may lead to the suppression of bone turnover and accumulation of microdamage. Bisphosphonates are a powerful class of drugs that suppress bone turnover, but may cause serious adverse clinical events such as gastrointestinal tract injury or osteonecrosis of the jaw. Unfortunately, little to no data exists currently which may help us provide answers regarding the risks of their use in a healthy astronaut cohort. While controversy exists in the literature regarding their mechanism and long-term consequences, the potential mission impact or lifetime health care impact of an adverse clinical event resulting from bisphosphonate therapy must be considered.

Fogarty, Jennifer A.↗

NASA NTRS2017

Meal Replacement Mass Reduction and Integration Acceptability Study

NASA, in planning for long-duration missions, has an imperative to provide a food system with the necessary nutrition, acceptability, and safety to ensure sustainment of crew health and performance. The Orion Multi-Purpose Crew Vehicle (MPCV) and future exploration missions are mass constrained; therefore the team is challenged to reduce the mass of the food system by 10% while maintaining product safety, nutrition, and acceptability. Commercially available products do not meet the nutritional requirements for a full meal replacement in the spaceflight food system, and it is currently unknown if daily meal replacements will impact crew food intake and psychosocial health over time. The purpose of this study was to develop a variety of nutritionally balanced breakfast replacement bars that meet spaceflight nutritional, microbiological, sensorial, and shelf-life requirements, while enabling a 10% savings in food mass. To date, six nutrient-dense meal replacement bars (approximately 700 calories per bar) have been developed, using traditional methods of compression as well as novel ultrasonic compression technologies developed by Creative Resonance Inc. (Phoenix, AZ). The four highest rated bars were evaluated in the Human Exploration Research Analog (HERA) to assess the frequency with which actual meal replacement options may be implemented. Specifically, overall impact of bars on mood, satiety, digestive discomfort, and satisfaction with food. These factors are currently being analyzed to inform successful implementation strategies where crew maintain adequate food intake. In addition, these bars are currently undergoing shelf-life testing to determine long-term sensory acceptability, nutritional stability, qualitative stability of analytical measurements (i.e. water activity and texture), and microbiological compliance over two years of storage at room temperature and potential temperature abuse conditions to predict long-term acceptability. It is expected that this work will enable a successful meal replacement strategy to be implemented that will maintain crew food consumption and health, while informing exploration missions with appropriate mass savings expectations.

Sirmons, T.↗

NASA NTRSDate not supplied

Pick-and-Eat Space Crop Production Flight Testing on the International Space Station

Growing fresh, nutritious, palatable produce for crew consumption during spaceflight may provide health-promoting, bioavailable nutrients and enhance the astronaut dietary experience as we move toward longer-duration missions. However, requirements to support consistent growth of a variety of high-quality crops under spaceflight environmental conditions remain unclear. This study explores the potential to grow crops for consumption on the International Space Station (ISS) using Veggie, NASA’s vegetable production chamber system. VEG-04A and VEG-04B were two flight tests with ground components conducted with the leafy green crop mizuna mustard. In each location, mizuna was grown in two Veggie units simultaneously, with the chambers set to different red-to-blue-to-green light formulations. Preflight verification testing with various lighting treatments was conducted to down-select two treatments that contributed to the best desirable growth and sensory qualities in mizuna mustard. For the flight tests, one Veggie was programmed as “red-rich” with an average of 270 μmol m-2 s-1 of 630 nm red light, 30 μmol m-2 s-1 of 455 nm blue light, and 30 μmol m-2 s-1 of 530 nm green light. The second Veggie was “blue-rich” with an average of 150 µmol m-2 s-1 of 630 nm red light, 150 µmol m-2 s-1 of 455 nm blue light, and 30 µmol m-2 s-1 of 530 nm green light. Light quality is known to impact plant growth, nutrition, microbiology, and sensory characteristics on Earth, and the Veggie flight tests examined how these impacts might differ in microgravity. VEG-04A, a 35-day growth test with a single harvest, was initiated in June and harvested in July 2019. VEG-04B, a 56-day test with three harvests from the same plants, assessed sustained productivity. Preflight testing for VEG-04B was conducted after the VEG-04A flight test to improve the operations, approaches, and watering requirements, which resulted in better crop establishment in the VEG-04B flight test. VEG-04B was initiated in October 2019 with harvests at four, six, and eight weeks after initiation. At all of the harvests, the astronauts froze half of the edible plant tissue to return to Earth and weighed the remaining half using the Mass Measurement Device (MMD). Weighed samples were then cleaned with produce-sanitizing wipes, and consenting crew members participated in sensory evaluations of the fresh produce. The remaining sanitized produce was available for crew consumption as desired. Frozen flight samples were returned to Earth for chemical and microbial analyses to assess nutritional quality and food safety. Flight-grown mizuna was generally more acceptable to the crew and had higher nutrient levels, although mizuna grown in the ground control performed better in terms of higher yield and lower microbial load. This presentation will focus on results from the nutritional and sensory analyses, including how nutrients identified as key for supplementing the crew diet varied across lighting treatments, harvest approaches, and spaceflight versus ground conditions. It is our hope that these tests on the ISS will help mitigate the risk of an inadequate food supply for long-duration missions by adding fresh vegetables to the crew diet. This study was supported by NASA’s Human Research and Space Biology Programs through the HERO NNJ13ZSA002N-ILSRA grant solicitation.

Jess Bunchek↗

NASA NTRS2016

Meal Replacement Mass Reduction and Integration Acceptability Study

NASA, in planning for long duration missions, has an imperative to provide a food system with the necessary nutrition, acceptability, and safety to ensure sustainment of crew health and performance. The Orion Multi-Purpose Crew Vehicle (MPCV) and future exploration missions are mass constrained; therefore we are challenged to reduce the mass of the food system by 10% while maintaining safety, nutrition, and acceptability for exploration missions. Food bars have previously been used to supplement meals in the Skylab food system, indicating that regular consumption of bars will be acceptable. However, commercially available products do not meet the requirements for a full meal replacement in the spaceflight food system. The purpose of this task is to develop a variety of nutritionally balanced breakfast replacement bars, which meet spaceflight nutritional, microbiological, sensorial, and shelf-life requirements, while enabling a 10% food mass savings. To date, six nutrient-dense meal replacement bars have been developed, using both traditional methods of compression as well as novel ultrasonic compression technologies developed by Creative Resonance Inc. (Phoenix, AZ). All bars will be prioritized based on acceptability and the four top candidates will be evaluated in the Human Exploration Research Analog (HERA) to assess the frequency with which actual meal replacement options may be implemented. Specifically, overall impact to mood, satiety, dietary discomfort, and satisfaction with food will be analyzed to inform successful implementation strategies. In addition, these bars will be evaluated based on final product sensory acceptability, nutritional stability, qualitative stability of analytical measurements (i.e. water activity and texture), and microbiological compliance over two years of storage at room temperature and potential temperature abuse conditions to predict long-term acceptability. It is expected that this work will enable a successful meal replacement strategy to be implemented that maintains crew food consumption and health, while informing exploration missions with appropriate mass savings expectations.

Sirmons, T.↗

NASA NTRS2007

Nutritional Status Assessment (SMO 016E)

It has not been possible to assess nutritional status of crew members on the ISS during flight because blood and urine could not be collected during ISS missions. Postflight observations of alterations in nutritional status for several nutrients are troubling, and we require the ability to monitor the status of these nutrients during flight to determine if there is a specific impetus or timeframe for these changes. In addition to the monitoring of crew nutritional status during flight, in-flight sample collection would allow better assessment of countermeasure effectiveness. SMO 016E is also designed to expand the current medical requirement for nutritional assessment (MR016L) to include additional normative markers for assessing crew health and countermeasure effectiveness. Additional markers of bone metabolism will be measured to better monitor bone health and the effectiveness of countermeasures to prevent bone resorption. New markers of oxidative damage will be measured to better assess the type of oxidative insults that occur during space flight. The array of nutritional assessment parameters will be expanded to include parameters that will allow us to better understand changes in folate and vitamin B6 status, and related cardiovascular risk factors during and after flight. Additionally, stress hormones and hormones that affect bone and muscle metabolism will also be measured. This additional assessment will allow us to better monitor the health of crew members and make more accurate recommendations for their rehabilitation. Several nutritional assessment parameters are altered at landing, but it is not known how long these changes persist. We extended the current protocol to include an additional postflight blood and urine sample collection 30 days after landing. Data are being collected before, during, and after flight. These data will provide a complete survey of how nutritional status and related systems are affected by space flight. Analyzing the data will help us to define nutritional requirements for long-duration missions. This expanded set of measurements will also aid in the identification of nutritional countermeasures to counteract, for example, the deleterious effects of microgravity on bone and muscle and the effects of space radiation.

Smith, S. M.↗

NASA NTRS2002

Alterations in protein metabolism during space flight and inactivity

Space flight and the accompanying diminished muscular activity lead to a loss of body nitrogen and muscle function. These losses may affect crew capabilities and health in long-duration missions. Space flight alters protein metabolism such that the body is unable to maintain protein synthetic rates. A concomitant hypocaloric intake and altered anabolic/catabolic hormonal profiles may contribute to or exacerbate this problem. The inactivity associated with bedrest also reduces muscle and whole-body protein synthesis. For this reason, bedrest provides a good model for the investigation of potential exercise and nutritional countermeasures to restore muscle protein synthesis. We have demonstrated that minimal resistance exercise preserves muscle protein synthesis throughout bedrest. In addition, ongoing work indicates that an essential amino acid and carbohydrate supplement may ameliorate the loss of lean body mass and muscle strength associated with 28 d of bedrest. The investigation of inactivity-induced alterations in protein metabolism, during space flight or prolonged bedrest, is applicable to clinical populations and, in a more general sense, to the problems associated with the decreased activity that occur with aging.

Non-NASA Center↗

NASA NTRSDate not supplied

Earth Independent Medical Operations (EIMO) Datascope: Challenges and Potential Solutions

Data flows and storage/retrieval capacity are severely constrained during missions in space and challenges will become even greater during exploration class missions. There is a need for an artificial intelligence (AI)-based clinical decision support system (CDSS) to monitor and analyze data to provide real-time consultative support for crew medical officer (CMO) decision-making. EIMO is defined as the gradual transition of medical care and decision making from terrestrial to space-based assets, enabling support of astronaut health and performance and reducing overall mission risk. While a hallmark of this paradigm shift from low-earth orbit is that on-board care will increasingly become the responsibility of the astronauts for primary management and decision making, terrestrial assets will continue to be paramount in pre-mission screening and planning, as well as prevention, health maintenance and long-term care contingencies. New capabilities and systems that enable progressively more robust and resilient systems and crews will be necessary to reduce risk and increase probability of deep space exploration mission success. An aspiration for EIMO is to develop AI-enhanced solutions for analysis of crew health & performance data and to facilitate clinical decision support for autonomous medical operations. A “system of systems” approach is envisioned whereby EIMO will deploy AI-supported natural language processing and machine learning (ML) techniques to utilize embedded reference databases and real-time data streams [input vectors] from multiple data sources. Constituent input vectors may include environmental controls, countermeasures data, behavioral data, physiologic wearables, point-of-care laboratory tests, personalized medical records, inventory trade space risk assessments, COTS medical databases, and ground support inputs. An ideal AI capability would possess trained fusion algorithms to cross reference input vectors with medical ‘knowledge’ [cultivated database] to stratify relevant data streams for predictive and actionable capabilities. In addition, EIMO will feature mobility, in that it can be accessed and can push/pull data within and between multiple vehicles/habitats. Large amounts and variable sources of data can be leveraged to diagnose, inform treatment strategies, and potentially predict medical events and performance decrements. Inclusion of advanced training tools using extended reality will enable increasingly autonomous medical care to aid a CMO when ground support is unavailable or time-delayed beyond required action window, e.g., emergent medical situations. EIMO CDSS would require very large datasets to train pre-flight and significant amounts of data are needed to support ML via in-flight CDSS operations. An additional challenge will be to find sufficient data to train a model relevant to astronaut demographics. The rapid, accelerating evolution of this field creates a propitious solution space to leverage multi-modal AI through public-private partnership(s). The status of multi-modal AI systems today would preclude their use for long duration missions as they remain unreliable and are subject to “digital hallucinations” and other errors that could pose operational risk. A federated labs structure is being considered to test and optimize data flow from the multiple input vectors leading to field testing in suitable ground/flight analogs. Critical to the success of an EIMO CDSS will be integration and interoperability and success will be defined by a system that can serve as an in-flight medical consult for the CMO providing critical support during medical contingencies. Benefits to terrestrial medicine may be significant as an outflow of the EIMO medical system, particularly for remote areas and communities lacking significant infrastructure, personnel and resources.

J Lemery↗

NASA NTRS2024

Earth Independent Medical Operations (EIMO) Datascope: Challenges and Potential Solutions

Medical Operations↗