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Biological and physiological problems in aviation space medicine - decompression sickness, enzyme changes, weightlessness, fatigue, and radiation protection
Annotated bibliography and indexes on Aerospace Medicine and Biology - Nov. 1970
The physical principles of gravitation are discussed, such as gravitational and intertial forces, weight and mass, weightlessness, size and scale effects, scale limits of gravitational effects, and gravity as a biogenic factor. The behavior of the accelerative force gravitation, is described. This law proposes and quantifies the mutual gravitational attraction existing between all bodies of matter, the force being proportional to the product of masses, and inversely related to the square of the distance separating them. Gravity orientation, chronic acceleration, and hematology are examined. Systematic responses, such as circulation and renal functions, are also considered, along with animal response to a decreased acceleration field and physiology of hyper- and hypodynamic fields.
Barometric pressure, gas composition, toxicity, and thermal exchange of spacecraft cabin atmospheres are discussed. Effects of gravitation, acceleration, weightlessness, noise, and vibration on human behavior and performance during space flight are also described.
The influence on living organisms of radiant energy, the psychophysical problems of space flight, methods of physiological investigations in flight, and the transmission of information are considered.
The results of medical and biological research in space are presented. Specific topics discussed include: methods of providing life support systems for astronauts, characteristics of integrated life support systems, protection against adverse factors of space flight, selection and training of astronauts, and future space biomedical research.
This viewgraph presentation reviews issues of health care in space. Some of the issues reviewed are: (1) Physiological adaptation to microgravity, partial gravity, (2) Medical events during spaceflight, (3) Space Vehicle and Environmental and Surface Health Risks, (4) Medical Concept of Operations (CONOPS), (4a) Current CONOPS & Medical Hardware for Shuttle (STS) and ISS, (4b) Planned Exploration Medical CONOPS & Hardware needs, (5) Exploration Plans for Lunar Return Mission & Mars, and (6) Developing Medical Support Systems.
Sterile delivery devices can be created by integrating a medicine delivery instrument with surfaces that are coated with germicidal and anti-fouling material. This requires that a large-surface-area template be developed within a constrained volume to ensure good contact between the delivered medicine and the germicidal material. Both of these can be integrated using JPL-developed silicon nanotip or cryo-etch black silicon technologies with atomic layer deposition (ALD) coating of specific germicidal layers. The application of semiconductor processing techniques and technologies to the problems of fluid manipulation and delivery has enabled the integration of chemical, electrical, and mechanical manipulation of samples all within a single microfluidic device. This approach has been successfully applied at JPL to the automated processing, detection, and analysis of minute quantities (parts per trillion level) of biomaterials to develop instruments for in situ exploration or extraterrestrial bodies. The same nanofabrication techniques that are used to produce a microfluidics device are also capable of synthesizing extremely high-surface-area templates in precise locations, and coating those surfaces with conformal films to manipulate their surface properties. This methodology has been successfully applied at JPL to produce patterned and coated silicon nanotips (also known as black silicon) to manipulate the hydrophilicity of surfaces to direct the spreading of fluids in microdevices. JPL's ALD technique is an ideal method to produce the highly conformal coatings required for this type of application. Certain materials, such as TiO2, have germicidal and anti-fouling properties when they are illuminated with UV light. The proposed delivery device contacts medicine with this high-surface-area black silicon surface coated with a thin-film germicidal deposited conformally with ALD. The coating can also be illuminated with ultraviolet light for the purpose of sterilization or identification of the medicine itself. This constrained volume that is located immediately prior to delivery into a patient, ensures that the medicine delivery device is inherently sterile. An additional benefit to integrating a high-surface-area template within the fluid channel of a medicine delivery device is that one can envision a number of different functional coatings that could facilitate the capture and analysis of either microbial contaminants or the medicine itself. For example, one could attach antibodies or some other binding agent with a specific affinity to the silicon nanotip template. Once a target molecule or microbe is bound to the high-surface- area template, one could use an optical analytical technique such as fluorescence or adsorption to determine the identity and potentially the concentration of the species of interest. By illuminating the bound species from the back, it may also be possible to probe only the molecules with an evanescent wave, making detection of the species from the front side of the device much simpler.
The NASA Shuttle Program began with congressional budget approval in January 5, 1972 and the launch of STS-1 on April 12, 1981 and recently concluded with the landing of STS-135 on July 21, 2011. The evolution of the medical standards and care of the Shuttle Era Astronauts began in 1959 with the first Astronaut selection. The first set of NASA minimal medical standards were documented in 1977 and based on Air Force, Navy, Department of Defense, and the Federal Aviation Administration standards. Many milestones were achieved over the 30 years from 1977 to 2007 and the subsequent 13 Astronaut selections and 4 major expert panel reviews performed by the NASA Flight Medicine Clinic, Aerospace Medicine Board, and Medical Policy Board. These milestones of aerospace medicine standards, evaluations, and clinical care encompassed the disciplines of preventive, occupational, and primary care medicine and will be presented. The screening and retention standards, testing, and specialist evaluations evolved through periodic expert reviews, evidence based medicine, and Astronaut medical care experience. The last decade of the Shuttle Program saw the development of the International Space Station (ISS) with further Space medicine collaboration and knowledge gained from our International Partners (IP) from Russia, Canada, Japan, and the European Space Agencies. The Shuttle Program contribution to the development and implementation of NASA and IP standards and waiver guide documents, longitudinal data collection, and occupational surveillance models will be presented along with lessons learned and recommendations for future vehicles and missions.
The purpose of Space Medicine is to ensure mission success by providing quality and comprehensive health care throughout all mission phases to optimize crew health and performance and to prevent negative long-term health consequences. Space flight presents additional hazards and associated risks to crew health, performance, and safety. With an extended human presence in space it is expected that illness and injury will occur on orbit, which may present a significant threat to crew health and performance and to mission success. Maintaining crew health, safety and performance and preventing illness and injury are high priorities necessary for mission success and agency goals. Space flight health care should meet the standards of practice of evidence based clinical medicine. The function of Space Medicine is expected to meet the agency goals as stated in the 1998 NASA Strategic Plan and the priorities established by the Critical Path Roadmap Project. The Critical Path Roadmap Project is an integrated NASA cross-disciplinary strategy to assess, understand, mitigate, and manage the risks associated with long-term exposure to the space flight environment. The evidence based approach to space medicine should be standardized, objective process yielding expected results and establishing clinical practice standards while balancing individual risk with mission (programmatic) risk. The ability to methodically apply available knowledge and expertise to individual and mission health issues will ensure appropriate priorities are assigned and resources are allocated. NASA Space Medicine risk management process is a combined clinical and engineering approach. Competition for weight, power, volume, cost, and crew time must be balanced in making decisions about the care of individual crew with competing agency resources.
Space medicine is primarily preventative medicine Outcomes of space medicine pharmaceutical care are: a) Elimination or reduction of a patient's symptomatology; b) Arresting or slowing of long term effects from microgravity; and c) Preventing long term effects or symptomatology as a result of microgravity. Space medicine pharmaceutical care is about both the patient and the mission. Pharmaceutical care in the area of space medicine is evolving. A pharmacist serves a critical role in this care. Commercial space travel will require pharmacist involvement.
The National Academy of Sciences Committee on Space Biology and Medicine points out that space medicine is unique among space sciences, because in addition to addressing questions of fundamental scientific interest, it must address clinical or human health and safety issues as well. Efforts to identify how microgravity affects human physiology began in earnest by the United States in 1960 with the establishment of the National Aeronautics and Space Administration (NASA's) Life Sciences program. Before the first human space missions, prediction about the physiological effects of microgravity in space ranged from extremely severe to none at all. The understanding that has developed from our experiences in space to date allows us to be guardedly optimistic about the ultimate accommodations of humans to space flight. Only by our travels into the microgravity environment of space have we begun to unravel the mysteries associated with gravity's role in shaping human physiology. Space medicine is still at its very earliest stages. Development of this field has been slow for several reasons, including the limited number of space flights, the small number of research subjects, and the competition within the life sciences community and other disciplines for flight opportunities. The physiological changes incurred during space flight may have a dramatic effect on the course of an injury or illness. These physiological changes present an exciting challenge for the field of space medicine: how to best preserve human health and safety while simultaneously deciphering the effects of microgravity on human performance. As the United States considers the future of humans in long-term space travel, it is essential that the many mysteries as to how microgravity affects human systems be addressed with vigor. Based on the current state of our knowledge, the justification is excellent indeed compelling- for NASA to develop a sophisticated capability in space medicine. Teams of physicians and scientists should be actively engaged in fundamental and applied research designed to ensure that it is safe for humans to routinely and repeatedly stay and work in the microgravity environment of space.
Sterile delivery devices can be created by integrating a medicine delivery instrument with surfaces that are coated with germicidal and anti-fouling material. This requires that a large-surface-area template be developed within a constrained volume to ensure good contact between the delivered medicine and the germicidal material. Both of these can be integrated using JPL-developed silicon nanotip or cryo-etch black silicon technologies with atomic layer deposition (ALD) coating of specific germicidal layers. Nanofabrication techniques that are used to produce a microfluidics device are also capable of synthesizing extremely hig-hsurface-area templates in precise locations, and coating those surfaces with conformal films to manipulate their surface properties. This methodology has been successfully applied at JPL to produce patterned and coated silicon nanotips (also known as black silicon) to manipulate the hydrophilicity of surfaces to direct the spreading of fluids in microdevices. JPL s ALD technique is an ideal method to produce the highly conformal coatings required for this type of application. Certain materials, such as TiO2, have germicidal and anti-fouling properties when they are illuminated with UV light. The proposed delivery device contacts medicine with this high-surface-area black silicon surface coated with a thin-film germicidal deposited conformally with ALD. The coating can also be illuminated with ultraviolet light for the purpose of sterilization or identification of the medicine itself. This constrained volume that is located immediately prior to delivery into a patient, ensures that the medicine delivery device is inherently sterile.
While this third volume of the bibliography was in preparation, a number of changes and new developments took place which, it is hoped, will be instrumental in furthering the bibliography's main objective: to provide as rapidly as possible comprehensive coverage of the aerospace-medical and bio-astronautical literature. To begin with, it will be noted that the title of the compilation has been changed from Aviation Medicine to Aerospace Medicine and Biology. This will bring into relief the fact that the general subject scope of the bibliography has been expanded to include new areas of interest in space-medical and space-biological research. Thus, to the subject fields heretofore covered by the bibliography (a full listing of which may be found in the Preface to Volume 2) new ones have been added, such as Biological Rhythms, Biological Orientation, Closed Ecological Systems, Physiological and Psychological Effects of Heat, Cold, Isolation, Restraint, and many others. Another important change was administrative in nature. Sponsorship of the bibliography for the fiscal year 1959/60 was taken over by the U. S. Advanced Research Project Agency (ARPA), the U. S. Aeronautics and Space Administration (NASA), and the Defense Research Board of Canada. Under a substantially increased budget, the Library of Congress was enabled to produce two volumes during the fiscal year. The Library also agreed to prepare selected abstracts from the current aerospace and bio-astronautic literature, which are published monthly in Aerospace Medicine, the official organ of the Aerospace Medical Association.*) If the present rate of production can be maintained, it will be possible to bring the bibliography up to date within about three years. In format, style, and arrangement, this volume follows closely the preceding ones. References are arranged alphabetically by author; abstracts are informative; and full bibliographic information is provided, including foreign and translated titles, volume and issue numbers, place of publication (if foreign), inclusive paging, full dates, and library call numbers or other location symbols. While the bulk of the publication is devoted to journal articles, reports, and monographs published during the year 1954, items published in 1952 or 1953 not included in the preceding volumes have been incorporated in this volume. For quick identification, the publication years of these off-year references have been printed next to the first author's name. As before, cumulated corporate and secondary author and subject indexes are included, the latter being revised and enlarged considerably, in keeping with the over-all expansion of subject scope.
NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.
A list is given of the publications of investigators supported by the Biomedical Research and Clinical Medicine Programs of the Space Medicine and Biology Branch, Life Sciences Division, Office of Space Science and Applications. It includes publications entered into the Life Sciences Bibliographic Database by the George Washington University as of December 31, 1986. Publications are organized into the following subject areas: Clinical Medicine, Space Human Factors, Musculoskeletal, Radiation and Environmental Health, Regulatory Physiology, Neuroscience, and Cardiopulmonary.
Coded-aperture imaging is a technique for imaging sources that emit high-energy radiation. This type of imaging involves shadow casting and not reflection or refraction. High-energy sources exist in x ray and gamma-ray astronomy, nuclear reactor fuel-rod imaging, and nuclear medicine. Of these three areas nuclear medicine is perhaps the most challenging because of the limited amount of radiation available and because a three-dimensional source distribution is to be determined. In nuclear medicine a radioactive pharmaceutical is administered to a patient. The pharmaceutical is designed to be taken up by a particular organ of interest, and its distribution provides clinical information about the function of the organ, or the presence of lesions within the organ. This distribution is determined from spatial measurements of the radiation emitted by the radiopharmaceutical. The principles of imaging radiopharmaceutical distributions with coded apertures are reviewed. Included is a discussion of linear shift-variant projection operators and the associated inverse problem. A system developed at the University of Arizona in Tucson consisting of small modular gamma-ray cameras fitted with coded apertures is described.
The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.