ALBERT

Description: Ground-based analogs of spaceflight are an important means of studying physiological and nutritional changes associated with space travel, particularly since exploration missions are anticipated, and flight research opportunities are limited. A clinical nutritional assessment of the NASA Extreme Environment Mission Operation V (NEEMO) crew (4 M, 2 F) was conducted before, during, and after the 14-d saturation dive. Blood and urine samples were collected before (D-12 and D-1), during (MD 7 and MD 12), and after (R + 0 and R + 7) the dive. The foods were typical of the spaceflight food system. A number of physiological changes were reported both during the dive and post dive that are also commonly observed during spaceflight. Serum hemoglobin and hematocrit were decreased (P less than 0.05) post dive. Serum ferritin and ceruloplasmin significantly increased during the dive, while transferring receptors tended to go down during the dive and were significantly decreased by the last day (R + 0). Along with significant hematological changes, there was also evidence for increased oxidative damage and stress during the dive. 8-hydroxydeoxyguanosine was elevated (P less than 0.05) during the dive, while glutathione peroxidase and superoxide disrnutase activities were decreased (P less than 0.05) during the dive. Serum C-reactive protein (CRP) concentration also tended to increase during the dive, suggesting the presence of a stress-induced inflammatory response, Decreased leptin during the dive (P less than 0.05) may also be related to the increased stress. Similar to what is observed during spaceflight, subjects had decreased energy intake and weight loss during the dive. Together, these similarities to spaceflight provide a model to further define the physiological effects of spaceflight and investigate potential countermeasures.

Description: This abstract describes the content of a presentation for ground rounds at Mt. Sinai School of Medicine. The presentation contains three sections. The first describes the history of aerospace medicine beginning with early flights with animals. The second section of the presentation describes current programs and planning for future missions. The third section describes the medical challenges of exploration missions.

Description: The presentation covers five main topical areas. The first is a description of how things work in the microgravity environment such as convection and sedimentation. The second part describes the effects of microgravity on human physiology. This is followed by a description of the hazards of space flight including the environment, the space craft, and the mission. An overview of biomedical research in space, both on shuttle and ISS is the fourth section of the presentation. The presentation concludes with a history of space flight from Ham to ISS. At CART students (11th and 12th graders from Fresno Unified and Clovis Unified) are actively involved in their education. They work in teams to research real world problems and discover original solutions. Students work on projects guided by academic instructors and business partners. They will have access to the latest technology and will be expected to expand their learning environment to include the community. They will focus their studies around a career area (Professional Sciences, Advanced Communications, Engineering and Product Development, or Global Issues).

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

Description: Current International Space Station (ISS) crew schedules include 1.5 h/d for completion of resistive exercise and 1 h/d of aerobic exercise , 6 d/wk. While ISS post flight decrements in muscle strength, bone m ineral density, and aerobic capacity improved in some crewmembers, de conditioning was still evident even with this volume of exercise. Res ults from early ISS expeditions show maximum loss in bone mineral density of the lumbar spine and pelvis in excess of 1.5% per month, with all crewmembers demonstrating significant bone loss in one or more re gions. Similarly, post flight muscle strength losses in the hamstring and quadriceps muscle groups exceeded 30% in the immediate post miss ion period in some crewmembers. Measures of aerobic capacity early in the mission show average decrements of 15%, but with onboard aerobic exercise capability, the crew has been able to "train up" over the co urse of the mission. These findings are highly variable among crewmem bers and appear to be correlated with availability and reliability of the inflight resistive exercise device (RED), cycle ergometer, and t readmill. This suite of hardware was installed on ISS with limited op erational evaluation in groundbased test beds. As a result, onorbit hardware constraints have resulted in inadequate physical stimulus, d econditioning, and increased risk for compromised performance during intra and extravehicular activities. These issues indicate that the c urrent ISS Countermeasures System reliability or validity are not ade quate for extendedduration exploration missions. Learning Objective: A better understanding of the status of ISS exercise countermeasures , their ability to protect physiologic systems, and recommendations for exploration exercise countermeasures.

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

Description: The Medical Informatics and Health Care Systems group in the Office of Space Medicine at NASA Johnson Space Center (JSC) has been tasked by NASA with improving overall medical care on the International Space Station (ISS) and providing insights for medical care for future exploration missions. To accomplish this task, a three day Operational and Research Musculoskeletal Summit was held on August 23-25th, 2005 at Space Center Houston. The purpose of the summit was to review NASA#s a) current strategy for preflight health maintenance and injury screening, b) current treatment methods in-flight, and c) risk mitigation strategy for musculoskeletal injuries or syndromes that could occur or impact the mission. Additionally, summit participants provided a list of research topics NASA should consider to mitigate risks to astronaut health. Prior to the summit, participants participated in a web-based pre-summit forum to review the NASA Space Medical Conditions List (SMCL) of musculoskeletal conditions that may occur on ISS as well as the resources currently available to treat them. Data from the participants were compiled and integrated with the summit proceedings. Summit participants included experts from the extramural physician and researcher communities, and representatives from NASA Headquarters, the astronaut corps, JSC Medical Operations and Human Adaptations and Countermeasures Offices, Glenn Research Center Human Research Office, and the Astronaut Strength, Conditioning, and Reconditioning (ASCR) group. The recommendations in this document are based on a summary of summit discussions and the best possible evidence-based recommendations for musculoskeletal care for astronauts while on the ISS, and include recommendati ons for exploration class missions.