ALBERT

Description: High-protein and acidogenic diets induce hypercalciuria. Foods or supplements with excess sulfur-containing amino acids increase endogenous sulfuric acid production and therefore have the potential to increase calcium excretion and alter bone metabolism. In this study, effects of an amino acid/carbohydrate supplement on bone resorption were examined during bed rest. Thirteen subjects were divided at random into two groups: a control group (Con, n = 6) and an amino acid-supplemented group (AA, n = 7) who consumed an extra 49.5 g essential amino acids and 90 g carbohydrate per day for 28 days. Urine was collected for n-telopeptide (NTX), deoxypyridinoline (DPD), calcium, and pH determinations. Bone mineral content was determined and potential renal acid load was calculated. Bone-specific alkaline phosphatase was measured in serum samples collected on day 1 (immediately before bed rest) and on day 28. Potential renal acid load was higher in the AA group than in the Con group during bed rest (P 〈 0.05). For all subjects, during bed rest urinary NTX and DPD concentrations were greater than pre-bed rest levels (P 〈 0.05). Urinary NTX and DPD tended to be higher in the AA group (P = 0.073 and P = 0.056, respectively). During bed rest, urinary calcium was greater than baseline levels (P 〈 0.05) in the AA group but not the Con group. Total bone mineral content was lower after bed rest than before bed rest in the AA group but not the Con group (P 〈 0.05). During bed rest, urinary pH decreased (P 〈 0.05), and it was lower in the AA group than the Con group. These data suggest that bone resorption increased, without changes in bone formation, in the AA group.

Description: No abstract available

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: Medical requirements for the future Crew Exploration Vehicle (CEV), Lunar Surface Access Module (LSAM), advanced Extravehicular Activity (EVA) suits and Lunar habitat are currently being developed. Crews returning to the lunar surface will construct the lunar habitat and conduct scientific research. Inherent in aggressive surface activities is the potential risk of injury to crewmembers. Physiological responses and the operational environment for short forays during the Apollo lunar missions were studied and documented. Little is known about the operational environment in which crews will live and work and the hardware will be used for long-duration lunar surface operations. Additional information is needed regarding productivity and the events that affect crew function such as a compressed timeline. The Space Medicine Division at the NASA Johnson Space Center (JSC) requested a study in December 2005 to identify Apollo mission issues relevant to medical operations that had impact to crew health and/or performance. The operationally oriented goals of this project were to develop or modify medical requirements for new exploration vehicles and habitats, create a centralized database for future access, and share relevant Apollo information with the multiple entities at NASA and abroad participating in the exploration effort.

Description: After an initial stone episode persons are at increased risk for future stone formation. A systematic approach is required to monitor the efficacy of treatment and preventive measures, and to assess the risk of developing new stones. This is important for persons working in critical jobs or austere environments, such as astronauts. A literature review of the current standards of care for renal stone monitoring and imaging was done. Military and civil aviation standards were also reviewed, as well as the medical precedents from the space program. Additionally, a new, more effective, renal stone ultrasound protocol has been developed. Using this work, a monitoring algorithm was proposed that takes into consideration the unique mission and operational environment of spaceflight. The approach to imaging persons with history of renal stones varies widely in the literature. Imaging is often done yearly or biannually, which may be too long for mission critical personnel. In the proposed algorithm astronauts with a history of renal stone, who may be under consideration for assignment, are imaged by a detailed, physiciandriven, ultrasound protocol. Unassigned personnel are monitored by yearly ultrasound and urine studies. Any positive ultrasound study is then followed by low-dose renal computed tomography scan. Other criteria are also established. The proposed algorithm provides a balanced approach between efficacy and reduced radiation exposure for the monitoring of astronauts with a renal stone history. This may eventually allow a transition from a risk-averse, to a risk-modifying approach that can enable continued service of individuals with history of renal stone that have adequately controlled risk factors.

Description: To date six long duration astronauts have experienced in flight visual changes and post flight signs of optic disc edema, globe flattening, choroidal folds, hyperoptic shifts and or raised intracranial pressure. In some cases the changes were transient while in others they are persistent with varying degrees of visual impairment. Given that all astronauts exposed to microgravity experience a cephalad fluid shift, and that both symptomatic and asymptomatic patients have exhibited optic nerve sheath edema on MRI, there is a high probability that all astronauts develop in-flight idiopathic intracranial hypertension to some degree. Those who are susceptible, have an increased likelihood of developing treatment resistant papilledema resulting in visual impairment and possible long-term vision loss. Such an acquired disability would have a profound mission impact and would be detrimental to the long term health of the astronaut. The visual impairment and increased intracranial pressure phenomenon appears to have multiple contributing factors. Consequently, the working "physiological fault bush" with elevated intracranial pressure at its center, is divided into ocular effects, and CNS and other effects. Some of these variables have been documented and or measured through operational data gathering, while others are unknown, undocumented and or hypothetical. Both the complexity of the problem and the urgency to find a solution require that a unique, non-traditional research model be employed such as the Accelerated Research Collaboration(TM) (ARC) model that has been pioneered by the Myelin Repair Foundation. In the ARC model a single entity facilitates and manages all aspects of the basic, translational, and clinical research, providing expert oversight for both scientific and managerial efforts. The result is a comprehensive research plan executed by a multidisciplinary team and the elimination of stove-piped research. The ARC model emphasizes efficient and effective communication between management and investigators; and real-time sharing of scientific discoveries in an effort to solve complex problems.

Description: No abstract available

Description: In May of 2007, The Space Life Sciences Strategy was published, launching a series of efforts aimed at driving human health and performance innovations that both meet space flight needs and benefit life on Earth. These efforts, led by the Space Life Science Directorate (SLSD) at the NASA Johnson Space Center, led to the development and implementation of the NASA Human Health and Performance Center (NHHPC) in October 2010. The NHHPC now has over 100 members including seven NASA centers; other federal agencies; some of the International Space Station partners; industry; academia and non-profits. The NHHPC seeks to share best practices, develop collaborative projects and experiment with open collaboration techniques such as crowdsourcing. Using this approach, the NHHPC collaborative projects are anticipated to be at the earliest possible stage of development utilizing the many possible public-private partnerships in this center. Two workshops have been successfully conducted in 2011 (January and October) with a third workshop planned for the spring of 2012. The challenges of space flight are similar in many respects to providing health care and environmental monitoring in challenging settings on the earth. These challenges to technology development include the need for low power consumption, low weight, in-situ analysis, operator independence (i.e., minimal training), robustness, and limited resupply or maintenance. When similar technology challenges are identified (such as the need to provide and monitor a safe water supply or develop a portable medical diagnostic device for remote use), opportunities arise for public-private partnerships to engage in co-creation of novel approaches for space exploration and health and environmental applications on earth. This approach can enable the use of shared resources to reduce costs, engage other organizations and the public in participatory exploration (solving real-world problems), and provide technologies with multiple uses for space exploration and life on earth. Several examples will be provided that demonstrate the application of a technology to solve a space exploration need and to provide a positive impact to the quality of life on earth.

Description: Humans can travel safely into space in low Earth orbit (LEO) or to near-Earth objects if several medical, physiological, environmental, and human factors issues risks are mitigated. Research must be performed in order to set standards in these four areas, and current NASA standards are contained in the Space Flight Human System Standards volumes 1 and 2, and crew medical certification standards. These three sets of standards drive all of the clinical, biomedical research and environmental technology development for the NASA human space flight program. These standards also drive the identification of specific risks to crew health and safety, and we currently manage 65 human system risks within the human space flight program. Each risk has a specific program of research, technology development, and development of operational procedures to mitigate the risks. Some of the more important risks tat will be discussed in this talk include exposure to radiation, behavioral health due to confinement in a closed cabin, physiological changes such as loss of bone, muscle and exercise capability, reduction in immune system capability, environmental threats of maintaining an adequate atmosphere and water for drinking, avoidance of toxic or infectious material, protection of hearing, and human factors issues of equipment and task design. A nutritious and varied food supply must also be provided. All of these risks will be discussed and current strategies for mitigating these risks for long-duration human space flight. In mitigating these 65 human system risks, novel approaches to problem solving must be employed to find the most appropriate research and technology based applications. Some risk mitigations are developed internally to NASA while others are found through research grants, technology procurements, and more recently open innovation techniques to seek solutions from the global technical community. Examples and results will be presented from all of these approaches including the more recent use of prizes to stimulate innovation.

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.