ALBERT

Description: NASA maintains on site occupational health clinics at all Centers and major facilities NASA maintains an on-site clinic that offers comprehensive health care to astronauts at the Johnson Space Center NASA deploys limited health care capability to space and extreme environments Focus is always on preventive health care

Description: A former Ames Research Center engineer, Dr. Robert Whalen, invented a treadmill that he licensed to a Menlo Park, California company, Alter-G Inc. The company s G-Trainer is an enclosed treadmill that uses air pressure to help patients feel up to 80 percent lighter, easing discomfort during rehabilitation. A patient desiring more weightlessness during a workout can simply press a button and the air pressure increases, lifting the body and reducing strain and impact. The U.S. Food and Drug Administration cleared the G-Trainer for medical use in January 2008, and researchers are now assessing the G-Trainer s effectiveness in aiding patients with various neurological or musculoskeletal conditions.

Description: This slide presentation reviews the requirement from an Anthropometric standpoint for the development of the Constellation's programs hardware, specifically the Orion crew exploration vehicle. The NASA JSC Anthropometry and Biomechanics Facility (ABF) provides anthropometry, strength, mobility, and mass properties requirements; gathers, interprets, manages and maintains the flight crew anthropometry database; and participates and provides input during crew selection. This is used to assist in requirements for vehicle and space suit design and for crew selection.

Description: There is ample evidence to suggest that space flight leads to immune system dysregulation, however the nature of the phenomenon as it equilibrates over longer flights has not been determined. This dysregulation may be a result of microgravity, confinement, physiological stress, radiation, environment or other mission-associated factors. The clinical risk (if any) for exploration-class space flight is unknown, but may include increased incidence of infection, allergy, hypersensitivity, hematological malignancy or altered wound healing. The objective of this Supplemental Medical Objective (SMO) is to determine the status of the immune system, physiological stress and latent viral reactivation (a clinical outcome that can be measured) during both short and long-duration spaceflight. In addition, this study will develop and validate an immune monitoring strategy consistent with operational flight requirements and constraints. Pre-mission, in-flight and post-flight blood and saliva samples will be obtained from participating crewmembers. Assays included peripheral immunophenotype, T cell function, cytokine profiles (RNA, intracellular, secreted), viral-specific immunity, latent viral reactivation (EBV, CMV, VZV), and stress hormone measurements. This study is currently ongoing. To date, 10 short duration and 5 long-duration crewmembers have completed the study. Technically, the study is progressing well. In-flight blood samples are being collected, and returned for analysis, including functional assays that require live cells. For all in-flight samples to date, sample viability has been acceptable. Preliminary data (n = 4/7; long/short duration, respectively) indicate that distribution of most peripheral leukocyte subsets is largely unaltered during flight. Exceptions include elevated T cells, reduced B/NK cells, increased memory T cells and increased central memory CD8+ T cells. General T cell function, early blastogenesis response to mitogenic stimulation, is markedly reduced in-flight. In-vivo cytokine production profiles are altered, with in-flight dysregulation observed in the Th1/Th2/Treg equilibrium. EBV specific T cell levels are increased during flight, whereas their function is reduced. VZV reactivation was observed inflight and several days post flight with highest levels measured later during long-duration flight. The shedding of CMV in the urine was detected of 4/5 long duration and 4/7 short duration crewmembers. Plasma cortisol was not elevated during flight. Further data will be required to validate the initial observations.

Description: This slide presentation reviews the Functional Task Test (FTT), an interdisciplinary testing regimen that has been developed to evaluate astronaut postflight functional performance and related physiological changes. The objectives of the project are: (1) to develop a set of functional tasks that represent critical mission tasks for the Constellation Program, (2) determine the ability to perform these tasks after space flight, (3) Identify the key physiological factors that contribute to functional decrements and (4) Use this information to develop targeted countermeasures.

Description: The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction ratings were captured.

Description: The NASA Biological Specimen Repository (NBSR) has been established to collect, process, annotate, store, and distribute specimens under the authority of the NASA/JSC Committee for the Protection of Human Subjects. The International Space Station (ISS) provides a platform to investigate the effects of microgravity on human physiology prior to lunar and exploration class missions. The NBSR is a secure controlled storage facility that is used to maintain biological specimens over extended periods of time, under well-controlled conditions, for future use in approved human spaceflight-related research protocols. The repository supports the Human Research Program, which is charged with identifying and investigating physiological changes that occur during human spaceflight, and developing and implementing effective countermeasures when necessary. The storage of crewmember samples from many different ISS flights in a single repository will be a valuable resource with which researchers can validate clinical hypotheses, study space-flight related changes, and investigate physiological markers All samples collected require written informed consent from each long duration crewmember. The NBSR collects blood and urine samples from all participating long duration ISS crewmembers. These biological samples are collected pre-flight at approximately 45 days prior to launch, during flight on flight days 15, 30, 60 120 and within 2 weeks of landing. Postflight sessions are conducted 3 and 30 days following landing. The number of inflight sessions is dependent on the duration of the mission. Operations began in 2007 and as of October 2009, 23 USOS crewmembers have completed or agreed to participate in this project. As currently planned, these human biological samples will be collected from crewmembers covering multiple ISS missions until the end of U.S. presence on the ISS or 2017. The NBSR will establish guidelines for sample distribution that are consistent with ethical principles, protection of crewmember confidentiality, prevailing laws and regulations, intellectual property policies, and consent form language. A NBSR Advisory Board composed of representatives of all participating agencies will be established to evaluate each request by an investigator for use of the samples to ensure the request reflects the mission of the NBSR.

Description: The Constellation Program's Crew Exploration Vehicle (CEV) is required to accommodate the full population range of crewmembers according to the anthropometry requirements stated in the Human-Systems Integration Requirement (HSIR) document (CxP70024). Seated height is one of many critical dimensions of importance to the CEV designers in determining the optimum seat configuration in the vehicle. Changes in seated height may have a large impact to the design, accommodation, and safety of the crewmembers. Seated height can change due to elongation of the spine when crewmembers are exposed to microgravity. Spinal elongation is the straightening of the natural curvature of the spine and the expansion of inter-vertebral disks. This straightening occurs due to fluid shifts in the body and the lack of compressive forces on the spinal vertebrae. Previous studies have shown that as the natural curvature of the spine straightens, an increase in overall height of 3% of stature occurs which has been the basis of the current HSIR requirements. However due to variations in the torso/leg ratio and impact of soft tissue, data is nonexistent as to how spinal elongation specifically affects the measurement of seated height. In order to obtain this data, an experiment was designed to collect spinal elongation data while in a seated posture in microgravity. The purpose of this study was to provide quantitative data that represents the amount of change that occurs in seated height due to spinal elongation in microgravity environments. Given the schedule and budget constraints of ISS and Shuttle missions and the uniqueness of the problem, a methodology had to be developed to ensure that the seated height measurements were accurately collected. Therefore, simulated microgravity evaluations were conducted to test the methodology and procedures of the experiment. This evaluation obtained seat pan pressure and seated height data to a) ensure that the lap restraint provided sufficient restraint to eliminate any gap between the subject s gluteal surface and the seat pan and b) to document any necessary design and procedural changes needed due to the microgravity environment. The methodology and setup used during the simulated microgravity evaluations was replicable to the proposed methodology and setup for in-space missions. A flight-like Shuttle seat, pressure sensors, anthropometer, and existing hardware was used to measure seated height and contact area while experiencing microgravity. The outlying buttock and thigh surface contact areas were collected to determine if the subjects were in contact with the seat pan, while a measurer recorded their seated height with an anthropometer. The Anthropometry and Biomechanics Facility (ABF) completed data collection from three microgravity flights to assess the restraint methods and techniques to be used for the in-flight procedures performed by the crewmembers in orbit. The first flight demonstrated that the restraint system on the seat, used in a nominal configuration, did not sufficiently restrain a person in the seat. The results showed the subjects were not in full contact with the seat pan, resulting in inaccurate sitting height data. Thus, a second flight was conducted to test different restraint system options. The results showed that by 1) changing the restraint system from the nominal 3-points of the 5-point harness, which is used for crewmembers when fully suited with emergency equipment, and 2) rerouting the lap straps around the joint of the backrest, where the backrest and seat pan are joined, resulted in the optimal method to restrain a subject. This rerouting method allowed for the anchor location to change and pull the subjects back into the seat instead of being anchored at the side of the subjects thighs. The results from the third flight validated the final restraint system, which resulted in a verified methodology for collecting seated anthropometry to ultimately determine the amount of spil elongation in a microgravity environment.

Description: Astronauts experience alterations in multiple physiological systems due to exposure to the microgravity conditions of space flight. These physiological changes include sensorimotor disturbances, cardiovascular deconditioning and loss of muscle mass and strength. These changes might affect the ability of crewmembers to perform critical mission tasks immediately after landing on lunar and Martian surfaces. To date, changes in functional performance have not been systematically studied or correlated with physiological changes. To understand how changes in physiological function impact functional performance an interdisciplinary pre/postflight testing regimen (Functional Task Test, FTT) has been developed that systematically evaluates both astronaut postflight functional performance and related physiological changes. The overall objectives of the FTT are to: Develop a set of functional tasks that represent critical mission tasks for Constellation. Determine the ability to perform these tasks after flight. Identify the key physiological factors that contribute to functional decrements. Use this information to develop targeted countermeasures. The functional test battery was designed to address high priority tasks identified by the Constellation program as critical for mission success. The set of functional tests making up the FTT include the: 1) Seat Egress and Walk Test, 2) Ladder Climb Test, 3) Recovery from Fall/Stand Test, 4) Rock Translation Test, 5) Jump Down Test, 6) Torque Generation Test, and 7) Construction Activity Board Test. Corresponding physiological measures include assessments of postural and gait control, dynamic visual acuity, fine motor control, plasma volume, orthostatic intolerance, upper and lower body muscle strength, power, fatigue, control and neuromuscular drive. Crewmembers will perform both functional and physiological tests before and after short (Shuttle) and long-duration (ISS) space flight. Data will be collected on R+0 (Shuttle only), R+1, R+6 and R+30. Using a multivariate regression model we will identify which physiological systems contribute the most to impaired performance on each functional test. This will allow us to identify the physiological systems that play the largest role in decrement in functional performance. Using this information we can then design and implement countermeasures that specifically target the physiological systems most responsible for the altered functional performance associated with space flight.

Description: Space radiation poses significant challenges to space travel, and it is essential to understand the possible adverse effects from space radiation exposure to the radiosensitive organ systems that are important for immediate survival of human, e.g., the hematopoietic system. In this presentation a biomathematical model of granulocytopoiesis is described and used to analyze the blood granulocyte changes seen in the blood of mammalians under continuous and acute radiation exposure. This is one of a set of hematopoietic models that have been successfully utilized to simulate and interpret the experimental data of acute and chronic radiation on rodents. We discuss the underlying implicit regulation mechanism and the biological relevance of the kinetic parameters estimation method. Extension of the model to predictions in dogs and humans systems indicates that the modeling results are consistent with the cumulative experimental and empirical data from various sources. This implies the potential to integrate the models into one united system for monitoring the hematopoietic response of various species under irradiation. Based on the evidence of threshold responses of dogs to extended periods of low daily dose exposures, we discuss the potential health risks of the space traveler under chronic stress of low-dose irradiation and the possibly encountered Solar Particle Events.