ALBERT

Description: An historical look at exploration medicine, upcoming missions and medical challenges, risk and spaceflight events, getting the medicine into the engineering system

Description: Prolonged microgravity exposure disrupts natural bone remodeling processes and can lead to a significant loss of bone strength, increasing injury risk during missions and placing astronauts at a greater risk of bone fracture later in life. Resistance-based exercise during missions is used to combat bone loss, but current exercise countermeasures do not completely mitigate the effects of microgravity. To address this concern, we present work to develop a personalizable, site-specific computational modeling toolchain of bone remodeling dynamics to understand and estimate changes in volumetric bone mineral density (BMD) in response to microgravity-induced bone unloading and in-flight exercise. The toolchain is evaluated against data collected from subjects in a 70-day bedrest study and is found to provide insight into the amount of exercise stimulus needed to minimize bone loss, quantitatively predicting post-study volumetric BMD of control subjects who did not perform exercise, and qualitatively predicting the effects of exercise. Results suggest that, with additional data, the toolchain could be improved to aid in developing customized in-flight exercise regimens and predict exercise effectiveness.

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Description: The purpose of this testing is to characterize the ISSI IS46DR16640B-25DBA25 parameter degradation for total dose response. This tests purpose is to evaluate and compare lot date codes for sensitivity. In the test, the device is exposed to both low dose and high dose rate (HDR) irradiations using gamma radiation. Device parameters such as leakage currents, quantity of upset bits or addresses, and overall chip and die health are investigated to determine which lot is more robust. These parameters directly affect the functionality of the memory within a system and may determine thresholds necessary to mitigate failure.

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Description: Goals of Stability Studies: Identify medications that are stable under real and simulated space conditions, especially deep space radiation; Identify medications that are potent and safe after their expiration dates; Ultimately provide a safe and effective formulary for exploratory spaceflight missions. ExMC: Exploration Medical Capabilities.

Description: Space Biology and Human Research Projects Integrated Proposal to use the JAXA MARS facility to be presented to JAXA and JAXA investigator audience at JAXA Kibo Utilization Symposium and OP3 negotiation for 2019 ISS rodent mission. Slides present a pictorial overview of the proposed science and analysis techniques desired from the US investigator team. Prior published data form a recent collaboration with JAXA is also mentioned.

Description: The Accepted Medical Conditions List (AMCL) is a product designed to provide a traceable, repeatable, evidence-based consensus process for scoping the medical capability needs for future design reference missions (DRMs) and upcoming programs. These include a Mars transit DRM and a shorter duration cis-lunar DRM. The development of a baseline AMCL by the Exploration Medical Capability (ExMC) Element will assist the effort to identify high priority medical capabilities for inclusion in mission and vehicle planning and provide traceable and documented clinical needs to the Systems Engineering teams tasked with requirements development and design work.

Description: Orbital spaceflight perturbs the human immune system significantly; Natural Killer (NK) and T-lymphocyte (T) cell functions are most susceptible to spaceflight-induced impairment. This loss of function may manifest in persistent latent virus reactivation (CMV, EBV, VZV), which does occur at a higher frequency in astronauts compared to earthlings.

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Description: - Medical System Content Development - 2019: Develop clinical content to inform medical system design; Iterate on content with wider ExMC (Exploration Medical Capability) team; Capture processes used to perform these tasks. - Using model content to inform system design - SME (Subject Matter Expert) collaboration to refine systems using clinical content.

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Description: Context: Recently, The American College of Graduate Medical Education (ACGME) has included the medical decision making as a core competency in several specialties. To date, the ability to demonstrate and measure a pedagogical evolution of medical judgment in a medical education program has been limited. Objective: In this study we hope to examine differences in medical decision making ability of different physicians across their various stages of post-graduate hierarchy. Method: Physcians spanning a wide spectrum of scientific disciplines were recruited for three catagories: administrative physicians(AP) representing physcians with the most experience but mostly practice administratively; resident physicians completing their postgraduate medical training (RP) and seasoned attending physicians with mastery level experience (MP). Participants completed four medical simulations focused on abdominal pain: cholecystitis (CH) and renal colic(RC) and chest pain; Cardiac ischemia (STEMI) and pneumothorax (PX). Simulation were ordered randomly so that there was no systematic bias due to learning or to fatigue. The Medical judgment metric (MJM) was used to evaluate medical decision-making. Results: There were no significant differences between the AP, RP, and MP groups in the gender, race, ethnicity, education, and baseline heart rate. There was a significant (p=0.002) interaction effect for simulation time and RP group, 6.2 minutes (+/-1.58); MP group, 8.7 minutes (+/-2.46); and AP group, 10.3 minutes (+/-2.78). The RC MJM scores were significantly (P=0.10) worse in the AP group 12.3 (+/-2.66) then the RP 14.7(+/-1.15) and MP17.7 (+/-1.15) groups. In every simulation, the AP group MJM scores were worse on average (no significantly) compared to the MP and RP groups. The AP group was significantly (P=0.040) less likely to stabilize the subject in the RC simulation than MP and RP groups. Conclusion: There remains significant variability in the medical education and skill retention influences medical decision making throughout a physician's career.

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Description: Spacecraft cabin air quality is of fundamental importance to crew health, with concerns encompassing both gaseous contaminants and airborne particles. Quantification of spacecraft indoor aerosols will increase our understanding of crew exposure and cabin cleanliness. Aerosols on the International Space Station (ISS) have been sampled and brought back to Earth for analysis to characterize the airborne particulate matter in the cabin. Microscopic analyses have been performed to determine morphology and particle size information, and Energy Dispersive X-ray Spectroscopy (EDS) provides information on the chemical elements present in the particles. With the use of IntelliSEM software for computer-controlled scanning electron microscopy (CCSEM), this data provides particle size distribution information and statistics on particle materials. Many of the particles collected were made up of multiple elements and had uncommon morphologies compared to typical indoor aerosols on Earth. These characteristics are thought to be from unique formation mechanisms in the microgravity environment. Several notable particle types are examined further in this work. Bromine-containing particles and cadmium-containing particles are discussed as they constitute a health hazard to crew members. Humans in indoor living and working spaces are typically the single largest particle emission source, and this was observed in the sampled aerosols in ISS as well.

Description: This study compares squat and deadlift exercises performed with two different loading configurations: 1) on a novel single-cable resistance exercise countermeasure device (ECD) for spaceflight and 2) with free weights. The results compare joint kinematics and kinetics between different loading configurations for each exercise, and also between the two exercises for each loading configuration. Single-cable versions of the squat (using a harness) and deadlift (using a T-bar) performed on the Hybrid Ultimate Lifting Kit (HULK) ECD have significantly different sagittal plane joint angle kinematics (both peak angle and range of motion) as well as joint kinetics (both peak joint moment and joint impulse) vs. their free weight equivalents at the same load. Differences also exist in hip abduction and rotation. Overall, the single-cable configurations tend to reduce peak joint angles, ranges of motion, peak joint moment and joint impulse vs. free weights. A notable exception is the lumbar joint, which is more heavily loaded for single-cable squats vs. free weight squats. This may have implications for both training benefit and possible risk of injury. Deadlift and squat exercises work the lower body musculature in different ways, with the deadlift emphasizing hip and lumbar extension and the squat emphasizing knee extension. Based on these findings, we would advocate the use of both movements in the exercise prescriptions of astronaut crews on deep-space missions.

Description: This collection of photographic highlights covers the past 25 years of international collaboration in human space flight. Beginning in 1993, the international community came together to develop the medical systems for an international space station. Initially, this collaboration was bilateral in support of the Shuttle / Mir Space Station (Phase 1). However, the framework that was established to serve as the medical authority structure provided a foundation for the multilateral boards and panel, which were codified in the memoranda of understanding. The Multilateral Medical Policy Board, the Multilateral Space Medicine Board, and the Multilateral Medical Operations Panel were developed in a collegial and mutually beneficial environment by the men and women of the space agencies of Canada, Europe, Japan, Russia, and the United States. This collection of photographs from official and personal collections captures the spirit and collegiality to which we have grown accustomed. They are also presented to commemorate the integrity, professionalism, tenacity, and dedication to human space exploration consistently demonstrated by individuals involved in this amazing effort.

Description: Forces generated by gravity have a profound impact on the behavior of cells in tissues affecting the course of the cell cycle and differentiation fate of progenitors in mammalian tissues. These cells are contributing to normal tissue regenerative health and defence against disease. In Human space exploration context, it is extremely important to determine spaceflight provoked changes in tissue's regenerational capabilities. Microgravity experienced during spaceflight causes unloading and mechanical disuse on all orthostatic support tissues, therefore impacting stem cell fate and lineage commitment decisions. Investigating how ESCs respond to mechanical stimulation is a platform for fundamental developmental and regeneration research applicable for spaceflight. However, the gene expression programs associatiated with early committment stem cell pathways in response to physical stimulation are not readily known. Single-cell RNA-seq technologies have recently revolutionized the world of molecular biology by providing the capability to assess gene expression pattern within a single cell. Our method isolates and separately barcodes mRNAs from thousands of single cells and sequences their expressomes. Understanding regenerative processes on a molecular level would not only help reduce long-term spaceflight impact on health, but also may enable the development of novel tissue regenerative approaches to tissue degeneration on Earth.

Description: Astronauts embarking on missions beyond low Earth orbit (LEO) will be exposed to a radiation field that may increase the risks of developing cancer, cardiovascular diseases, central nervous system disorders, and immune decrements. Operational parameters will be the primary determinants of crew radiation exposure. NASA uses integrated design tools and risk models to optimize these parameters to minimize radiation exposure. NASA is also considering medical countermeasures (MCMs) to reduce radiation-associated health risks. MCMs for potential use in space-based applications can be developed from a variety of sources, including: a) population-based chemoprevention trials against targeted diseases b) drug development efforts focused on treating acute effects from accidental radiation exposures c) drug development to mitigate side effects of radiotherapy d) mechanistic studies of distinct damage caused by high charge (Z) and energy (HZE) radiation. Use of agents developed for other applications, or repurposed, is advantageous because long-term safety in humans is already established.

Description: Suited vacuum chamber testing is critical to flight crew training, sustaining engineering, and development engineering. Most suited vacuum chamber testing at NASAs Johnson Space Center (JSC) involves crewmembers or human test subjects working at a hypobaric pressure of 4.3 psia, which requires that an oxygen prebreathe be performed prior to decompression to reduce the risk of decompression sickness (DCS). Since 1986, NASAs policy has been to require a 4-hour resting prebreathe for hypobaric chamber exposures of 4.2 psia lasting greater than 30 minutes. There have been no reports of Type II (i.e., serious, potentially life-threatening) DCS at NASA while using this prebreathe protocol. Several chamber runs, believed to be approximately 5% of all runs, are believed to have been terminated due to Type I DCS symptoms that were performance impairing; however, detailed records of DCS symptoms during suited vacuum chamber runs are not available. The adequacy of the 4-hour prebreathe protocol, as well as the processes by which prebreathe protocols and policies are established, became the subject of significant discussion in April 2018 when medical planning was initiated for chamber runs that were scheduled to occur later in 2018 that would last 8 hours or more with high metabolic rates.

Description: The many known health risks currently associated with space travel include increased risk of cardiovascular disease, cancer, central nervous system related diseases, muscle degeneration, and changes with host-gut microbiome interactions that can have profound impact with these and other health risks. The majority of the risk from space travel stem of the two components of the space environment which are microgravity and radiation. From our earlier work (Beheshti et al, PLOS One, 2018), we predicted that there is a systemic component of the host that causes general increased health risks due to spaceflight driven by a circulating microRNA (miRNA) signature consisting of 13 miRNAs that directly regulates both p53 and TGF1. MiRNAs are small non-coding RNA molecules with a negative and post-transcriptional regulation on gene expression) are increasingly recognized as major systemic regulators of responses to stressors, including microgravity, oxidative stress, and DNA damage. In addition, due to the size and stability of miRNAs, it is known that miRNAs can circulate throughout the body and have been found in the majority of the bodily fluids including blood, urine, saliva, and tears. Here, we start to dissect the actual impact of this miRNA signature on both the radiation and microgravity components and prove that this miRNA signature actually exists in the circulation of a host. To achieve this, we obtained multiple tissues including, serum, liver, and spleen and utilizing droplet digital PCR (ddPCR), we start to show how this circulating miRNA signature impacts which component of the spaceflight. The tissue was obtained from experiments performed on C57BL/6 male mice (N=10 for each condition) that were hindlimb unloaded (HU) to simulated microgravity, irradiated with 2Gy gamma (IR), HU plus IR, and control mice under normal conditions. It was shown that these miRNAs were present in the serum as predicted by the in silico prediction from our earlier predictions. The HU vs Controls show significant increases of the predicted miRNAs in the serum for more than half of the miRNA signature, with remaining miRNAs increasing comparing to the controls close to statistical significance. IR vs control mice showed increases for the miRNAs, but not has pronounced as the HU conditions. Finally, the combination of the HU+IR vs controls showed increases for the majority of the miRNA signature. The data indicates that the miRNA signature originally predicted through in silico methods is mainly associated with the microgravity component and is circulating throughout the host resulting in a systemic impact of the miRNAs on the host. These miRNAs are shown in the literature to potentially increase health risks associated with several diseases. In addition, we have begun testing the potential of utilizing antagonists to this miRNA signature to act as a potential countermeasure to mitigate radiation impact on the organism. This work demonstrates for the first time the potential of a minimally invasive novel biomarker and countermeasure that can be used to mitigate both radiation and microgravity effects.

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Description: Sleep loss and circadianmisalignment have long been known to impair human cognitive and motor performance with significant societal and health consequences. It is well known that human reaction time to a visual cue is impaired following sleep loss and circadian misalignment, but it has remained unclear how more complex visuomotor control behaviour is altered under these conditions. In this study, we measured 14 parameters of the voluntary ocular tracking response of 12 human participants (six females) to systematically examine the effects of sleep loss and circadianmisalignment using a constant routine 24 h acute sleep-deprivation paradigm. The combination of state-of-the-art oculometric and sleep-research methodologies allowed us to document, for the first time, large changes in many components of pursuit, saccades and visual motion processing as a function of time awake and circadian phase. Further, we observed a pattern of impairment across our set of oculometric measures that is qualitatively different from that observed previously with other mild neural impairments. We conclude that dynamic vision and visuomotor control exhibit a distinct pattern of impairment linked with time awake and circadian phase. Therefore, a sufficiently broad set of oculometric measures could provide a sensitive and specific behavioural biomarker of acute sleep loss and circadian misalignment. We foresee potential applications of such oculometric biomarkers assisting in the assessment of readiness-to-perform higher risk tasks and in the characterization of sub-clinical neural impairment in the face of a multiplicity of potential risk factors, including disrupted sleep and circadian rhythms.

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Description: This year marks the 50th anniversary of Apollo 11, the first time humans set foot on the Moon. The Apollo missions not only help answer questions related to our solar system, they also highlight many hazards associated with human space travel. One major concern is the effect of extraterrestrial dust on astronaut health. In an effort to expand upon previous work indicating lunar dust is respirable and reactive, the authors initiated an extensive study evaluating the role of a particulates innate geochemical features (e.g., bulk chemistry, internal composition, morphology, size, and reactivity) in generating adverse toxicological responses in vitro and in vivo. To allow for a broader planetary and geochemical assessment, seven samples were evaluated: six meteorites from either the Moon, Mars, or Asteroid 4 Vesta and a terrestrial basalt analogue. Even with the relatively small geochemical differences (all samples basaltic in nature), significant difference in cardiopulmonary inflammatory markers developed in both single exposure and multiple exposure studies. More specifically: 1) the single exposure studies reveal relationships between toxicity and a meteorite samples origin, its pre-ejected state (weathered versus un-weathered), and geochemical features (e.g. bulk iron content) and 2) multiple exposure studies reveal a correlation with particle derived reactive oxygen species (ROS) formation and neutrophil infiltration. Extended human exploration will further increase the probability of inadvertent and repeated exposures to extraterrestrial dusts. This comprehensive dataset allows for not only the toxicological evaluation of extraterrestrial materials but also clarifies important correlations between geochemistry and health. The utilization of an array of extraterrestrial samples from Moon, Mars, and asteroid 4Vesta will enable the development of a geochemical based toxicological hazard model that can be used for: 1) mission planning, 2) rapid risk assessment in cases of unexpected exposures, and 3) evaluation of the efficacy of various in situ techniques in gauging surface dust toxicity. Furthermore, by better understanding the importance of geochemical features on exposure related health outcomes in space, it is possible to better understand of the deleterious nature of dust exposure on Earth.

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Description: Human behavior often consists of a series of distinct activities, each characterized by a unique pattern of interaction with the visual environment. This is true even in a restricted domain, such as a pilot flying an airplane; in this case, activities with distinct visual signatures might be things like communicating, navigating, monitoring, etc. We propose a novel analysis method for gaze-tracking data, to perform blind discovery of these hypothetical activities. We compare, not individual fixations, but groups of fixations aggregated over a fixed time interval (Tau). We assume that the environment has been divided into a finite set of discrete areas-of-interest (AOIs). For a given time interval, we compute the proportion of time spent fixating each AOI, resulting in an N-dimensional vector, where N is the number of AOIs. These proportions can be converted to integer counts by multiplying by Tau divided by the average fixation duration, a parameter that we fix at 283 milliseconds. We compare different intervals by computing the chi-squared statistic. The p-value associated with the statistic is the likelihood of observing the data under the hypothesis that the data in the two intervals were generated by a single process with a single set of probabilities governing the fixation of each AOI. We cluster the intervals, first by merging adjacent intervals that are sufficiently similar, optionally shifting the boundary between non-merged intervals to maximize the difference. Then we compare and cluster non-adjacent intervals. The method is evaluated using synthetic data generated by a hand-crafted set of activities. While the method generally finds more activities than put into the simulation, we have obtained agreement as high as 80 percent between the inferred activity labels and ground truth.

Description: Clinical breath analysis is based on the fact that many important metabolites and biomarker molecules are present at detectable levels in exhaled breath, and many of these molecules correlate with human disease or correlate with physiological states that could lead to a decline in health. Presented is a technology that utilizes an array of chemical sensors combined with humidity, temperature and pressure for real time breath analysis to correlate the chemical information in the breath with the state and functioning of different human organs. For example, a marker for pulmonary inflammation processes of the lower respiratory tract, e.g. asthma, is the increase of the nitrogen oxide (NO) concentration in breath. Other volatile biomarkers may correlate with infectious process, metabolic conditions and inflammatory diseases, such as traumatic brain injury (TBI). This technology is also called "electronic nose" (E-Nose) in the sense that the device can mimic human nose to smell odors using a pattern recognition technique to analyze the sensor array data. Breath sampling is non-invasive and can be analyzed in real-time.

Description: While evidence suggests that astronauts and cosmonauts suffer from immune disorders both during and after spaceflight, the underlying causes are still poorly understood, due in part to the fact that there are so many variables to consider when investigating the human immune system in a complex environment. Furthermore, research has shown that common human pathogens also become more virulent after experiencing spaceflight, which can be especially concerning in the context of potentially immunocompromised astronauts. Invertebrates have become popular models for studying human disease because they have immune systems with a high genetic similarity to humans. Recently, the common bacterial pathogen Serratia marcescens was shown to become more lethal to the fruit fly, Drosophila melanogaster, after being cultured in space, suggesting that not only do we need to consider host changes in susceptibility, but also changes in the pathogen itself after exposure to spaceflight conditions. Being able to simulate spaceflight conditions in a controlled environment on the ground gives us the ability to understand how the microorganisms that cause immune disorders are being affected by these drastic environmental shifts. In this study, I use both spaceflight and Low-shear modeled microgravity (LSMMG) environments to examine the genetic changes associated with increased S. marcescens virulence in order to understand how microgravity is affecting this pathogen, as well as how these genetic changes influence and interact with the host immune system. I also examined the effects of nutrient composition and altered growth conditions on the LSMMG-induced increase in virulence, as well as changes in gene expression mediated by both nutrient composition and exposure to LSMMG. This study will provide us with more directed approaches to studying the effects of spaceflight on human beings, with the ultimate goal of being able to prevent human immune dysfunction in future space exploration.

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Description: The prevalence of electronic health record (EHR) systems has brought prodigious biomedical informatics opportunity. Automated machine learning methods can effectively utilize such data and have become common tools for healthcare predictive modeling. Researches in medical informatics have explored the potential of deep learning and classical models in emergent care scenarios. In particular, predicting differential diagnoses for admissions have proven useful in decreasing unnecessary lab tests and improving inpatient triage decision-making. Moreover, identification of high-risk patients for in-hospital mortality is vitally important to maximize allocation of medical resources.The Medical Information Mart for Intensive Care (MIMIC-III) database, containing de-identified critical care inpatient was used in our study. This data set captures hospital patient laboratory measurements, pharmacologic prescriptions, diagnostic data and procedure event recordings. When considering adult patients and discounting admissions with ICU length of stay less than 24 hours, there were 37,787 unique admissions and 30,414 total patients. We examined the top 25 most prevalent ICD-9 group-level disease specificities in MIMIC-III using a multi-label classification model. In-hospital mortality was modeled as binary classification with 4,155 (13%) adult patients that expired, of which 3,138 (75.5%) were in the ICU setting. The metrics AUC, F1 score, sensitivity and specificity values calculated for each disease label measured prediction performance.The usage of ICD-9 group codes reduced feature dimension from 14,567 to 942 and greatly improved distribution of patient diagnostic categories. Disease temporal patterns were captured by considering the most frequently sampled 6 vital signs and 13 laboratory values. Missing data were imputed at each time-stamp. Time-series raw hourly average values were converted into 5 summary features (mean, standard deviation, number of observations, min & max values). Patient demographic variables such as age, gender, marital status and ethnicity were also factored into the modeling. Choi et al showed that contextual embedding of medical data, diagnostic and procedural codes alone can predict future diagnoses with sensitivity as high as 0.79. We utilized an embedding technique called word2vec which allowed sparse representations of medical history to be transformed into dense word vectors. The mappings captured contextual information by treating each admission as a sentence and learning the most likely neighboring words in a sliding window fashion. Binary and multi-label classification was achieved via collapse models, which do not consider temporal information, as well as recurrent neural networks with regularization, Softmax output layer activation together with categorical cross-entropy as the loss function.

Description: No abstract available

Description: Prolonged microgravity exposure disrupts natural bone remodeling processes and can lead to a significant loss of bone strength, increasing injury risk during missions and placing astronauts at a greater risk of bone fracture later in life. Resistance based exercise during missions is used to combat bone loss, but current exercise countermeasures do not completely mitigate the effects of microgravity. To address this concern, we present work to develop a personalizable, site-specific computational modeling tool chain of bone remodeling dynamics to understand and estimate changes in volumetric bone mineral density (BMD) in response to microgravityinduced bone unloading and in-flight exercise. The toolchain is evaluated against data collected from subjects in a 70-day bed rest study and is found to provide insight into the amount of exercise stimulus needed to minimize bone loss, quantitatively predicting post-study volumetric BMD of control subjects who did not perform exercise, and qualitatively predicting the effects of exercise. Results suggest that, with additional data, the toolchain could be improved to aid in developing customized in-flight exercise regimens and predict exercise effectiveness.

Description: Spaceflight perturbs the human immune system. Among other manifestations, crewmembers may experience latent herpes viruses reactivation due to impaired lymphocyte function, as well as allergic/hypersensitivity reactions. Considering future space travel will be of longer duration (thereby increasing stress, exposure to radiation, etc) with no rapid return option, it is of paramount importance to develop a countermeasure(s) to immune dysregulation. Monophosphoryl lipid A (MPLA) is a derivative of lipopolysaccharide (LPS), a potent inflammatory agent that can cause septic shock. MPLA possesses the immune-stimulatory effects of LPS without the adverse inflammatory effects. We hypothesize that treating immune cells with MPLA will boost their function enough to overcome the inhibitory effects of microgravity. While MPLA has been tested as an adjuvant extensively in mice and preliminarily for human vaccines, it has never been assessed for efficacy in microgravity.

Description: The biomechanics of exercise in space is difficult to study and there are unknowns surrounding exercise performance on future space exploration countermeasures systems. These issues are beginning to be addressed through enhanced modeling techniques fueled initially by human-in-the-loop data collections in ground-based environments. The presentation will focus on an effort completed at the University of South Florida to apply the Computer Assisted Rehabilitation Environment (CAREN) system to address a human spaceflight need. The research explored the interaction between a human and a moving platform while exercise was completed.

Description: While astronauts are returning from long duration spaceflight with multiple ocular signs that mimic those seen in terrestrial patients with elevated intracranial pressure (ICP), evidence has yet to prove a clinically significant increase in ICP during space.1 Preliminary research evidence may even suggest that ICP decreases in microgravity. Idiopathic intracranial hypertension (IIH) has long been considered the ideal terrestrial analogue to Spaceflight Associated Neuro-ocular Syndrome (SANS).1 However, there are several critical features of SANS that do not complement any reported case of IIH on Earth. These findings mandate a closer look at the accuracy of IIH as a terrestrial SANS analog.

Description: Vision changes identified in long duration spaceflight astronauts has led Space Medicine at NASA to adopt a more comprehensive clinical monitoring protocol. Optical Coherence Tomography (OCT) was recently implemented at NASA, including on board the International Space Station in 2013. NASA is collaborating with Heidelberg Engineering to increase the fidelity of the current OCT data set by integrating the traditional circumpapillary OCT image with radial and horizontal block images at the optic nerve head. The retinal nerve fiber layer was segmented by two experienced individuals. Intra-rater (N=4 subjects and 70 images) and inter-rater (N=4 subjects and 221 images) agreement was performed. The results of this analysis and the potential benefits will be presented.

Description: The purpose of this pilot study is to investigate the collection, preparation, and analysis of tear biomarkers as a means of assessing ocular, neurological, and immunological health. At present, no published data exists on the cytokine profiles of tears from astronauts exposed to long periods of microgravity and space irradiations. In addition, no published data exist on cytokine (biomarker) profiles of tears that have been collected from irradiated non-human biological systems (primates and other animal models). A goal for the proposed pilot study is to discover novel tear biomarkers which can help inform researchers, clinicians, epidemiologist and healthcare providers about the health status of a living biological system, as well as informing them when a disease state is triggered. This would be done via analysis of the onset of expression of pro-inflammatory cytokines, leading up to the full progression of a disease (i.e. cancer, loss of vision, radiation-induced oxidative stress, cardiovascular disorders, fibrosis in major organs, bone loss). Another goal of this pilot study is to investigate the state of disease against proposed medical countermeasures, in order to determine whether the countermeasures are efficacious in preventing or mitigating these injuries. An example of an up and coming tear biomarker technology, Ascendant Dx, a clinical stage diagnostic company, is developing a screening test to detect breast cancer using proteins from tears. The team utilized Liquid Chromatography -Mass Spectrometry with Mass analysis (LC MS/MS) as a discovery platform followed by validation with ELISA to come up with a panel of protein biomarkers that can differentiate breast cancer samples from control ("cancer free") samples with results far surpassing the results of imaging techniques in use today. Continued research into additional proteins is underway to increase the sensitivity and specificity of the test and development efforts are on the way to transfer the test onto a fast, accurate and inexpensive point of care platform. In conclusion, the expected results from this proposed pilot study are to: a) establish an SOP for retrieving/storing/transporting tear fluid samples from multicentre sites b) establish a normal range for relevant biomarkers in tears; and c) establish a database (biobank) of tears of space nave versus veteran astronauts, to establish a personal baseline for long-term ocular health monitoring

Description: The International Space Station Medical Projects (ISSMP) Element provides planning, integration, and implementation services for HRP research studies for both spaceflight and flight analog research. Through the implementation of these two efforts, ISSMP offers an innovative way of guiding research decisions to meet the unique challenges of understanding the human risks to space exploration. Flight services provided by ISSMP include leading informed consent briefings, developing and validating in-flight crew procedures, providing ISS crew and ground-controller training, real-time experiment monitoring, on-orbit experiment and hardware operations and facilitating data transfer to investigators. For analog studies at the NASA Human Exploration Research Analog (HERA), the ISSMP team provides subject recruitment and screening, science requirements integration, data collection schedules, data sharing agreements, mission scenarios and facilities to support investigators. The ISSMP also serves as the HRP interface to external analog providers including the :envihab bed rest facility (Cologne, Germany), NEK isolation chamber (Moscow, Russia) and the Antarctica research stations. Investigators working in either spaceflight or analog environments requires a coordinated effort between NASA and the investigators. The interdisciplinary nature of both flight and analog research requires investigators to be aware of concurrent research studies and take into account potential confounding factors that may impact their research objectives. Investigators must define clear research requirements, participate in Investigator Working Group meetings, obtain human use approvals, and provide study-specific training, sample and data collection and procedures all while adhering to schedule deadlines. These science requirements define the technical, functional and performance operations to meet the research objectives. The ISSMP maintains an expert team of professionals with the knowledge and experience to guide investigators science through all aspects of mission planning, crew operations, and research integration. During this session, the ISSMP team will discuss best-practices approaches for successfully preparing and conducting studies in both the flight and analog environments. Critical tips and tricks will be shown to greatly improve your chances of successfully completing your research aboard the International Space Station and in Spaceflight Analogs.

Description: No abstract available

Description: Microgravity inflicts substantial, but undercharacterized, pressure on organisms that induces metabolic responses such as increased microbial virulence and antibiotic resistance, altered organ weights in developing rats, and loss of bone tissue in astronauts. Numerous studies have analyzed the effects of microgravity on specific organisms, tissues, or test conditions, but these projects are necessarily limited by the small sample size of space research. Increasing the sample size of spaceflight studies is non-trivial; however, pooling data from numerous studies can greatly increase the statistical rigor of comparative analyses. The GeneLab houses datasets from 73 spaceflight studies that performed transcription profiling assays. These data encompass a diverse array of organisms ranging from Escherichia coli to Mus musculus to Homo sapiens and comprise studies analyzing ionizing radiation, mammalian pregnancy, etc. Collectively, the GeneLab database contains a large quantity of transcription assays and RNA sequence data analyzing Differential Gene Expression (DGE) between microand normogravity. Xspecies, a cross-species analysis method for DGE developed by Kristiansson, et al. in 2012, identifies homologous genes between species that are universally up- or downregulated in response to test conditions. Previous work by an intern at GeneLab applied Xspecies to 19 datasets containing seven different species and identified 14 homologous groups differentially expressed under spaceflight conditions including several heat shock proteins and cytoskeletal components. Unfortunately, these results may be biased by the disproportionate number of studies on Arabidopsis thaliana (5) and Mus musculus (6) and the results are not normalized by evolutionary distances. Here, we present modifications to the Xspecies algorithm that permits incorporation of multi-omic data and normalizes data for effect size, directionality, and evolutionary distances. We then apply this algorithm to all currently available GeneLab studies

Description: A sensor platform based on vertically aligned carbon nanofibers (CNFs) has been developed. Their inherent nanometer scale, high conductivity, wide potential window, good biocompatibility and well-defined surface chemistry make them ideal candidates as biosensor electrodes. Here, we report two studies using vertically aligned CNF nanoelectrodes for biomedical applications. CNF arrays are investigated as neural stimulation and neurotransmitter recording electrodes for application in deep brain stimulation (DBS). Polypyrrole coated CNF nanoelectrodes have shown great promise as stimulating electrodes due to their large surface area, low impedance, biocompatibility and capacity for highly localized stimulation. CNFs embedded in SiO2 have been used as sensing electrodes for neurotransmitter detection. Our approach combines a multiplexed CNF electrode chip, developed at NASA Ames Research Center, with the Wireless Instantaneous Neurotransmitter Concentration Sensor (WINCS) system, developed at the Mayo Clinic. Preliminary results indicate that the CNF nanoelectrode arrays are easily integrated with WINCS for neurotransmitter detection in a multiplexed array format. In the future, combining CNF based stimulating and recording electrodes with WINCS may lay the foundation for an implantable smart therapeutic system that utilizes neurochemical feedback control while likely resulting in increased DBS application in various neuropsychiatric disorders. In total, our goal is to take advantage of the nanostructure of CNF arrays for biosensing studies requiring ultrahigh sensitivity, high-degree of miniaturization, and selective biofunctionalization.

Description: No abstract available

Description: The risk of developing radiation-induced lung cancer differs between different strains of mice, but the underlying cause of the strain differences is unknown. Strains of mice also differ in their ability to efficiently repair DNA double strand breaks resulting from radiation exposure. We phenotyped mouse strains from the CcS/Dem recombinant congenic strain set for their efficacy in repairing DNA double strand breaks during protracted radiation exposures. We monitored persistent gamma-H2AX radiation induced foci (RIF) 24 hours after exposure to chronic gamma-rays as a surrogate marker for repair deficiency in bronchial epithelial cells for 17 of the CcS/Dem strains and the BALB/cHeN founder strain. We observed a very strong correlation R2 = 79.18%, P 〈 0.001) between the level of persistent RIF and radiogenic lung cancer percent incidence measured in the same strains. Interestingly, spontaneous levels of foci in non-irradiated strains also showed good correlation with lung cancer incidence (R2=32.74%, P =0.013). These results suggest that genetic differences in DNA repair capacity largely account for differing susceptibilities to radiation-induced lung cancer among CcS/Dem mouse strains and that high levels of spontaneous DNA damage is also a relatively good marker of cancer predisposition. In a smaller pilot study, we found that the repair capacity measured in peripheral blood leucocytes also correlated well with radiogenic lung cancer susceptibility, raising the possibility that such phenotyping assay could be used to detect radiogenic lung cancer susceptibility in humans.

Description: The AMO (Autonomous Medical Operations) Project is working extensively to train medical models on the reliability and confidence of computer-aided interpretation of ultrasound images in various clinical settings, and of various anatomical structures. AI (Artificial Intelligence) algorithms recognize and classify features in the ultrasound images, and these are compared to those features that clinicians use to diagnose diseases. The acquisition of clinically validated image assessment and the use of the AI algorithms constitutes fundamental baseline for a Medical Decision Support System that will advise crew on long-duration, remote missions.

Description: Head-up tilt (HUT) tests often are used in research to measure orthostatic intolerance (OI) (inability to appropriately control blood pressure while upright) in clinical populations and otherwise healthy individuals after interventions. Post-space flight orthostatic intolerance is a well-known phenomenon, and countermeasures to its development has been an active area of research at NASA. In the NASA HUT protocol, subjects lie horizontally on an automatic tilt table for baseline measurements before being raised to 80deg head-up tilt for a defined period of time or until signs or symptoms of presyncope ensues (light-headedness, nausea, dizziness, sweating, weakness or fainting). Multiple measures are collected to evaluate the cardiovascular system's ability to respond appropriately to the orthostatic challenge. However if the intended duration of the HUT is short, the ability to detect changes in OI due to an intervention or its prevention by a countermeasure may be limited by a small number of failures to permit comparisons based on survival time alone. Thus, the time-trajectory of the cardiovascular data becomes an important additional source of information. In particular, we will show how various measures of trajectory variability can effectively augment survival analysis for the assessment of OI in a joint model when high censoring rates are present.

Description: 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 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, 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.

Description: No abstract available

Description: No abstract available

Description: Coronary artery disease (CAD) surveillance has led to the development of risk stratification tools that drive clinical mitigation efforts for CAD risk. As common risk assessment tools, including the Framingham Risk Score (FRS) or Pooled Cohort Risk Equations, have insufficient accuracy on an individual level to meet NASAs stringent screening guidelines, NASA has required new approaches to address the risk of catastrophic cardiovascular (CV) medical events among astronauts. Coronary artery calcium (CAC) scanning has emerged as the current best tool to enhance CV risk assessment in asymptomatic individuals, with risk information incremental to FRS data.

Description: The Bellagio II Summit sought to correlate current ISS (International Space Station) Space Medicine practice in the screening/assessment and management of CAD (Coronary Artery Disease) and to identify terrestrial applications for the general population pertaining to primary, secondary and tertiary diagnoses and treatments. We identified current Space Medicine practice for screening and monitoring cosmonaut and astronaut in the pre-, in-, and post-flight mission phases. We will discuss current Space Medicine standards and guidelines in the recognition and monitoring of CAD development, stabilization, and regression.

Description: Hydroxyapatites single crystals have been investigated their applications as the laser host material. Czochralksi and flux growth methods have been utilized to achieve single crystals. Because of their bioactivities with tissues these have attracted interest for bone applications. For low temperature processing we have used several techniques. We utilized some organic melt and oriented the grains by the directional solidification method. This organic treated material has different characteristics than coarsened oxide materials. Our approach involved low temperature processing using nano-engineered powders of the material system MgO-Na2O-K2O-CaO-SrO-SiO2 and also borates were processed by sintering and grain growth. Our results indicate that substitution of calcium and strontium with some other elements such as gallium and magnesium have great potential to improve the mechanical properties of bones.

Description: Outline: Background; Terrestrial experience -Initial investigation into MSK (MusculoSKeletal) injuries -MSK Medicine Program -Training injuries -NBL (Neutral Buoyancy Laboratory) EMU (Extravehicular activity Mobility Unit) Work Hardening Program -Return to duty -Post-flight reconditioning program; Inflight musculoskeletal conditions; Lunar Surface Operations; Post-flight injuries.

Description: The Human Research Program funded the development of the Integrated Medical Model (IMM) to quantify the medical component of overall mission risk. The IMM uses Monte Carlo simulation methodology, incorporating space flight and ground medical data, to estimate the probability of mission medical outcomes and resource utilization. To determine the credibility of IMM output, the IMM project team completed two validation studies that compared IMM predicted output to observed medical events from a selection of Shuttle Transportation System (STS) and International Space Station (ISS) missions. The validation study results showed that the IMM underpredicted the occurrence of ~10% of the modeled medical conditions for the STS missions and overpredicted ~20% of the modeled medical conditions for the ISS missions. These findings imply that the strength of IMM predictions to inform decisions depends on simulated mission specifications including length. This discrepancy could result from medical recording differences between ISS and STS that possibly influence observed incidence rates, IMM combining all "mission type" data as constant occurrence rate or fixed proportion across both mission types, misspecification of symptoms to conditions, and gaps in the literature informing the model. Some of these issues will be alleviated by updating the IMM source data through incorporation of the observed validation data.

Description: The International Space Station is a unique laboratory for performing investigations that affect human health both in space and on Earth. During its time in orbit, the space station has enabled research that is providing a better understanding of many aspects of human health including aging, trauma, disease and environmental impacts. Driven by the need to support astronaut health, several biological and human physiological investigations have yielded important results that we on Earth can also benefit from. These results include new ways to mitigate bone loss, insights into bacterial behavior, and innovative wound-healing techniques. Advances in telemedicine, disease models, psychological stress response systems, nutrition and cell behavior are just a few more examples of the benefits that have been gained from applying studies in orbit to human health back on Earth.

Description: Aerobic fitness is best measured by Maximal Aerobic Capacity or VO2 Max which is defined as a measure of oxygen utilization and transport. Increased Vo2 max indicates improved oxygen consumption during high level exercise and is widely accepted as a predictor of an individual's likelihood of successfully completing a demanding task. As such, agencies and organizations have adopted VO2 max as part of a comprehensive set of physical requirements. The purpose of this study is to review the literature and existing medical and occupational VO2 max data, to propose a VO2 max standard for NASA astronauts for training and spaceflight.

Description: New initiatives to begin Lunar and Martian human surface operations within the next few decades are illustrative of the resurgence of interest in human space exploration. However, as with all exploration, there are risks. The previous manned missions to the Moon highlight a major hazard for future human exploration of the Moon and beyond: surface dust. Not only did the dust cause mechanical and structural integrity issues with the suits, the dust 'storm' generated upon reentrance into the crew cabin caused "lunar hay fever" and "almost blindness.". It was further reported that the allergic response to the dust worsened with each exposure. Due to the prevalence of these high exposures, the Human Research Roadmap developed by NASA identifies the Risk of Adverse Health and Performance Effects of Celestial Dust Exposure as an area of concern.

Description: No abstract available

Description: Final Paper and not the abstract is attached. see attached

Description: Medical simulation is a useful tool that can be used to train personnel, develop medical processes, and assist cross-disciplinary communication. Medical simulations have been used in the past at NASA for these purposes, however they are usually created ad hoc. A stepwise approach to scenario development has not previously been used. The NASA Exploration Medical Capability (ExMC) created a medical scenario development tool to test medical procedures, technologies, concepts of operation and for use in systems engineering (SE) processes.

Description: Historical solar particle events (SPEs) provide context for some understanding of acute radiation exposure risk to astronauts traveling outside of low Earth orbit. Modeling of potential doses delivered to exploration crewmembers anticipates limited radiation-induced health impacts, including prodromal symptoms of nausea, emesis, and fatigue, but suggests that more severe clinical manifestations are unlikely. Recent large animal-model research in space-analogs closely mimicking SPEs has identified coagulopathic events independent of the hematopoietic sequelae of higher radiation doses, similar in manifestation to disseminated intravascular coagulation (DIC). We explored the challenges of clinical management of radiation-related clinical manifestations, using currently accepted modeling techniques and anticipated physiological sequelae, to identify medical capabilities needed to successfully manage SPE-induced radiation illnesses during exploration spaceflight.

Description: No abstract available

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Description: As humans venture further into space and beyond low Earth orbit, space radiation is one of the main challenges for astronauts' health. Radiation-induced bone loss is a potential health problem for long duration habitation in space. We showed that a dietary countermeasure prevents bone loss in mice exposed to total body irradiation (TBI). We used a range of ionizing radiation, gamma (137Cs), proton (1H), iron (56Fe), and a combination of sequential proton and iron beam (1H/56Fe/1H) to evaluate skeletal responses. These TBI cover a range of linear energy transfer (LET), from low-LET such as proton, to high-LET such as 56Fe (HZE: high Z- high energy) at doses between 1-2 Gy. The countermeasure diet, composed of 25% Dried Plum (DP) was effective at preventing radiation-induced cancellous bone loss in appendicular bone (tibia). Furthermore, exposing mice to HZE radiation, such as 56Fe (1Gy), impaired ex vivo growth of marrow-derived, bone-forming osteoblasts, which led to reduced mineralization capacity (-77%). In contrast, mice fed the DP diet did not display these deficits, showing the diet's capacity to protect marrow-derived osteoprogenitors. Dietary DP prevented the increase of bone resorbing osteoclast cells, inflammation and oxidative stress, while protecting the osteoprogenitors and mesenchymal stem cells, which few drugs against osteoporosis may achieve. Spaceflight is a combination of multiple factors including microgravity, in addition to space radiation. Therefore, we conducted additional studies to determine if the DP diet could prevent simulated spaceflight (simulated microgravity and radiation combined) bone loss. Mice were exposed to gamma (TBI, 137Cs, 2 Gy), simulated microgravity (using the hindlimb unloading system, HU) or TBI+HU. While we observed bone loss in mice fed the control diet (CD) due to both treatments (TBI=14%, HU=20%), and a worse effect with combined treatments (TBI+HU=25%), mice fed the DP diet did not sustain significant bone loss relative to untreated controls. The DP diet prevented microarchitectural decrements in both appendicular bone (tibia) and axial bone (vertebrae). In addition, the DP diet mitigated HU-induced deficits in osteoblastogenesis. Interestingly, lower doses of DP diet (5%, 10%) did not appear to prevent cancellous bone loss, which shows the importance of identifying the active component(s) of DP. Finally, we have preliminary data showing the potential of DP to prevent radiation-induced damage at a systematic level.. In summary, this novel dietary countermeasure is a promising candidate nutritional countermeasure for spaceflight-induced bone loss and tissue damage.

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Description: Changes in urine chemistry, during and post-flight, potentially alter the likelihood of renal stones in astronauts. Although much is known about the effects of space flight on urine chemistry, no inflight incidences of renal stones in US astronauts exist and the question How much does this risk change with space flight? remains difficult to accurately quantify. Previous work by our group has illustrated the application of multi-factor deterministic and probabilistic modeling to assess the change in predicted likelihood of renal stone. Utilizing 1517 astronaut urine chemistries to inform the renal stone occurrence rate forecasting model, we performed a sensitivity analysis on urine chemistry components for their influence on predictions of renal stone size and rate of renal stone occurrence.

Description: A key component in the development of NASA Human Research Programs (HRP) next generation risk model, the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) intends to deliver a means to quantify how HRP products impact astronaut medical and health risks. MEDPRAT is extensible to the majority of exploration missions. Similar to other risk models, the tool utilizes the available space and terrestrial medical data. MEDPRAT is designed to be extended with additional human health research information, medical equipment, space and terrestrial standards and practices to assess space flight medical risk in a manner consistent with other risk measures used in spacecraft and mission design. This tool provides risk-based medical system design information necessary to evaluate new technologies, procedures, research insights and mission plans.

Description: This study illustrates the potential gains obtained by leveraging computational modeling to improve experimental efficiency in NASA research and counter measures studies through implementation of Model-Based Design of Experiments (MBDOE). MBDOE is a method to utilize analogous computational models to improve understanding of complex, multifactor, experimental responses and to determine experimental conditions and optimize information in the fewest number of experimental tests.

Description: Biomechanical models of human motion can estimate kinetic outcomes, such as joint moments, joint forces and muscle forces. Typically, one performs an inverse dynamics (ID) analysis to compute joint moments from joint angles and measured external forces. Sometimes it is impractical to measure ground reaction forces and moments (GRF&M). We devised an empirical method for performing ID analysis of resistance exercises without measured GRF&M. The method solves the multibody dynamics equations of motion with four key assumptions about the GRF&M that reduce the number of unknowns. The assumptions are 1) negligible ground reaction moments, 2) fixed lateral/medial location of the center of pressure (COP), 3) equal fore/aft location of the COP between the feet, and 4) constant angle of the GRF vector relative to the vertical axis in the frontal plane. We used evaluation trials from a spaceflight countermeasure resistance training device to test this approach. Four participants performed squat and deadlift exercises at various loads. We compared results from traditional ID analysis to results without measured GRF&M using our method. We found that joint moment trajectories in the sagittal plane were qualitatively similar in shape between the two methods, and the amount of root mean squared error (RMSE), measured by difference in joint moment impulse, was typically under 10 percent. Non-sagittal joint moment trajectories, which are much lower in overall magnitude, were not qualitatively similar in shape between the two methods. Non-sagittal moments displayed much higher RMSE, with typical values well over 50 percent. These findings were further supported by validation metrics (Sprague and Geers' P and M metrics, Pearson's r correlation coefficient). Based on these findings, we concluded that useful kinetic results are obtained from ID analysis of squat and deadlift exercises, even when GRF&M are not measured, as long as the outcomes of interest lie in the sagittal plane.

Description: INTRODUCTION: Longitudinal analysis on how spaceflight affects human health requires significant amounts of data. Missing data, especially if missing in a non-random fashion, could be a significant challenge to the success and validity of ongoing occupational surveillance and research. Astronaut occupational health data have been collected since 1959 in various formats and as part of several flight programs. As a result of changing methodologies over this span, epidemiologists in the NASA Lifetime Surveillance of Astronaut Health (LSAH) project regularly compile data sets with important exposure or outcome data missing. METHODS: NASA medical records of astronauts participating in voluntary annual LSAH examinations were reviewed and compiled to develop Individual Exposure Profiles (IEP) for each astronaut. These data were supplemented by an interview. If the interview yielded medically relevant information absent from the medical record, that information was considered an update. The IEPs were analyzed to identify trends regarding the characteristics of astronauts who provided updates and what kinds of information were consistently being updated. RESULTS: To date, 190 astronauts have participated in the IEP project. Medical information was updated for 119 individuals during these interviews. The astronauts' likelihood of updating their record upon interview was not significantly related to their spaceflight experience, era of active spaceflight, or duration of longest spaceflight. The most commonly updated categories of medical information were issues encountered during spaceflights, including CO2 symptoms, vision changes, back pain, headaches, and space motion sickness. DISCUSSION: The most commonly updated categories correspond to areas where LSAH has ongoing analysis efforts and therefore do not appear to have been reported at random. This presentation will address identification of missing astronaut health data and trends, forward work identified by the IEP project and how this information may be used for future LSAH data gap analyses.

Description: As early as 1980, Donald MacLeod coined the term "optoretinogram" to describe a change in the near-infrared reflectance of the retina following visual stimulation. The hope that such signals might exist was stimulated by an observation of a change in the infrared transmission of isolated toad retinae. This signal showed a time course of several seconds, much slower than the electroretinogram, and was thought to be related to some chemical step in the phototransduction cascade. During the early 1980's, we made several attempts to observe such signals in vivo in humans, without success. In the intervening decades, however, researchers have succeeded in observing what are now known as "intrinsic optical signals" or IOSs. Responses from single photoreceptors (obtained using adaptive optics) are surprisingly heterogenous, with some cells increasing their reflectance in response to visual stimulation, while others decrease. This talk will review our early work, survey recent findings, and consider various theories for the origin of the effect.

Description: In recent years microbe a plethora of microbe populations have been identified onboard the ISS (International Space Station). Approaches for real-time tracking of microbes for routine housekeeping and food/water safety monitoring will be critical for mission safety and crew health on future longer duration missions to the Moon or Mars. This work is a proof-of-concept study demonstrating an end-to-end phylogenetic identification and full genome sequencing effort of multiple microbial populations. Our methodology utilized the ISS flight-certified WetLab-2 molecular toolbox and the Biomolecule Sequencer projects for real-time end-to-end on-orbit microbial biological samples processing and molecular analysis with real time results generated utilizing only field "offline" analytic software. For this experiment we colony-cultured several ISS isolated microorganisms before generation of the pre-sequencing library via the automated VolTRAX device which enabled high library turnover with little wet-bench activity or potential future costly astronaut time. The pre-sequencing library is diluted in loading buffer and injected into the MinION sample port, drawn into the nanopore window by capillary action, and sequenced using the MinKnown. 16S and full genome alignment, nucleotide matching, gene identification, and phylogenetic sorting was accomplished utilizing the Epi2me software and the offline NCBI Blast viral, microbiome, and human somatic databases. In short, the methodologies developed herein replace the myriad of specific, often highly targeted microbiological tests used in the clinical laboratory, which would be difficult if not impossible to currently implement aboard the ISS or in deep space, with a single metagenomics test.

Description: The Human Research Program funded the development of the Integrated Medical Model (IMM) to quantify the medical component of overall mission risk. The IMM uses Monte Carlo simulation methodology, incorporating space flight and ground medical data, to estimate the probability of mission medical outcomes and resource utilization. To determine the credibility of IMM output, the IMM project team completed two validation studies that compared IMM predicted output to observed medical events from a selection of Shuttle Transportation System (STS) and International Space Station (ISS) missions. The validation study results showed that the IMM underpredicted the occurrence of ~10% of the modeled medical conditions for the STS missions and overpredicted ~20% of the modeled medical conditions for the ISS missions. These findings imply that the strength of IMM predictions to inform decisions depends on simulated mission specifications including length. This discrepancy could result from medical recording differences between ISS and STS that possibly influence observed incidence rates, IMM combining all "mission type" data as constant occurrence rate or fixed proportion across both mission types, misspecification of symptoms to conditions, and gaps in the literature informing the model. Some of these issues will be alleviated by updating the IMM source data through incorporation of the observed validation data.

Description: We have prepared silicate based hard materials and have processed it with organic flux. Because of the bioactivities of hydroxyapatites with tissues, this class of materials have attracted interest for bone applications. We have utilized low temperature processing techniques. Organic melt was used and the directional solidification method to cast the shaped sample. This organic treated material has different characteristics than coarsened oxide materials. Our approach involved low temperature processing using nano and micron sized powders of the material system Na2O-K2O-CaO- MgO-Ga2O3-SiO2, and titanates were processed by sintering and grain growth. Our results indicate that substitution of gallium and magnesium or titanium with some variation in processing methods have great potential to improve the glassy characteristics without decreasing the mechanical properties of bones. Effect of radiation on bone was studied by exposing with commercially available Cs137 gamma ray source. It was observed that electrical resistivity increased due to radiation exposure for this system.

Description: Discuss current evidence based capabilities of percutaneous drainage (PCD) for spaceflight.

Description: No abstract available

Description: Short-term and long-term spaceflight missions can cause immune system dysfunction in astronauts. Recent studies indicate elevated white blood cells (WBC) and polymorphonuclear neutrophils (PMN) in astronaut blood, along with unchanged or reduced lymphocyte counts, and reduced T cell function, during short-(days) and long-(months) term spaceflight. A high PMN to lymphocyte ratio (NLR) can acts as a strong predictor of poor prognosis in cancer, and as a biomarker for subclinical inflammation in humans and chronic stress in mouse models, however, the NLR has not yet been identified as a predictor of astronaut health during spaceflight. For this, complete blood cell count data collected from astronauts and rodents that have flown for short- and long-term missions on board the International Space Station (ISS) was repurposed to determine the NLR pre-, in-, and post-flight. The results displayed that the NLR progressively increased during spaceflight in both human and mice, while a spike in the NLR was observed at post-flight landing, suggesting stress-induced factors may be involved. In addition, the ground-based chronic microgravity analog, hindlimb unloading in mice, indicated an increased NLR, along with induced myeloperoxidase expression, as measured by quantitative (q)PCR. The mechanism for increased NLR was further assessed in vitro using the NASA-developed rotating wall vessel (RWV) cell culture suspension system with human WBCs. The results indicated that simulated microgravity led to increased mature PMN counts, NLR profiles, and production of reactive oxygen species (ROS). Collectively, these studies show that an increased NLR is observed in spaceflight missions, and in chronic microgravity-analog simulation in mice, and that this effect may be potentiated by the oxidative stress response in blood cells under microgravity conditions. Furthermore, these results suggest that a disrupted NLR profile in spaceflight may further disrupt immune homeostasis, potentially causing chronic immune-mediated inflammatory diseases. Thus, we propose that the health status of astronauts during short- and long-term space missions can be monitored by their NLR profile, in addition to utilizing this measurement as a tool for interventions and countermeasure development to restore homeostatic immunity.

Description: The suite of exercise hardware aboard the International Space Station (ISS) generates an immense amount of data. The data collected, treadmill, cycle ergometer, and resistance strength training hardware, are basic exercise parameters (time, heart rate, speed, load, etc.). The raw data are processed in the laboratory and more detailed parameters are calculated from each exercise data file. Updates recently have been made to how these valuable data are stored, adding an additional level of security, increasing accessibility, and resulting in overall increased efficiency of medical report delivery. Questions regarding exercise performance or how exercise may influence other variables of crew health frequently arise within the crew health care community. Inquiries regarding the health of the exercise hardware often need quick analysis and response to ensure the exercise system is operable on a continuous basis. Consolidating all of the exercise system data in a single repository enables a quick response to both the medical and engineering communities. A SQL server database is currently in use, and provides a secure location for all of the exercise data starting at ISS Expedition 1 to current date. The database has been structured to update derived metrics automatically, making analysis and reporting available within minutes of dropping the in-flight data into the database. Commercial tools were evaluated to help aggregate and visualize data from the SQL database. The Tableau software provides manageable interface, which has improved the laboratorys output time of crew reports by 67%. Expansion of the SQL database, to be inclusive of additional medical requirement metrics, addition of app-like tools for mobile visualization, and collaborative use (e.g., operational support teams, research groups, and International Partners) of the data system, is currently being explored.

Description: Accelerated research by NASA has investigated the significant risks incurred during long-duration missions in microgravity for Space Flight-Associated Neuro-ocular Syndrome (SANS, formerly known as Visual Impairments associated with Increased Intracranial Pressure, VIIP) [1]. For our study, NASA's VESsel GENeration Analysis (VESGEN) was used to investigate the role of retinal blood vessels in the etiology of SANS/VIIP. The response of retinal vessels to microgravity was evaluated in astronaut crew members pre and post flight to the International Space Station (ISS), and compared to the response of retinal vessels in healthy volunteers to 6deg head-down tilt during 70 days of bed rest (HDTBR). For the study, we are testing the hypothesis that long-term cephalad fluid shifts resulting in ocular and visual impairments are necessarily mediated in part by retinal blood vessels, and therefore are accompanied by structural adaptations of the vessels. METHODS: Vascular patterns in the retinas of crew members and HDTBR subjects extracted from 30deg infrared (IR) Heidelberg Spectralis images collected pre/postflight and pre/post HDTBR, respectively, were analyzed by VESGEN (patent pending). VESGEN is a mature, automated software developed as a research discovery tool for progressive vascular diseases in the retina and other tissues. The multi-parametric VESGEN analysis generates maps of branching arterial and venous trees quantified by parameters such as the fractal dimension (Df, a modern measure of vascular space-filling capacity), vessel diameters, and densities of vessel length and number classified into specific branching generations according to vascular physiological branching rules. The retrospective study approved by NASA's Institutional Review Board included the analysis of bilateral retinas in eight ISS crew members monitored by routine occupational surveillance and six HDTBR subjects (NASA FARU Campaign 11, for example). The VESGEN analysis was conducted in a blinded fashion, with IR retinal images masked to the subject's identity, ophthalmic and clinical characteristics, and to the temporal sequence of image collection. To complete our study, VESGEN results will be analyzed statistically and correlated with other ophthalmic and medical findings. RESULTS: Preliminary results for changes in the pre to post status of vascular patterning in the retinas of crew members and HDTBR subjects are interestingly opposite. By Df and other vascular branching measures, the space-filling capacity of arterial and venous trees decreased in the majority of crew members (11/16 retinas). In contrast, vascular densities increased in HDTBR subjects by the same parameters (6/10 retinas). To conclude the study, biostatistics and medical analyses will be conducted to quantify and draw conclusions about how the changes associated with flight compare to those associated with HDTBR. CONCLUSIONS: Vascular densities appeared to decrease in the retinas of ISS crew members and increase in HDTBR subjects. Differences in arterial and venous response to cephalad fluid shifts induced by ISS and HDTBR may have resulted from a long-duration conditioning phenomenon (for example, 6-month ISS missions compared to 70 days HDTBR), or the presence of gravity in HDTBR compared to microgravity on the ISS. In addition, increased and decreased vessel diameters for Crew Members and HDTBR, respectively, are subject to limits of im

Description: The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

Description: The NASA has determined that a multi-functional exercise device will be developed for use as an exercise device during exploration missions. The device will allow for full body resistance and metabolic exercise necessary to minimize physiological losses during space flight and to maintain fitness necessary to perform critical mission tasks. Prior to implementation as an exercise device on an Exploration vehicle, there will be verification and validation testing completed to determine device efficacy at providing the necessary training stimuli to achieve desired goals. Because the exploration device will be new device that has yet be specified, specific Verification and Validation (V&V) protocols have yet to be developed. Upon delivery of an exploration exercise device training unit, stakeholders throughout NASA will develop V&V plans that include ground-based testing and testing on the International Space Station (ISS). Stakeholders will develop test protocols that include success criterion for the device. Ground tests will occur at NASA Johnson Space Station prior to flight testing. The intents of the ground tests are to allow crew, spaceflight medicine, science, engineering, Astronaut Strength, Conditioning, and Reconditioning staff, and others to gain experience in the best utilization of the device. The goal is to obtain an evidence base for recommending use of the device on the ISS. The developed protocol will be created to achieve multiple objectives, including determining if the device provides an adequate training stimulus for 5th - 95th percentile males and females, allows for exercise modalities that protect functional capability, and is robust and can withstand extensive human use. Although protocols are yet to be determined, current expectations include use of the device by test subjects and current crew in order to obtain quantitative and qualitative feedback. Information obtained during the ground tests may be used to influence device modifications during design iterations. Assuming successful ground tests, the device will be installed on the ISS for testing during space flight. Spaceflight testing is envisioned to include an activation and checkout (ACO) phase and a V&V phase. During the ACO phase, 1-2 crewmembers will exercise with the device to ensure proper function. ACO is expected to last multiple months because of the many modes and methods of exercise that need to be assessed. However, the goal is to complete the ACO as quickly as possible. Once successful ACO occurs, the crew will be free to use the device for normal exercise pending concurrence from stakeholders. V&V tests on the ISS will ideally consist of crew using the device for all of their exercise for an entire mission. Exercise prescriptions will be supplied that replicate expected prescriptions during exploration missions. Crew that are not enrolled in the V&V studies would be also free to use the device as their schedule permits. As experience is gained by users, exercise protocols could change. The intent of all V&V testing is to ensure that all have thorough understanding of experience at optimizing device capability

Description: Deep Space Gateway and Transport missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The ExMC Systems Engineering team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is using Model-Based System Engineering (MBSE) to accomplish its integrative goals. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system, and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. This talk will discuss how ExMC is using MBSE to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. How MBSE is being used to integrate across disciplines and NASA Centers will also be described. The medical system being discussed in this talk is one system within larger habitat systems. Data generated within the medical system will be inputs to other systems and vice versa. This talk will also describe the next steps in model development that include: modeling the different systems that comprise the larger system and interact with the medical system, understanding how the various systems work together, and developing tools to support trade studies.

Description: ExMC is creating an ecosystem of tools to enable well-informed medical system trade studies. The suite of tools address important system implementation aspects of the space medical capabilities trade space and are being built using knowledge from the medical community regarding the unique aspects of space flight. Two integrating models, a systems engineering model and a medical risk analysis model, tie the tools together to produce an integrated assessment of the medical system and its ability to achieve medical system target requirements. This presentation will provide an overview of the various tools that are a part of the tool ecosystem. Initially, the presentation's focus will address the tools that supply the foundational information to the ecosystem. Specifically, the talk will describe how information that describes how medicine will be practiced is captured and categorized for efficient utilization in the tool suite. For example, the talk will include capturing what conditions will be planned for in-mission treatment, planned medical activities (e.g., periodic physical exam), required medical capabilities (e.g., provide imaging), and options to implement the capabilities (e.g., an ultrasound device). Database storage and configuration management will also be discussed. The presentation will include an overview of how these information tools will be tied to parameters in a Systems Modeling Language (SysML) model, allowing traceability to system behavioral, structural, and requirements content. The discussion will also describe an HRP-led enhanced risk assessment model developed to provide quantitative insight into each capability's contribution to mission success. Key outputs from these various tools, to be shared with the space medical and exploration mission development communities, will be assessments of medical system implementation option satisfaction of requirements and per-capability contributions toward achieving requirements.

Description: Exploration spaceflight poses several challenges to the provision of a comprehensive medication formulary. This formulary must accommodate the size and space limitations of the spacecraft, while addressing individual medication needs and preferences of the crew, consequences of a degrading inventory over time, the inability to resupply used or expired medications, and the need to forecast the best possible medication candidates to treat conditions that may occur. The Exploration Medical Capability (ExMC) Element's Pharmacy Project Team has developed a research plan (RP) that is focused on evidence-based models and theories as well as new diagnostic tools, treatments, or preventive measures aimed to ensure an available, safe, and effective pharmacy sufficient to manage potential medical threats during exploration spaceflight. Here, we will discuss the ways in which the ExMC Pharmacy Project Team pursued expert evaluation and guidance, and incorporated acquired insight into an achievable research pathway, reflected in the revised RP.

Description: The suite of exercise hardware aboard the International Space Station (ISS) generates an immense amount of data. The data collected from the treadmill, cycle ergometer, and resistance strength training hardware are basic exercise parameters (time, heart rate, speed, load, etc.). The raw data are post processed in the laboratory and more detailed parameters are calculated from each exercise data file. Updates have recently been made to how this valuable data are stored, adding an additional level of data security, increasing data accessibility, and resulting in overall increased efficiency of medical report delivery. Questions regarding exercise performance or how exercise may influence other variables of crew health frequently arise within the crew health care community. Inquiries over the health of the exercise hardware often need quick analysis and response to ensure the exercise system is operable on a continuous basis. Consolidating all of the exercise system data in a single repository enables a quick response to both the medical and engineering communities. A SQL server database is currently in use, and provides a secure location for all of the exercise data starting at ISS Expedition 1 - current day. The database has been structured to update derived metrics automatically, making analysis and reporting available within minutes of dropping the inflight data it into the database. Commercial tools were evaluated to help aggregate and visualize data from the SQL database. The Tableau software provides manageable interface, which has improved the laboratory's output time of crew reports by 67%. Expansion of the SQL database to be inclusive of additional medical requirement metrics, addition of 'app-like' tools for mobile visualization, and collaborative use (e.g. operational support teams, research groups, and International Partners) of the data system is currently being explored.

Description: The yield of chromosomal aberrations has been shown to increase in the lymphocytes of astronauts after long-duration missions of several months in space. Chromosome exchanges, especially translocations, are positively correlated with many cancers and are therefore a potential biomarker of cancer risk associated with radiation exposure. Although extensive studies have been carried out on the induction of chromosomal aberrations by low- and high-LET radiation in human lymphocytes, fibroblasts, and epithelial cells exposed in vitro, there is a lack of data on chromosome aberrations induced by low dose-rate chronic exposure and mixed field beams such as those expected in space. Chromosome aberration studies at NSRL will provide the biological validation needed to extend the computational models over a broader range of experimental conditions (more complicated mixed fields leading up to the galactic cosmic rays (GCR) simulator), helping to reduce uncertainties in radiation quality effects and dose-rate dependence in cancer risk models. These models can then be used to answer some of the open questions regarding requirements for a full GCR reference field, including particle type and number, energy, dose rate, and delivery order. In this study, we designed a simplified mixed field beam with a combination of proton, helium, oxygen, and iron ions with shielding or proton, helium, oxygen, and titanium without shielding. Human fibroblasts cells were irradiated with these mixed field beam as well as each single beam with acute and chronic dose rate, and chromosome aberrations (CA) were measured with 3-color fluorescent in situ hybridization (FISH) chromosome painting methods. Frequency and type of CA induced with acute dose rate and chronic dose rates with single and mixed field beam will be discussed. A computational chromosome and radiation-induced DNA damage model, BDSTRACKS (Biological Damage by Stochastic Tracks), was updated to simulate various types of CA induced by acute exposures of the mixed field beams used for the experiments. The chromosomes were simulated by a polymer random walk algorithm with restrictions to their respective domains in the nucleus [1]. The stochastic dose to the nucleus was calculated with the code RITRACKS [2]. Irradiation of a target volume by a mixed field of ions was implemented within RITRACKs, and the fields of ions can be delivered over specific periods of time, allowing the simulation of dose-rate effects. Similarly, particles of various types and energies extracted from a pre-calculated spectra of galactic cosmic rays (GCR) can be used in RITRACKS. The number and spatial location of DSBs (DNA double-strand breaks) were calculated in BDSTRACKS using the simulated chromosomes and local (voxel) dose. Assuming that DSBs led to chromosome breaks, and simulating the rejoining of damaged chromosomes occurring during repair, BDSTRACKS produces the yield of various types of chromosome aberrations as a function of time (only final yields are presented). A comparison between experimental and simulation results will be shown.

Description: Of the many possible health challenges posed during extended exploratory missions to space, the effects of space radiation on cardiovascular disease and cancer are of particular concern. There are unique challenges to estimating those radiation risks; care and appropriate and rigorous methodology should be applied when considering small cohorts such as the NASA astronaut population. The objective of this work was to establish whether there is evidence for excess cardiovascular disease or cancer mortality in an early NASA astronaut cohort and determine if a correlation exists between space radiation exposure and mortality.

Description: Accelerated research by NASA [1] has investigated the significant risks for visual and ocular impairments Spaceflight Associated Neuro-Ocular Syndrome /Visual Impairment/Intracranial Pressure (SANS/VIIP) incurred by microgravity spaceflight, especially long-duration missions. Our study investigates the role of blood vessels in the incidence and etiology of SANS/VIIP within the retinas of Astronaut crewmembers pre-and post-flight to the International Space Station (ISS) by NASA's VESsel GENeration Analysis (VESGEN). The response of retinal vessels in crewmembers to microgravity was compared to that of retinal vessels to Head-Down Tilt (HDT) in subjects undergoing 70-Day Bed Rest. The study tests the proposed hypothesis that cephalad fluid shifts missions, resulting in ocular and visual impairments, are necessarily mediated in part by retinal blood vessels, and are therefore accompanied by significant remodeling of retinal vasculature.Vascular patterns in the retinas of crew members and HDTBR subjects extracted from 30 infrared (IR) Heidelberg Spectralis images collected pre/postflight and pre/post HDTBR, respectively, were analyzed by VESGEN (patent pending). a mature, automated software developed as a research discovery tool for progressive vascular diseases in the retina and other tissues [2]. The weighted, multi-parametric VESGEN analysis generates maps of branching arterial and venous trees and quantification by parameters such as the fractal dimension (Df, a modern measure of vascular space-filling capacity), vessel diameters, and densities of vessel length and number classified into specific branching generations by vascular physiological branching rules [2,3]. The retrospective study approved by NASAs Institutional Review Board included six HDT subjects (NASA Flight Analogs Research Unit [FARU] Campaign 11; for example, [4]) and eight ISS crewmembers monitored by routine occupational surveillance who provided their study consents to NASAs Lifetime Surveillance of Astronaut Health (LSAH). For the initial blinded VESGEN phase, ophthalmic retinal images were masked as to subject identity and pre- and post-status. In the second unblinded phase, VESGEN results were analyzed according to the pre- and post-status of left and right retinas matched to each subject. To complete our study, vascular results will be subjected to NASA biostatistical analysis and correlated with other ophthalmic and medical findings. Preliminary results for changes in the pre- to post-status of vascular patterning in the retinas of crewmembers and HDT subjects are strikingly opposite. By Df and other vascular branching measures, the space-filling capacity of arterial and venous trees decreased in a substantial subset of crewmembers (11/16 retinas). In contrast, vascular densities increased in a substantial subset of HDT subjects by the same parameters (6/10 retinas, currently excluding one anomalous subject). To conclude the study, biostatistical and medical analyses will be of critical importance for investigating the validity of these vascular findings. Vascular densities appeared to decrease in the retinas of crewmembers following ISS Missions, and increase in subjects after HDT. The vascular increases and decreases most likely derive primarily from limits of resolution to the ophthalmic imaging that does not capture the smallest vessels, rather than from vessel growth or atrophy. Differences in arterial and venous response to cephalad fluid shifts induced by ISS and HDT may have resulted from a long-duration conditioning phenomenon (for example, 6-month ISS missions compared to 70-day HDT), or the presence of gravity in HDT compared to microgravity onboard the ISS. To conclude our study, the biostatistical and medical analyses will be of critical importance for investigating the validity and significance of the VESGEN findings.

Description: The National Aeronautics and Space Administration (NASA) has identified a potential risk of spatial disorientation, motion sickness, and degraded performance to astronauts during re-entry and landing of the proposed Orion crew vehicle. The purpose of this study was to determine if a physiological training procedure, Autogenic-Feedback Training Exercise (AFTE), can mitigate these adverse effects. Fourteen men and six women were assigned to two groups (AFTE, no-treatment Control) matched for motion sickness susceptibility and gender. All subjects received a standard rotating chair test to determine motion sickness susceptibility; three training sessions on a manual performance task; and four exposures in the rotating chair (Orion tests) simulating angular accelerations of the crew vehicle during re-entry. AFTE subjects received 2 hours of training before Orion tests 2, 3, and 4. Motion sickness symptoms, task performance, and physiological measures were recorded on all subjects. Results showed that the AFTE group had significantly lower symptom scores when compared to Controls on test 2 (p=.05), test 3 (p=.03), and test 4 (p=.02). Although there were no significant group differences on task performance, trends showed that AFTE subjects were less impaired than Controls. Heart rate change scores (20 revolutions per minute minus baseline) of AFTE subjects indicated significantly less reactivity on Test 4 compared to Test 1 (10.09 versus 16.59, p=.02), while Controls did not change significantly across tests. Results of this study indicate that AFTE may be an effective countermeasure for mitigating spatial dis-orientation and motion sickness in astronauts.

Description: This presentation reviews non-auditory effects of noise relevant to habitable volume requirements in cislunar space. The non-auditory effects of noise in future long-term space habitats are likely to be impactful on team and individual performance, sleep, and cognitive well-being. Recommendations are provided for future standards and procedures for long-term space flight habitats, along with recommendations for NASA's Human Research Program in support of DST mission success. The following non-auditory effects of noise are addressed: performance-teamwork; sleep disturbance; and cognitive well-being, all of which impact crew performance and readiness to perform. It reviews the relevance of research performed on earth to the space environment, the quality of the measurement metrics used, and potentially significant research gaps. Auditory effects of noise are considered to the degree that measurement metrics overlap with non-auditory effects.

Description: NASA's BioSentinel mission is a 6U nanosatellite with autonomous life support that will utilize the budding yeast Saccharomyces cerevisiae to study the DNA damage response to the deep space radiation environment. BioSentinel is planned to launch in 2019 as a secondary payload on the Space Launch System's first Exploration Mission (EM-1), and will undergo a lunar fly-by and enter heliocentric orbit after deployment. As the first biological mission beyond Low Earth Orbit (LEO) in nearly half a century, this mission will help fill critical gaps in knowledge about the effects of uniquely composed, chronic, low-flux deep space radiation on biological systems. Yeast is well-suited for this mission due to its desiccation tolerance and space-flight heritage. As a eukaryotic model organism, it also serves as a robust analog for human cells. Data gathered on this mission will thus inform us of the hazards involved in long-duration human exploration in deep space, and the protections necessary to mitigate them. Due to its low-cost, flexible and advanced technology, the 4U BioSensor payload contained within the nanosatellite is adaptable to other model microorganisms, exploration platforms and environments relevant to human exploration, such as the ISS, the Lunar Orbital Platform - Gateway and future lunar landers. In order to query the DNA damage response to deep space radiation, BioSentinel contains a wild type yeast strain as a positive control, and a radiation sensitive rad51 mutant strain that is defective for DNA repair. Yeast cells are desiccated in microfluidic cards, and rehydrated with growth medium and metabolic indicator dye at the desired time points during the mission. A thermal control system supports these stasis and growth states, and an optical system continuously measures cell growth and metabolism. An onboard radiation spectrometer and dosimeter allows us to correlate the dose, energy and particle-type of deep space radiation to the biological response. Data received from the deep space biosensor will be compared to control payloads on Earth and the ISS. Ongoing science testing for the BioSentinel project includes optimization for cell viability, desiccation tolerance, and long-term biocompatibility, as well as radiation experiments to understand the sensitivity and responsiveness of cells to varying radiation doses and particle types.