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PubMed1993

Earthbound applications for NASA's physician workstation.

The dream of a space probe to Mars or an astronaut colony on the moon persists. Despite years of setbacks and delays, NASA continues to lay the foundation for a new frontier in space. The necessity of a self contained health maintenance facility is an integral part of this stellar venture. As a subsystem of this health maintenance facility, the physician or astronaut workstation was envisioned as the vehicle of interface between the computer resources of the space station and the care provider. Our efforts to define and build this interface have resulted in a series of programs which can now be tested and refined using earth-based applications. The modules which have dual-use application from the NASA workstation include: patient scheduling and master patient index, pharmacy, laboratory, medical library, problem list/progress notes, and digital medical records. Our current plan is to develop these tools as objects that can be assembled in a variety of configurations. This will allow the technology to be used by the private sector where each doctor can select the starting point of his outpatient office system and add modules as he makes progress in system integration and training.

Aerospace Medicine↗

PubMed1996

Musculoskeletal injury review in the U.S. space program.

Astronauts in NASA's space program are expected to remain fit to complete their on-orbit tasks and to function effectively in the event of contingency operations. Due to the generally self-directed exercise program and reliance on competitive sports and running for conditioning, plus limited emphasis on training techniques and rehabilitation, there have been a surprising number of orthopedic injuries and surgeries in this small adult population. This article examines the orthopedic injury history of U.S. astronauts during the period from 1987-95. The type of injury, activity involved, and subsequent surgical interventions are cataloged. There were a total of 26 fractures, 36 serious ligament, cartilage, or soft tissue injuries, and 28 orthopedic surgical procedures in this adult group with a mean astronaut corps size of only 94. Women accounted for 16% of the study population but accounted for only 1 of 28 surgical procedures. Knee injuries required surgical intervention 19 times. Running, skiing, and basketball were most frequently associated with injuries. The descriptive data regarding frequency of adverse events and activity associated with injuries is presented. These injury patterns are analyzed and suggestions made for future improvement, including decreased reliance on running and competitive athletics for conditioning, improved personal fitness training preflight, and coordinated rehabilitation postflight. Also recommended is the use of a lap pool for preflight total body fitness training, since swimming provides conditioning to those muscle groups used during spaceflight, and for variably weighted gravity rehabilitation postflight.

Adult↗

PubMed2005

Human behavioral research in space: quandaries for research subjects and researchers.

With the advent of long-duration spaceflight on board the International Space Station (ISS) and possible future missions beyond low Earth orbit (LEO) such as Mars, it is critical that those at NASA have a realistic assessment of the challenges that will face individuals on long-duration missions so that they can develop preventive and real-time countermeasures to behavioral health issues. While space travellers are very interested in having countermeasures to the deleterious effects of space missions, they have a powerful disincentive to participate in this research if they feel it could in any way negatively affect their flight status. The behavioral issues of isolation and confinement for extended-duration space missions are reviewed. Areas of basic and clinical behavioral research are listed. And the classical clinical model for research is not considered appropriate for the current configuration of the space program. The use of analogue environments and advanced statistical analysis are suggested as ways to address the limited spaceflight research opportunities. The challenge of research subject or patient confidentiality vs. mission safety and issues of personal flight status are addressed.

Adaptation, Physiological↗

PubMedDate not supplied

Skylab experiment M-171 "Metabolic Activity"--results of the first manned mission.

The experiment was performed to ascertain whether man's ability to perform mechanical work would be altered as a result of exposure to the weightless environment. Skylab II crewmen were exercised on a bicycle ergometer at loads approximating 25%, 50%, and 75% of their maximum oxygen uptake while their physiological responses were monitored. The results of these tests indicate that the crewmen had no significant decrement in their response to exercise during their exposure to zero gravity. Immediately postflight, however, all crewmen demonstrated an inability to perform the programmed exercise with the same metabolic effectiveness as they did both preflight and inflight. The most significant changes were elevated heart rates for the same work load and oxygen consumption (decreased oxygen pulse), decreased stroke volume, and decreased cardiac output at the same oxygen consumption level. It is apparent that the changes occurred inflight, but did not manifest themselves until the crewmen attempted to readapt to the 1-G environment.

Adaptation, Physiological↗

PubMed1984

Approaches to radiation guidelines for space travel.

There are obvious risks in space travel that have loomed larger than any risk from radiation. Nevertheless, NASA has maintained a radiation program that has involved maintenance of records of radiation exposure, and planning so that the astronauts' exposures are kept as low as possible, and not just within the current guidelines. These guidelines are being reexamined currently by NCRP Committee 75 because new information is available, for example, risk estimates for radiation-induced cancer and about the effects of HZE particles. Furthermore, no estimates of risk or recommendations were made for women in 1970 and must now be considered. The current career limit is 400 rem to the blood forming organs. The appropriateness of this limit and its basis are being examined as well as the limits for specific organs. There is now considerably more information about age-dependency for radiation effects and this will be taken into account. In 1973 a committee of the National Research Council made a separate study of HZE particle effects and it was concluded that the attendant risks did not pose a hazard for low inclination near-earth orbit missions. Since that time work has been carried out on the so-called microlesions caused by HZE particles and on the relative carcinogenic effect of heavy ions, including iron. A remaining question is whether the fluence of HZE particles could reach levels of concern in missions under consideration. Finally, it is the intention of the committee to indicate clearly the areas requiring further research.

Aerospace Medicine↗

PubMed1991

Can the adult skeleton recover lost bone?

The loss of bone mineral with aging and subsequent development of osteoporosis is a common problem in elderly women, and as life expectancy increases, in elderly men as well. Space flight also causes bone loss and could be a limiting factor for long duration missions, such as, a Mars expedition or extended occupation of a space station. Before effective countermeasures can be devised, a thorough knowledge of the extent, location, and rate of bone loss during weightlessness is needed from actual space flight data or ground-based disuse models. In addition, the rate and extent that these losses are reversed after return from space flight are of primary importance. Although the mechanisms are not likely to be the same in aging and space flight, there are common elements. For example, strategies developed to prevent disuse bone loss or to enhance the rate of recovery following space flight might have direct applicability to clinical medicine. For various reasons, little attention has been given to recovery of bone mass following space flight. As a prelude to the design of strategies to enhance recovery of bone, this paper reviews published literature related to bone recovery in the adult. We conclude that recovery can be expected, but the rate and extent will be individual and bone site dependent. The development of strategies to encourage or enhance bone formation following space flight may be as important as implementing countermeasures during flight.

Adult↗

PubMed1989

Assessing applicants to the NASA flight program for their renal stone-forming potential.

Spaceflight could provoke formation of kidney stones, in part by causing hypercalciuria and hyperphosphaturia. Applicants for spaceflight who have metabolic or environmental derangements to begin with might be particularly susceptible to stone formation in space. We, therefore, analyzed 24-h urine samples for stone-forming risk factors in 104 male applicants before their selection into the astronaut-mission specialist corps. The urinary environment was abnormally supersaturated with calcium oxalate in 25.0% of applicants, brushite in 36.5%, and monosodium urate in 66.3%, predisposing these applicants to crystallization of stone-forming calcium salts. This high level of supersaturation was caused by both "metabolic" and environmental disturbances. Thus, hypercalciuria was found in 11.5% of applicants, hyperoxaluria in 2.9%, hyperuricosuria in 18.3% and hypocitraturia in 5.8%. Environmental derangements were generally more prominent, as indicated by low urine volume of less than 2 L.d-1 in 84.6%, high urinary phosphate in 24.4%, and high urinary sodium in 10.6% of applicants. The results suggest that most of the abnormal stone risk factors disclosed among applicants for spaceflight programs were environmental in origin.

Adult↗

PubMed1992

Orthostatic hypotension of prolonged weightlessness: clinical models.

Orthostatic intolerance on return from space is a widely known consequence of space travel. Development of countermeasures against this problem is a major priority of the field of space physiology and medicine. The bedrest model is widely used in the investigation of this phenomenon, and has provided important data, but questions remain. In this article, we suggest that the disorders that produce chronic orthostatic hypotension have significant potential as models of microgravity-induced orthostatic intolerance. Understanding the pathophysiology of these syndromes may be useful to those involved in improving the operational aspects of manned space flight; four such syndromes and their possible relevance to space flight are described.

Autonomic Nervous System Diseases↗

PubMed1981

Evaluation of the NASA/JSC blood pressure screening clinic.

This study evaluated the NASA/Johnson Space Center's blood pressure screening program, which was designed to identify the proportion of NASA employees who were hypertensive and to identify self-report variables related to elevated pressures. In 1978, a random sample of 3892 employees was selected from over 2,100 NASA employees. Twenty-eight percent were classified as hypertensive by the criterion of systolic pressure of 140 or above or diastolic pressure of 90 or greater. Approximately 16% of all employees had a history of hypertension; the remaining 12% of the identified hypertensives were unaware of their potential health problem. Multivariate analysis showed that elevated systolic pressures were more prevalent in the older, heavier employees. Of hypertensives under treatment, about 74% were under poor control as judged from blood pressures randomly taken at their place of employment. These results demonstrated the effectiveness of screening for unsuspecting hypertensives in industry.

Adult↗

PubMed2002

History of nutrition in space flight: overview.

Major accomplishments in nutritional sciences for support of human space travel have occurred over the past 40 y. This article reviews these accomplishments, beginning with the early Gemini program and continuing through the impressive results from the first space station Skylab program that focused on life sciences research, the Russian contributions through the Mir space station, the US Shuttle life sciences research, and the emerging International Space Station missions. Nutrition is affected by environmental conditions such as radiation, temperature, and atmospheric pressures, and these are reviewed. Nutrition with respect to space flight is closely interconnected with other life sciences research disciplines including the study of hematology, immunology, as well as neurosensory, cardiovascular, gastrointestinal, circadian rhythms, and musculoskeletal physiology. These relationships are reviewed in reference to the overall history of nutritional science in human space flight. Cumulative nutritional research over the past four decades has resulted in the current nutritional requirements for astronauts. Space-flight nutritional recommendations are presented along with the critical path road map that outlines the research needed for future development of nutritional requirements.

Adaptation, Physiological↗

PubMed1991

Evaluation of the disposable absorption containment trunk for female U-2 and TR-1 pilots.

Female U-2 and TR-1 pilots needed a urine collection device as part of their high flight pressure suit ensembles. The Disposable Absorption Containment Trunk (DACT) had been designed for short term use with the NASA Space Shuttle Program. This study evaluated the DACT for the extended and repetitive use required for integration into the U-2 and TR-1 aircraft. Six female subjects were tested wearing a custom-fit DACT and the 1030 full pressure suit ensemble with torso harness. They were strapped into the U-2 ejection seat with parachute and seat kit for 10 h and 45 min every 3 d for a total of 5 sessions. The DACT was evaluated for absorptive capability and comfort. Subjects were monitored for dermatitis, vaginitis, and urinary tract infections. The DACT reliably absorbed menstrual flow and urinary outputs to 950 cc. Higher urinary outputs resulted in minimal leakage. Dermatitis in the form of mild erythema and chafing was present, but cleared between sessions without medical intervention. Complaints concerning comfort were minor and limited to fit problems. One case of vaginitis developed. There were no cases of urinary tract infection. The DACT was found to be an acceptable method of urine collection for female U-2 and TR-1 pilots. Minor changes in design will enhance the comfort and performance of the DACT.

Adult↗

PubMed1988

Soviet space flight: the human element.

Building on past experience and knowledge, the Soviet manned space flight effort has become broad, comprehensive, and forward-looking. Their long-running space station program has provided the capabilities to investigate long-term effects of microgravity on human physiology and behavior and test various countermeasures against microgravity-induced physiological deconditioning. Since the beginning of Soviet manned space flight, the biomedical training and preparation of cosmonauts has evolved from a process that increased human tolerance to space flight factors, to a system of interrelated measures to prepare cosmonauts physically and psychologically to live and work in space. Currently, the Soviet Union is constructing a multimodular space station, the Mir. With the emergence of dedicated laboratory modules, the Soviets have begun the transition from small-scale experimental research to large-scale production activities and specialized scientific work in space. In the future, additional laboratory modules will be added, including one dedicated to biomedical research, called the "Medilab." The longest manned space flight to date (326 days) has been completed by the Soviets. The biomedical effects of previous long-duration flights, and perhaps those of still greater length, may contribute important insight ito the possibility of extended missions beyond Earth, such as a voyage to Mars.

Adaptation, Physiological↗

PubMed2000

Computational model of cardiovascular function during orthostatic stress.

Orthostatic intolerance following spaceflight remains a critical problem in the current life-science space program. The study presented in this paper is part of an ongoing effort to use mathematical models to investigate the effects of gravitational stresses on the cardiovascular system of normals and microgravity adapted individuals. We employ a twelve compartment lumped parameter representation of the hemodynamic system coupled to set-point models of the arterial baroreflex and the cardiopulmonary reflex to investigate the transient response of heart rate to orthostatic stress. We simulate current hypotheses concerning the mechanisms underlying post-spaceflight orthostatic intolerance over a range of physiologically reasonable values and compare the simulations to astronaut stand-test data pre- and post-flight. Furthermore, we explore the effects of a potential countermeasure.

Aerospace Medicine↗

PubMedDate not supplied

Life science experiments during the German-Russian MIR '97 mission.

Manned spaceflight has been an important element of the German space program over the last decades. This is demonstrated by the nationally managed space missions Spacelab D-l (1985), D-2 (1993), and MIR '92 as well as by the participation in the 1st Spacelab mission FSLP (1983), the NASA missions IML-1 (1992) and IML-2 (1994), as well as in the ESA missions EUROMIR '94 and '95. On February 12th, this year, the German cosmonaut Reinhold Ewald was launched together with his Russian colleagues Wasilij Zibliew and Alexander Lasudkin onboard of a Soyuz spacecraft for another stay of a German cosmonaut onboard of the Russian Space Station MIR. This mission--the so-called German/Russian MIR '97--was, of course, another cornerstone with regard to the cooperation between Russian and German space organizations. The cooperation in the area of manned missions began 1978 with the flight of the German cosmonaut Sigmund Jahn onboard of Salyut 6, at that time a cooperation between the Soviet Union and the German Democratic Republic in the frame of the Interkosmos Program. In March 1992, it was followed by the flight of Klaus Dietrich Flade with his stay onboard of MIR. After two further successful ESA missions, EUROMIR '94 and '95 with the two German cosmonauts Ulf Merbold and Thomas Reiter and with a marked contribution of German scientists, the decision was taken to perform another German/Russian MIR mission, the so-called MIR '97. In Germany, MIR'97 was managed and performed in a joint effort between several partners. DARA, the German Space Agency, was responsible for the overall program and project management, while DLR, the German Aerospace Research Establishment, was responsible for the cosmonaut training, for medical operations, for the mission control at GSOC in Oberpfaffenhofen as well as for user support.

Adaptation, Physiological↗

PubMed2005

Space radiation measurements on-board ISS--the DOSMAP experiment.

The experiment 'Dosimetric Mapping' conducted as part of the science program of NASA's Human Research Facility (HRF) between March and August 2001 was designed to measure integrated total absorbed doses (ionising radiation and neutrons), heavy ion fluxes and its energy, mass and linear energy transfer (LET) spectra, time-dependent count rates of charged particles and their corresponding dose rates at different locations inside the US Lab at the International Space Station. Owing to the variety of particles and energies, a dosimetry package consisting of thermoluminescence dosemeter (TLD) chips and nuclear track detectors with and without converters (NTDPs), a silicon dosimetry telescope (DOSTEL), four mobile silicon detector units (MDUs) and a TLD reader unit (PILLE) with 12 TLD bulbs as dosemeters was used. Dose rates of the ionising part of the radiation field measured with TLD bulbs applying the PILLE readout system at different locations varied between 153 and 231 microGy d(-1). The dose rate received by the active devices fits excellent to the TLD measurements and is significantly lower compared with measurements for the Shuttle (STS) to MIR missions. The comparison of the absorbed doses from passive and active devices showed an agreement within +/- 10%. The DOSTEL measurements in the HRF location yielded a mean dose equivalent rate of 535 microSv d(-1). DOSTEL measurements were also obtained during the Solar Particle Event on 15 April 2001.

Aerospace Medicine↗

PubMed1995

Predicting human heat strain and performance with application to space operations.

This Institute has developed a USARIEM Heat Strain Prediction Model for predicting physiological responses and soldier performance in the heat, which has been programmed for use by hand-held calculators and personal computers, and incorporated into the development of a heat strain decision aid. This model is demonstrated to predict accurately (generally within +/- 1 SD/SEM) rectal temperature (Tre) responses for soldiers wearing various military clothing ensembles during U.S. or non-U.S. military scenarios in the heat at home or abroad. The value of this model is shown presently for three NASA scenarios involving the Launch and Entry Suit (LES). The LES (ventilated or unventilated) is modeled during pre-launch/launch, re-entry/landing, and emergency egress after re-entry/landing scenarios, predominately to evaluate heat acclimation and hydration state effects. During the pre-launch/launch scenario, predicted final Tre closely agrees with observed values suggesting minimal heat strain (Tre approximately 38.0 degrees C). In contrast, dehydrated (3%) unacclimated individuals show moderate levels of heat strain (Tre approximately 38.5 degrees C) for this same scenario. During the re-entry/landing and emergency egress scenarios, dehydrated unacclimated individuals are predicted to exhibit excessive heat strain (Tre > 39.0 degrees C). Thermal tolerance time is predicted to be only 6 min during emergency egress if individuals are dehydrated and unacclimated to heat while wearing the LES. If heat transfer values for space operations clothing are known, NASA can use this prediction model to help avoid undue heat strain involving astronauts for most scenarios during spaceflight.

Acclimatization↗

PubMed1995

Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series.

The healthy heartbeat is traditionally thought to be regulated according to the classical principle of homeostasis whereby physiologic systems operate to reduce variability and achieve an equilibrium-like state [Physiol. Rev. 9, 399-431 (1929)]. However, recent studies [Phys. Rev. Lett. 70, 1343-1346 (1993); Fractals in Biology and Medicine (Birkhauser-Verlag, Basel, 1994), pp. 55-65] reveal that under normal conditions, beat-to-beat fluctuations in heart rate display the kind of long-range correlations typically exhibited by dynamical systems far from equilibrium [Phys. Rev. Lett. 59, 381-384 (1987)]. In contrast, heart rate time series from patients with severe congestive heart failure show a breakdown of this long-range correlation behavior. We describe a new method--detrended fluctuation analysis (DFA)--for quantifying this correlation property in non-stationary physiological time series. Application of this technique shows evidence for a crossover phenomenon associated with a change in short and long-range scaling exponents. This method may be of use in distinguishing healthy from pathologic data sets based on differences in these scaling properties.

Heart Diseases↗

PubMed2001

Is there resetting of central venous pressure in microgravity?

In the early phase of the Space Shuttle program, NASA flight surgeons implemented a fluid-loading countermeasure in which astronauts were instructed to ingest eight 1-g salt tablets with 960 ml of water approximately 2 hours prior to reentry from space. This fluid loading regimen was intended to enhance orthostatic tolerance by replacing circulating plasma volume reduced during the space mission. Unfortunately, fluid loading failed to replace plasma volume in groundbased experiments and has proven minimally effective as a countermeasure against post-spaceflight orthostatic intolerance. In addition to the reduction of plasma volume, central venous pressure (CVP) is reduced during exposure to actual and groundbased analogs of microgravity. In the present study, we hypothesized that the reduction in CVP due to exposure to microgravity represents a resetting of the CVP operating point to a lower threshold. A lower CVP 'setpoint' might explain the failure of fluid loading to restore plasma volume. In order to test this hypothesis, we conducted an investigation in which we administered an acute volume load (stimulus) and measured responses in CVP, plasma volume and renal functions. If our hypothesis is true, we would expect the elevation in CVP induced by saline infusion to return to its pre-infusion levels in both HDT and upright control conditions despite lower vascular volume during HDT. In contrast to previous experiments, our approach is novel in that it provides information on alterations in CVP and vascular volume during HDT that are necessary for interpretation of the proposed CVP operating point resetting hypothesis.

Aerospace Medicine↗