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Stenger, M. B.

Publications and source records attributed to Stenger, M. B..

At least 19 records

Quantification of Ophthalmic Changes After Long-Duration Spaceflight, and Subsequent Recovery

A subset of crewmembers are subjected to ophthalmic structure changes due to long-duration spaceflight (>6 months). Crewmembers who experience these changes are described as having Spaceflight Associated Neuro-Ocular Syndrome (SANS). Characteristics of SANS include optic disk edema, cotton wool spots, choroidal folds, refractive error, and posterior globe flattening. SANS remains a major obstacle to deep-space and planetary missions, requiring a better understanding of its etiology. Quantification of ocular, structural changes will improve our understanding of SANS pathophysiology. Methods were developed to quantify 3D optic nerve (ON) and ON sheath (ONS) geometries, ON tortuosity, and posterior globe deformation using MR imaging.

Sater, S. H.

Apollo to Artemis: Mining 50-Year Old Records to Inform Future Human Lunar Landing Systems

Under the Artemis lunar exploration program, NASA is committed to landing American astronauts on the moon by 2024. While NASA’s new Space Launch System rocket and Orion capsule will carry astronauts from Earth to the Gateway, the human lunar landing system has not yet been fully defined. As in the Apollo program, there are concerns for vehicle weight and internal volume such that seats may not be desirable, and standing during lunar descent and ascent may be a preferred engineering solution. With such a design, astronauts will experience +GZ (head-to-foot) accelerations during capsule accelerations, and it is unclear whether spaceflight deconditioned astronauts can tolerate these. Apollo astronauts stood during lunar descent and ascent, and the data contained in the early program records for those missions represent a unique resource that may provide insights to the cardiovascular stress associated with this human landing system design.

Petersen, D.

Autonomous Diagnostic Imaging Performed by Untrained Operators using Augmented Reality as a Form of "Just-in-Time" Training

We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.

Martin, D. S.

Gradient Compression Garments as a Countermeasure to Post-Space Flight Orthostatic Intolerance: Potential Interactions with the Maximum Absorbency Garment

Astronauts and cosmonauts may experience symptoms of orthostatic intolerance during re-entry, landing, and for several days post-landing following short- and long-duration spaceflight. Presyncopal symptoms have been documented in approximately 20% of short-duration and greater than 60% of long-duration flyers on landing day specifically during 5-10 min of controlled (no countermeasures employed at the time of testing) stand tests or 80 deg head-up tilt tests. Current operational countermeasures to orthostatic intolerance include fluid loading prior to and whole body cooling during re-entry as well as compression garments that are worn during and for up to several days after landing. While both NASA and the Russian space program have utilized compression garments to protect astronauts and cosmonauts traveling on their respective vehicles, a "next-generation" gradient compression garment (GCG) has been developed and tested in collaboration with a commercial partner to support future space flight missions. Unlike previous compression garments used operationally by NASA that provide a single level of compression across only the calves, thighs, and lower abdomen, the GCG provides continuous coverage from the feet to below the pectoral muscles in a gradient fashion (from approximately 55 mm Hg at the feet to approximately 16 mmHg across the abdomen). The efficacy of the GCG has been demonstrated previously after a 14-d bed rest study without other countermeasures and after short-duration Space Shuttle missions. Currently the GCG is being tested during a stand test following long-duration missions (~6 months) to the International Space Station. While results to date have been promising, interactions of the GCG with other space suit components have not been examined. Specifically, it is unknown whether wearing the GCG over NASA's Maximum Absorbency Garment (MAG; absorbent briefs worn for the collection of urine and feces while suited during re-entry and landing) will interfere with the effectiveness of the GCG or conversely whether the GCG will reduce the fluid absorption capabilities of the MAG. Methods: This operational, directed study, will (1) determine whether the effectiveness of the GCG is affected by the MAG with regard to cardiovascular responses to head-up tilt, the standard orthostatic intolerance test employed for astronauts and bed rest subjects; (2) determine whether the effectiveness of the MAG is compromised by the GCG tested by injecting a standard fluid volume (950 ml in 3 separate simulated "urine voids") at a standardized rate (30 ml/sec); and (3) determine whether comfort is affected by wearing the MAG under the GCG using a standardized questionnaire. Results from this study will guide future development and operational use of the GCG and MAG to maximize crew health, safety, and comfort.

Lee, S. M. C.

Fluid Shifts

Introduction. NASA's Human Research Program is focused on addressing health risks associated with long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but now more than 50 percent of ISS astronauts have experienced more profound, chronic changes with objective structural findings such as optic disc edema, globe flattening and choroidal folds. These structural and functional changes are referred to as the visual impairment and intracranial pressure (VIIP) syndrome. Development of VIIP symptoms may be related to elevated intracranial pressure (ICP) secondary to spaceflight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration spaceflight and to determine if a relation exists with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as any VIIP-related effects of those shifts, are predicted by the crewmember's pre-flight status and responses to acute hemodynamic manipulations, specifically posture changes and lower body negative pressure. Methods. We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, and calcaneus tissue thickness (by ultrasound); (3) vascular dimensions by ultrasound (jugular veins, cerebral and carotid arteries, vertebral arteries and veins, portal vein); (4) vascular dynamics by MRI (head/neck blood flow, cerebrospinal fluid pulsatility); (5) ocular measures (optical coherence tomography; intraocular pressure; 2-dimensional ultrasound including optic nerve sheath diameter, globe flattening, and retina-choroid thickness; Doppler ultrasound of ophthalmic and retinal arteries and veins); (6) cardiac variables by ultrasound (inferior vena cava, tricuspid flow and tissue Doppler, pulmonic valve, stroke volume, right heart dimensions and function, four-chamber views); and (7) ICP measures (tympanic membrane displacement, otoacoustic emissions). Pre- and post-flight, acute head-down tilt will induce cephalad fluid shifts, whereas lower body negative pressure will oppose these shifts. Controlled Mueller maneuvers will manipulate cardiovascular variables. Through interventions applied before, during, and after flight, we intend to fully evaluate the relationship between fluid shifts and the VIIP syndrome. Discussion. Ten subjects have consented to participate in this experiment, including the recent One-Year Mission crewmembers, who have recently completed R plus180 testing; all other subjects have completed pre-flight testing. Preliminary results from the One-Year Mission crewmembers will be presented, including measures of ocular structure and function, vascular dimensions, fluid distribution, and non-invasive estimates of intracranial pressure.

Stenger, M. B.

Effects of Spaceflight on Venous and Arterial Compliance

The visual impairment and intracranial pressure (VIIP) syndrome is a spaceflight-associated set of symptoms affecting more than 50% of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures (e.g. optic disc edema, choroidal folds, and globe flattening) and is hypothesized to be related to elevated intracranial pressure secondary to a cephalad fluid shift. However, ocular symptoms have not been replicated in subjects completing prolonged bed rest, a well-accepted spaceflight analog. Altered vascular compliance along with spaceflight factors such as diet, radiation exposure, or environmental factors may cause alterations in the cardiovascular system that contribute to the manifestation of ocular changes. Loss of visual acuity could be a significant threat to crew health and performance during and after an exploration mission and may have implications for years post-flight. The overall objective of this project is to determine if spaceflight alters vascular compliance and whether such an adaptation is related to the incidence of VIIP. This objective will be met by completing three separate but related projects.

Ribeiro, L. C.

The Functional Task Test: Results from the One-Year Mission

Exposure to the microgravity conditions of spaceflight causes astronauts to experience alterations in multiple physiological systems including sensorimotor disturbances, cardiovascular deconditioning, and loss of muscle mass and strength. Some or all of these changes might affect the ability of crewmembers to perform critical mission tasks immediately after landing on a planetary surface. The goal of our recently completed Functional Task Test (FTT) study was to determine the effects of spaceflight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. The FTT is comprised of seven functional tests and a corresponding set of interdisciplinary physiological measures specifically targeting the sensorimotor, cardiovascular and muscular changes associated with exposure to spaceflight. Both Shuttle and International Space Station (ISS) astronauts were tested before and after spaceflight. Additionally, we conducted a supporting study in which subjects performed the FTT protocol before and after 70 days of 6 deg head-down bed rest, an analog for spaceflight. Two groups of bed rest subjects were studied: one group who performed aerobic and resistive exercise during bed rest using protocols similar to astronauts and one group who served as non-exercise controls. The bed rest analog allowed us to isolate the impact of body unloading without other spaceflight environmental factors on both functional tasks and on the underlying physiological factors that lead to decrements in performance, and then to compare those results with the results obtained in our spaceflight study. As an extension to the FTT study we collected data from one ISS crewmember who experienced 340 days in space using the same FTT protocol used previously to test spaceflight and bed rest subjects. Data were collected three times preflight and 1.7, 7.5 and 36.5 days after landing. The FTT one-year results will be presented at the meeting, and a comparison will be made with data previously obtained using the same protocol on astronauts tested before and after 6 months in space. Future work will focus on collecting data from additional subjects from one-year flights to gain a better assessment of extreme long-duration exposure to spaceflight on both functional measure of performance and physiological metrics.

Bloomberg, J. J

Field Test: Results from the One Year Mission

The One Year Mission was designed to aid in determining the effect that extending the duration on orbit aboard the International Space Station (ISS) would have on a number of biological and physiological systems. Two crewmembers were selected to participate in this endeavor, one U.S. On-Orbit Segment (USOS) astronaut and one Russian cosmonaut. The Neuroscience and Cardiovascular and Vision Laboratories at the Johnson Space Center and the Sensory-Motor and Countermeasures Division within the Institute for Biomedical Problems were selected to investigate vestibular, sensorimotor and cardiovascular function with the two long-duration crewmembers using the established methodology developed for the Field Test (FT).

Reschke, M. F.

Pilot Field Test: Use of a Compression Garment During a Stand Test After Long-Duration Space Flight

Orthostatic intolerance (OI) is a concern for astronauts returning from long-duration space flight. One countermeasure that has been used to protect against OI after short-duration bed rest and space flight is the use of lower body and abdominal compression garments. However, since the end of the Space Shuttle era we have not been able to test crewmembers during the first 24 hours after landing on Earth. NASA's Pilot Field Test provided us the opportunity to test cardiovascular responses of crewmembers wearing the Russian Kentavr compression garment during a stand test at multiple time points throughout the first 24 hours after landing. HYPOTHESIS We hypothesized that the Kentavr compression garment would prevent an increase in heart rate (HR) >15 bpm during a 3.5-min stand test. METHODS: The Pilot Field Test was conducted up to 3 times during the first 24 hours after crewmembers returned to Earth: (1) either in a tent adjacent to the Soyuz landing site in Kazakhstan (approx.1 hr) or after transportation to the Karaganda airport (approx. 4 hr); (2) during a refueling stop in Scotland (approx.12 hr); and (3) upon return to NASA Johnson Space Center (JSC) (approx.24 hr). We measured HR and arterial pressure (finger photoplethysmography) for 2 min while the crewmember was prone and throughout 3.5 min of quiet standing. Eleven crewmembers consented to participate; however, 2 felt too ill to start the test and 1 stopped 30 sec into the stand portion of the test. Of the remaining 8 crewmembers, 2 did not wear the Russian Kentavr compression garment. Because of inclement weather at the landing site, 5 crewmembers were flown by helicopter to the Karaganda airport before initial testing and received intravenous saline before completing the stand test. One of these crewmembers wore only the portion of the Russian Kentavr compression garment that covered the lower leg and thus lacked thigh and abdominal compression. All crewmembers continued wearing the Russian Kentavr compression garment during the second testing session in Scotland, but none wore it during testing at JSC. RESULTS: The mean Delta HR from the supine to standing position in the 8 crewmembers measured pre-flight or 60 days after return from long-duration space flight was 9.8 bpm. During the first few hours after landing from long-duration space flight, the mean Delta HR of the 6 crewmembers who wore the Russian Kentavr compression garment in Kazakhstan or Karaganda was +14 bpm and the change in mean arterial pressure (Delta MAP) was +0.8 mmHg, while the 2 crewmembers who did not wear the Russian Kentavr compression garment had a Delta HR of +38 bpm and a Delta MAP of +1.1 mmHg. In Scotland, 4 crewmembers wore the Russian Kentavr compression garment and had a Delta HR of +7.4 bpm while the 3 crewmembers who did not wear it had a Delta HR of +25.0 bpm. Seven crewmembers were tested upon return to JSC approx. 24 hr after landing, but none wore the Russian Kentavr compression garment and their Delta HR was 16.0 bpm. CONCLUSIONS: These are the first stand-test data to be collected from long-duration crewmembers during the first 24 hr of re-adaptation to gravity on Earth. The Delta HR measured in crewmembers who completed the stand-test while wearing Kentavr within the first approx.4 hours after returning to Earth was only slightly elevated from pre-flight Delta HR, while the few subjects who did not wear the Russian Kentavr compression garment had a much larger increase in HR in order to maintain arterial pressure throughout 3.5-min of standing. These data demonstrate the effectiveness of a compression garment in preventing large increases in HR during a 3.5 min stand test after long-duration space flight. However, the fact that three crewmembers were too ill to complete the test or was not able to complete 3.5 min of standing despite wearing the Russian Kentavr compression garment indicates that wearing a compression garment does not resolve all problems crewmembers face during the period of re-adaptation immediately after return to Earth's gravity.

Laurie, S. S.

Effect of 1% Inspired CO2 During Head-Down Tilt on Ocular Structures, Cerebral Blood Flow, and Visual Acuity in Healthy Human Subjects

The cephalad fluid shift induced by microgravity has been hypothesized to elevate intracranial pressure (ICP) and contribute to the development of the visual impairment/intracranial pressure (VIIP) syndrome experienced by many astronauts during and after long-duration space flight. In addition, elevated ambient partial pressure of carbon dioxide (PCO2) on the International Space Station (ISS) has also been hypothesized to contribute to the development of VIIP. We seek to determine if an acute, mild CO2 exposure, similar to that occurring on the ISS, combined with the cephalad fluid shift induced by head-down tilt will induce ophthalmic and ICP changes consistent with the VIIP syndrome.

Laurie, S. S.

Effects of Spaceflight on Venous and Arterial Compliance

The visual impairment and intracranial pressure (VIIP) syndrome is a spaceflight-associated medical condition consisting of a constellation of symptoms affecting less than 70% of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures and is hypothesized to be related to elevated intracranial pressure secondary to spaceflight-induced cephalad fluid shifts, although other space flight factors (e.g., diet, environmental factors) may contribute. Loss of visual acuity could be a significant threat to crew health and performance during and after an exploration mission and may have implications for years postflight.

Platts, S. H.

Pilot Field Test: The Ability to Ambulate Following Landing as Assessed with Seat Egress, Walk and Obstacle Testing

To date, changes in functional performance have been systematically studied after short-duration space flight. As important as the postflight functional changes have been, full functional recovery has never been investigated or established for long-duration flights. The Pilot Field Test (PFT) experiment, conducted with participation of ISS crewmembers traveling on Soyuz expeditions 34S - 41S, is comprised of several tasks designed to study the recovery of sensorimotor abilities of astronauts during the first 24 hours after landing and beyond. The objective of the Seat Egress - Walk and Obstacle Test, developed by NASA's Russian collaborators at the Institute for Biomedical Problems, is to address this gap in knowledge. This will allow us to characterize the ability of crewmembers to perform critical mission requirements that they will be expected to perform after an unassisted landing following 6 to 12 months in microgravity.

Fisher, E. A.