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All sourcesNASA NTRSDOE OSTI
NASA NTRSDate not supplied

Effects of Replacing Treadmill Running with Alternative Exercise Countermeasures During Long-Duration Spaceflight on Astronaut Health and Performance

INTRODUCTION Current exercise countermeasures on the International Space Station (ISS) include treadmill running, cycle ergometry, and resistive exercise, which are used to protect crewmember health and performance during long-duration spaceflight. However, exploration vehicles for Artemis missions to the Moon and beyond will have volume and power restrictions, requiring exercise hardware to have a smaller footprint and use fewer resources. Thus, recent efforts have focused on developing exercise devices that provide both aerobic and resistive capabilities on one platform without including a treadmill. The European Enhanced Exploration Exercise Device [E4D] is one such apparatus. It is critical to validate the efficacy of using exploration-focused exercise modalities to preserve muscle strength, aerobic fitness, bone density, and sensorimotor performance. Thus, the aim of this study is to determine the effectiveness of using nominal ISS exercise devices for an entire mission compared to exploration-forward exercise modalities to determine if a treadmill is required to maintain current levels of protection during long-duration missions. METHODS Crewmembers are assigned to one of three groups: 1) Controls (n ≥ 40), who partake in nominal exercise on the ISS, including running on the Treadmill with Vibration Isolation and Stabilization 2 (T2), cycling on the Cycle Ergometer with Vibration Isolation and Stabilization (CEVIS), and strength training on the Advanced Resistive Exercise Device (ARED); 2) Active Group 1, who exercise on the CEVIS and ARED only (n = 8); and 3) Active Group 2, who perform aerobic and resistive exercise on the E4D only (n = 8). For Active Group 1, nominal exercise on T2 will be replaced with corresponding exercise on CEVIS. For Active Group 2, a dedicated exercise prescription will be designed to maximize the capabilities of the E4D to include resistive exercise, cycle ergometry, rowing, and rope pulling. Crewmembers in both Active groups are not permitted to perform treadmill exercise for the entirety of their flight. Health and performance markers, including bone mineral density (dual-energy x-ray absorptiometry [DXA]), body composition (DXA), cardiovascular fitness (cycle VO2peak), muscle strength and endurance (isometric/isokinetic testing, power endurance testing), sensorimotor performance (sit-to-stand, obstacle course), postural control (computerized dynamic posturography), and blood and urine biochemical markers of bone metabolism will be assessed before, during, and after spaceflight. RESULTS Fifteen subjects (4 Active [CEVIS + ARED], 11 Control) have been recruited. Data collection is ongoing. CONCLUSIONS This study will assess the efficacy of using exploration exercise modalities, including removing the treadmill exercise capability or exclusively using the E4D, compared to the nominal ISS exercise regimen across an entire mission on bone, muscle, aerobic, and sensorimotor health and performance. Findings from this study will help provide a recommendation on whether these exploration exercise modalities can sufficiently protect against physiological deconditioning during spaceflight or whether a treadmill may be required to maintain current levels of protection during future exploration class spaceflight missions. Supported by the NASA Human Research Program and NASA Exploration Capabilities

A N Varanoske↗
NASA NTRS2017

Protecting the Health of Astronauts: Enhancing Occupational Health Monitoring and Surveillance for Former NASA Astronauts to Understand Long-Term Outcomes of Spaceflight-Related Exposures

The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. A better understanding of the individual, population, and mission impacts of astronaut occupational exposures is critical to providing clinical care, targeting occupational surveillance efforts, and planning for future space exploration. The ability to characterize the risk of latent health conditions is a significant component of this understanding. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA-Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential long-term health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging populations are necessary to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography); and expanded monitoring will increase NASA's ability to better characterize conditions resulting from astronaut occupational exposures. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of e an Astronaut Occupational Health program to include expanded medical monitoring of former NASA astronauts. Increasing the breadth of monitoring services will ultimately enrich the existing evidence base of occupational health risks to astronauts. Such an expansion would therefore improve the understanding of the health of the astronaut population as a whole, and the ability to identify, mitigate, and manage such risks in preparation for deep space exploration missions.

Rossi, Meredith↗
NASA NTRSDate not supplied

Assessment of Ultrasound Devices to Protect the Health of Astronauts in the New Era of Space Exploration: A Literature Review

Microgravity and radiation of space create harsh physiological strains on astronauts with significant damaging effects on cardiovascular and musculoskeletal systems among others. It is necessary to utilize medical technologies that can effectively monitor chronic and acute alterations to astronauts’ health statuses on spacecrafts. Future missions to distant planetary bodies will result in longer exposure to damaging environmental factors and limit crew access to healthcare resources and maintenance devices; thus, even greater logistical and quality considerations must be made. Remarkable advancements in ultrasound technology have created new powerful portable imaging devices and a potential chip-based alternative to piezoelectric crystals that are used in nearly all ultrasound devices. This literature review will investigate new commercial and prototypal ultrasound medical devices on their potential effectiveness in austere environments such as space. The accuracy, versatility, and practicality of each device will be compared to each other as well as the current technological gold standards of health monitoring used in traditional healthcare settings. Assessment of new ultrasound technology in this literature review will provide guidance to future missions by space agencies regarding the most optimal medical devices to protect astronauts and, therefore, enable further exploration of distant planets and solar systems.

Parag Vyas↗
NASA NTRS2016

Safeguarding the Health of the NASA Astronaut Community: the Need for Expanded Medical Monitoring for Former NASA Astronauts Under the Astronaut Occupational Health Program

The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential latent health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging communities are necessary for astronauts to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography), as opposed to conditions resulting directly from the astronaut occupation; and increased breadth of monitoring services will improve the understanding of occupational health risks and longitudinal health of the astronaut community, past, present, and future. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of expanding existing medical monitoring under the Astronaut Occupational Health program for former NASA astronauts.

Rossi, Meredith↗
NASA NTRSDate not supplied

Monitoring Biomarkers for Muscular Atrophy Using an Electrochemical Chip for Astronaut Space Health

Skeletal muscle atrophy is a serious health problem for astronauts in long-duration space flight under microgravity conditions. Preventative measures against muscle atrophy require specific exercise and dietary regimens. Preemptive measurements to improve treatment have the potential to streamline these regimens, decreasing their daily footprint and increasing astronaut quality of life. The objective of our proposed project is to (1) develop a fully integrated disposable microelectrode array chip (with the size of a stamp) that can be interfaced with a handheld electronic system for simultaneous detection of the a panel of biomarkers to monitor the progression of skeletal muscle atrophy due to disuse under microgravity in long-duration spaceflights; and (2) use such quantitative information to guide the combined countermeasures of physical exercise and pharmaceuticals (i.e. specific protease inhibitors) so that the intensity, duration and frequency of exercise can be reduced. Note: The presentation includes voice commentary and plays best as a slide show. The voice begins once the presentation starts, and only requires the user to click to the next slide each time. With a run time of ~15 mins.

Biosensor↗
NASA NTRS2024

Long-term effects of acute irradiation and isolation on crew age-matched mice

The future of space missions beyond low-Earth orbit presents exciting opportunities but may come with formidable health challenges. Astronauts face a unique combination of space stressors capable of exerting effects on the central nervous system (CNS) with possible sex-dependent differences. The interaction of these combined spaceflight stressors may induce oxidative stress, thereby altering brain integrity and behavioral performance. Understanding these changes is critical for safeguarding astronaut health and enabling successful exploration. By understanding the physiological responses to the combined effects of ionizing radiation (IR) and social isolation in the brain through immunohistochemistry (IHC), proteomics and cytokine expression analyses, we aim to identify CNS pathways ripe for countermeasure development to mitigate adverse brain changes with future deep space exploration. Here, we study the combined effects of simulated 5-ion galactic cosmic radiation (GCRsim) at acute dosage (5, 15, and 50 cGy) and social isolation on crew age-matched male and female mice at 124 days post-irradiation. We conducted analyses of hippocampal cytokine biomarkers and proteomic profiling on hippocampal lysates. Our findings reveal sex-specific regulation of hippocampal cytokines and proteomic profiles. Ongoing immunohistochemistry findings on the hippocampus will provide qualitative information regarding key protein expression and cellular changes such as microglial activation, blood brain barrier integrity, and neuroinflammation. With future plans for long-duration space missions, such as Mars exploration, understanding CNS changes over extended periods in mice can provide insights into potential long-term health impacts on astronauts. This project will provide us with valuable insights into sex-differences in neurobiological processes and disease mechanisms impacting men and women in space.

space radiation↗
NASA NTRS2017

VESsel GENeration Analysis (VESGEN): Innovative Vascular Mappings for Astronaut Exploration Health Risks and Human Terrestrial Medicine

Currently, astronauts face significant health risks in future long-duration exploration missions such as colonizing the Moon and traveling to Mars. Numerous risks include greatly increased radiation exposures beyond the low earth orbit (LEO) of the ISS, and visual and ocular impairments in response to microgravity environments. The cardiovascular system is a key mediator in human physiological responses to radiation and microgravity. Moreover, blood vessels are necessarily involved in the progression and treatment of vascular-dependent terrestrial diseases such as cancer, coronary vessel disease, wound-healing, reproductive disorders, and diabetes. NASA developed an innovative, globally requested beta-level software, VESsel GENeration Analysis (VESGEN) to map and quantify vascular remodeling for application to astronaut and terrestrial health challenges. VESGEN mappings of branching vascular trees and networks are based on a weighted multi-parametric analysis derived from vascular physiological branching rules. Complex vascular branching patterns are determined by biological signaling mechanisms together with the fluid mechanics of multi-phase laminar blood flow.

astronaut↗
NASA NTRSDate not supplied

The Partial Gravity of the Moon and Mars Appears Insufficient to Maintain Human Health

Astronauts who spend many weeks or months in space in microgravity suffer serious health problems including muscle atrophy, cardiovascular deconditioning, bone calcium loss, impaired vision, and immune system changes. The debilitating effects of weightlessness were first demonstrated on the early Skylab, Salyut, and Mir missions, but it was then hoped that countermeasures including in-flight exercise and resistance training could reduce most of these problems. Similar effects are anticipated in the partial gravity of the Moon and Mars. Direct evidence of the long-term effects of partial gravity on humans is not yet available, but indirect evidence suggests that partial gravity exposure below 0.4 g will be insufficient to maintain musculoskeletal and cardiopulmonary conditioning over the long term. Some studies show a strong correlation between heart rate, oxygen consumption, net metabolic rate, and simulated gravity from 0 to 1 g. Exposure to moon and Mars gravities will probably cause less severe physiological deconditioning than microgravity, but the benefit of partial gravity seems likely to be roughly proportional to the level of gravity experienced. As in microgravity, exercise countermeasures seem useful but insufficient to preserve all physiological systems as they would be in Earth gravity.

Harry W. Jones↗
NASA NTRSDate not supplied

Investigating the Relationship between the Cell Wall Integrity Pathway and Unfolded Protein Response

Plants have made significant contributions to astronaut health in spaceflight missions. To further spaceflight research in optimizing plant viability, this study aims to understand the factors involved in maintaining cell wall integrity, which is vital to plant morphology and structural stability. Spaceflight can negatively impact the cell wall; thus, it is crucial to investigate how to mitigate spaceflight stressors to maintain the integrity of the cell wall. The structural integrity of plants’ cell walls depends on secondary cell wall biogenesis, which enables the repair and architectural support of plants like A. thaliana. This biogenesis is triggered by a signal transduction cascade: first initiated by cell wall stress, the CWI (cell wall integrity) pathway is activated, followed by the UPR (unfolded protein response), then the cell wall’s integrity is maintained through secondary cell wall biogenesis. Through a re-analysis of GeneLab Dataset 321 (GLDS-321), a study from NASA’s Open Science Data Repository that investigates the effects of spaceflight on the UPR, several genes were found to be associated with the cell wall. This proposal postulates a relationship between the UPR and the CWI pathway and their direct effect on secondary cell wall biogenesis by investigating IRX7, a gene associated with secondary cell wall biogenesis. The predicted outcome of overexpressing IRX7 is increased resilience of the cell wall by upregulating both the UPR and the CWI pathway, while silencing IRX7 is predicted to compromise the cell wall integrity by downregulating the UPR and the CWI pathway. This study will give insight into the needed measures to increase cell wall resilience in stressful environments: As spaceflight durations increase and uncertain climate change events progress on Earth, understanding how to optimize cell wall resilience – a fundamental pillar of plant health – can effectively enhance mass crop production and quality and ensure the physical and psychological health of astronauts in long-term space missions.

GL4HS↗
NASA NTRSDate not supplied

An Approach to Quantitative Risk Assessment for Combined Spaceflight Hazards: Evaluating the Impact of Short Sleep Durations on Space Crew Cardiovascular Health

Astronauts embarking on long-duration missions will be exposed to multiple spaceflight hazards including radiation, isolation and confinement, distance from Earth, hostile closed environments, and altered gravity. These hazards pose health risks to the crew in-mission and postflight, including risks to cardiovascular health. For radiation, quantitative risk models have been developed that are based on large-scale epidemiological evidence from exposed terrestrial populations, which are extrapolated to account for the difference in radiological effectiveness between ground-based and in-flight exposures. •Cardiovascular diseases (CVD) are multifactorial, therefore multiple risk factors can influence disease risk estimates. •Astronauts with spaceflight experience is a very small population. •To overcome limitations of cohort, population data from presumed equivalent stressors on Earth can be used to quantitatively assess possible risks. •Sleep disruption and short sleep duration are known consequences of spaceflight and are also established risk factors for cardiovascular disease on earth (Pateletal.,2020). •Coronary Heart Disease (CHD), Myocardial Infarction (MI), and stroke are negative health effects due to short sleep durations and sleep disruptions (Yinetal.,2017); (Cappuccio et al., 2010). •A combined CVD risk model including spaceflight stressor such as sleep, stress, radiation, etc.) will provide more precise estimate of risks.

Spaceflight Hazards↗
NASA NTRSDate not supplied

2023 Artemis Crew Health and Performance System Model Development

While the NASA Human Research Program (HRP) utilizes a Crew Health and Performance (CHP) System to represent all the Agency’s efforts to ensure the health and performance of NASA astronauts, there is no shared mental model of a CHP system at NASA. Some groups may consider a CHP system to be only a medical kit, while others may not be using the concept at all. To facilitate the integration of functions and capabilities to ensure astronaut health and performance during vehicle development, HRP has proposed a CHP Shared Mental Model derived from the NASA Human Health, Medical, and Performance Spaceflight Standards (NASA-STD-3001 Vol.1/Vol.2). [1] Even though many vehicle, ground, and communication systems as well as mission operations are modeled for the Artemis Campaigns, no mission level CHP system model was created to achieve the intent of the HRP CHP Shared Mental Model. The lack of this model renders it difficult to visualize and understand how the many programs work together to provide the necessary cross program functions and capabilities to ensure the health and performance of the crew throughout an Artemis mission. For this purpose, the Exploration Medical Capability (ExMC) element of HRP developed a CHP system model for the Artemis III and IV missions to provide a view of how each program contributes to and interacts with the overall CHP system. To develop the 2023 Artemis CHP system model, ExMC leveraged existing data and models from the Moon to Mars Program Office, the Office of the Chief Health and Medical Officer (OCHMO) and the Orion, Gateway, Extravehicular Activity and Human Surface Mobility (EHP) and Human Landing System (HLS) programs. By using a Model-Based Systems Engineering (MBSE) approach, existing requirements, functions, and concepts of operations were combined to create a single system model focused on representing CHP from the launch to the return to Earth segments of the Artemis III and IV missions. Additionally, by incorporating the HRP Systems Platform for Aggregating and Relating Capabilities, or SPARC tool, the data from the programs was also related back to the 2nd volume of the NASA Human Health, Medical, and Performance Spaceflight Standard (NASA-STD-3001, Vol.2) and the human system risks identified by the Human System Risk Board (HSRB). The first version of the 2023 Artemis CHP system model was baselined in Fall of 2023 after the model was demonstrated to be a potentially useful tool for systems engineers integrating CHP capabilities in vehicle development as well as members of the Health and Medical Technical Authority providing oversight of those programs. The model may also be useful to any stakeholder of astronaut health and performance by providing insights on how an Artemis mission satisfies the NASA Human Health, Medical, and Performance Spaceflight Standards as well as how they mitigate the HSRB Human System Risks. This presentation highlights how the model was developed and the possible benefits of the model. [1] NASA HRP (2022), Crew Health and Performance System Whitepaper

Systems engineering↗
NASA NTRS2024

2023 Artemis Crew Health and Performance (CHP) System Model Development

While the NASA Human Research Program (HRP) utilizes a Crew Health and Performance (CHP) System to represent all the Agency’s efforts to ensure the health and performance of NASA astronauts, there is no shared mental model of a CHP system at NASA. Some groups may consider a CHP system to be only a medical kit, while others may not be using the concept at all. To facilitate the integration of functions and capabilities to ensure astronaut health and performance during vehicle development, HRP has proposed a CHP Shared Mental Model derived from the NASA Human Health, Medical, and Performance Spaceflight Standards (NASA-STD-3001 Vol.1/Vol.2). [1] Even though many vehicle, ground, and communication systems as well as mission operations are modeled for the Artemis Campaigns, no mission level CHP system model was created to achieve the intent of the HRP CHP Shared Mental Model. The lack of this model renders it difficult to visualize and understand how the many programs work together to provide the necessary cross program functions and capabilities to ensure the health and performance of the crew throughout an Artemis mission. For this purpose, the Exploration Medical Capability (ExMC) element of HRP developed a CHP system model for the Artemis III and IV missions to provide a view of how each program contributes to and interacts with the overall CHP system. To develop the 2023 Artemis CHP system model, ExMC leveraged existing data and models from the Moon to Mars Program Office, the Office of the Chief Health and Medical Officer (OCHMO) and the Orion, Gateway, Extravehicular Activity and Human Surface Mobility (EHP) and Human Landing System (HLS) programs. By using a Model-Based Systems Engineering (MBSE) approach, existing requirements, functions, and concepts of operations were combined to create a single system model focused on representing CHP from the launch to the return to Earth segments of the Artemis III and IV missions. Additionally, by incorporating the HRP Systems Platform for Aggregating and Relating Capabilities, or SPARC tool, the data from the programs was also related back to the 2nd volume of the NASA Human Health, Medical, and Performance Spaceflight Standard (NASA-STD-3001, Vol.2) and the human system risks identified by the Human System Risk Board (HSRB). The first version of the 2023 Artemis CHP system model was baselined in Fall of 2023 after the model was demonstrated to be a potentially useful tool for systems engineers integrating CHP capabilities in vehicle development as well as members of the Health and Medical Technical Authority providing oversight of those programs. The model may also be useful to any stakeholder of astronaut health and performance by providing insights on how an Artemis mission satisfies the NASA Human Health, Medical, and Performance Spaceflight Standards as well as how they mitigate the HSRB Human System Risks. This presentation highlights how the model was developed and the possible benefits of the model. [1] NASA HRP (2022), Crew Health and Performance System Whitepaper

Systems engineering↗
NASA NTRS2008

LED Device Illuminates New Path to Healing

Among NASA s research goals is increased understanding of factors affecting plant growth, including the effects of microgravity. Impeding such studies, traditional light sources used to grow plants on Earth are difficult to adapt to space flight, as they require considerable amounts of power and produce relatively large amounts of heat. As such, an optimized experimental system requires much less energy and reduces temperature variance without negatively affecting plant growth results. Ronald W. Ignatius, founder and chairman of the board at Quantum Devices Inc. (QDI), of Barneveld, Wisconsin, proposed using light-emitting diodes (LEDs) as the photon source for plant growth experiments in space. This proposition was made at a meeting held by the Wisconsin Center for Space Automation and Robotics, a NASA-sponsored research center that facilitates the commercialization of robotics, automation, and other advanced technologies. The Wisconsin group teamed with QDI to determine whether an LED system could provide the necessary wavelengths and intensities for photosynthesis, and the resultant system proved successful. The center then produced the Astroculture3, a plant growth chamber that successfully incorporated this LED light source, which has now flown on several space shuttle missions. NASA subsequently identified another need that could be addressed with the use of LEDs: astronaut health. A central concern in astronaut health is maintaining healthy growth of cells, including preventing bone and muscle loss and boosting the body s ability to heal wounds all adversely affected by prolonged weightlessness. Thus, having determined that LEDs can be used to grow plants in space, NASA decided to investigate whether LEDs might be used for photobiomodulation therapy (PBMT).

Source record↗
NASA NTRS2016

Recommended Methods for Monitoring Skeletal Health in Astronauts to Distinguish Specific Effects of Prolonged Spaceflight

NASA uses areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) to monitor skeletal health in astronauts after typical 180-day spaceflights. The osteoporosis field and NASA, however, recognize the insufficiency of DXA aBMD as a sole surrogate for fracture risk. This is an even greater concern for NASA as it attempts to expand fracture risk assessment in astronauts, given the complicated nature of spaceflight-induced bone changes and the fact that multiple 1-year missions are planned. In the past decade, emerging analyses for additional surrogates have been tested in clinical trials; the potential use of these technologies to monitor the biomechanical integrity of the astronaut skeleton will be presented. OVERVIEW: An advisory panel of osteoporosis policy-makers provided NASA with an evidence-based assessment of astronaut biomedical and research data. The panel concluded that spaceflight and terrestrial bone loss have significant differences and certain factors may predispose astronauts to premature fractures. Based on these concerns, a proposed surveillance program is presented which a) uses Quantitative Computed Tomography (QCT) scans of the hip to monitor the recovery of spaceflight-induced deficits in trabecular BMD by 2 years after return, b) develops Finite Element Models [FEM] of QCT data to evaluate spaceflight effect on calculated hip bone strength and c) generates Trabecular Bone Score [TBS] from serial DXA scans of the lumbar spine to evaluate the effect of age, spaceflight and countermeasures on this novel index of bone microarchitecture. SIGNIFICANCE: DXA aBMD is a widely-applied, evidence-based predictor for fractures but not applicable as a fracture surrogate for premenopausal females and males <50 years. Its inability to detect structural parameters is a limitation for assessing changes in bone integrity with and without countermeasures. Collective use of aBMD, TBS, QCT, and FEM analysis for astronaut surveillance could accommodate NASA's aggressive schedule for risk definition and inform a NASA-developed model which assesses the probability of overloading bones during mechanically-loaded mission tasks and possibly for physical activities after return to Earth.

Vasadi, Lukas J.↗
NASA NTRS2010

The New Face of Data Accessibility

Management of medical and research data at NASA's Johnson Space Center has been addressed with two separate, independent systems: the Lifetime Surveillance of Astronaut Health (formerly, The Longitudinal Study of Astronaut Health) (LSAH) and the Life Sciences Data Archive (LSDA). Project management for these has been autonomous with little or no cross-over of goals, objectives or strategy. The result has been limited debate and discussion regarding how contents from one repository might impact or guide the direction of the other. It is decidedly more efficient to use existing data and information than to re-generate them. Ensuring that both clinical and research data / information are accessible for review is a central concept to the decision to unify these repositories. In the past, research data from flight and ground analogs has been held in the LSDA and medical data held in the Electronic Medical Record or in console flight surgeon logs and records. There was little cross-pollination between medical and research findings and, as a result, applicable research was not being fully incorporated into clinical, in-flight practice. Conversely, findings by the console surgeon were not being picked up by the research community. The desired life cycle for risk mitigation was not being fully realized. The goal of unifying these repositories and processes is to provide a closely knit approach to handling medical and research data, which will not only engender discussion and debate but will also ensure that both categories of data and information are used to enhance the use of medical and research data to reduce risk and promote the understanding of space physiology, countermeasures and other mitigation strategies

Fitts, Mary A.↗
NASA NTRS2018

Pilot Study on the Investigation of Tear Fluid Biomarkers as an Indicator of Ocular, Neurological, and Immunological Health in Astronauts

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 naïve versus veteran astronauts, to establish a personal baseline for long-term ocular health monitoring

Morton, Stephen↗