Commercial Spaceflight Research Articles

Computational modelling of cardiovascular pathophysiology to risk stratify commercial spaceflight.

For more than 60 years, humans have travelled into space. Until now, the majority of astronauts have been professional, government agency astronauts selected, in part, for their superlative physical fitness and the absence of disease. Commercial spaceflight is now becoming accessible to members of the public, many of whom would previously have been excluded owing to unsatisfactory fitness or the presence of cardiorespiratory diseases. While data exist on the effects of gravitational and acceleration (G) forces on human physiology, data ontheeffects of the aerospace environment in unselected members of the public, and particularly in those with clinically significant pathology, are limited. Although short in duration, these high acceleration forces can potentiallyeither impair the experience or, more seriously, pose a risk to health in some individuals. Rather than expose individuals with existing pathology to G forces to collect data, computational modelling might be useful to predict the nature and severity of cardiovascular diseases that are of sufficient risk to restrict access, require modification, or suggest further investigation or training before flight. In this Review, we explore state-of-the-art, zero-dimensional, compartmentalized models of human cardiovascular pathophysiology that can be used to simulate the effects of acceleration forces, homeostatic regulation and ventilation-perfusion matching, using data generated by long-arm centrifuge facilities of the US National Aeronautics and Space Administration and the European Space Agency to riskstratify individuals and help to improve safety in commercial suborbital spaceflight.

Impact of Spaceflight on Upper Extremity Orthopedic Health

INTRODUCTION: With increased access to commercial spaceflight and space tourism, plus a push for longer duration spaceflights, it is especially important to understand the impact of spaceflight on musculoskeletal health. Upper extremity injuries are the most common musculoskeletal injuries in spaceflight. It is, therefore, vital to determine the changes to the upper extremities during spaceflight. The purpose of this study was to examine the state of knowledge on the impact of spaceflight on upper extremity orthopedic health, and to identify knowledge gaps and future areas of research. METHODS: A literature review was performed and studies and reports that amassed data on shoulder, elbow, wrist, and hand health were included. RESULTS: Spaceflight decreases bone mineral density in the upper extremities and increases risk of fracture, especially upon return to gravitational environments. Spaceflight does not uniformly affect all muscles; in the shoulder, the various muscles crossing the joint appear to be variably affected: the deltoid experiences a greater degree of atrophy than the rotator cuff muscles. Spaceflight additionally affects the peripheral nervous system, with astronauts experiencing hand numbness and loss of manual dexterity but cause of these symptoms is undetermined. Spacesuits have also been implicated in causing upper extremity injury, especially while training for or performing extravehicular activities. DISCUSSION: While upper extremity orthopedic health in spaceflight is incompletely understood, known adaptations increase risk for weakening and injury. Existing research provides valuable information for best practices, but there is still much to be discovered to optimize upper extremity health in spaceflight. Fiedler B, Jami M, Rakauskas T, Ahmed AS. Impact of spaceflight on upper extremity orthopedic health. Aerosp Med Hum Perform. 2024; 95(10):777–783.

Molecular and physiological changes in the SpaceX Inspiration4 civilian crew

Human spaceflight has historically been managed by government agencies, such as in the NASA Twins Study1, but new commercial spaceflight opportunities have opened spaceflight to a broader population. In 2021, the SpaceX Inspiration4 mission launched the first all-civilian crew to low Earth orbit, which included the youngest American astronaut (aged 29), new in-flight experimental technologies (handheld ultrasound imaging, smartwatch wearables and immune profiling), ocular alignment measurements and new protocols for in-depth, multi-omic molecular and cellular profiling. Here we report the primary findings from the 3-day spaceflight mission, which induced a broad range of physiological and stress responses, neurovestibular changes indexed by ocular misalignment, and altered neurocognitive functioning, some of which match those of long-term spaceflight2, but almost all of which did not differ from baseline (pre-flight) after return to Earth. Overall, these preliminary civilian spaceflight data suggest that short-duration missions do not pose a significant health risk, and moreover present a rich opportunity to measure the earliest phases of adaptation to spaceflight in the human body at anatomical, cellular, physiological and cognitive levels. Finally, these methods and results lay the foundation for an open, rapidly expanding biomedical database for astronauts3, which can inform countermeasure development for both private and government-sponsored space missions.

Commercial spaceflight: Regulatory framework assessment and safety perspectives

Recent years are witnessing the rapid technological development in airspace domain, actually paving the way to the development of a commercial space market. Until the recent past, space operations have been essentially performed by research centers or military agencies, in usually segregated areas to ensure third parties’ safety, governed by launch base regulations and organized in an unscheduled manner. However, with the entry of private companies into the space domain, a new market niche is being created: that of commercial space transportation. For example, a promising area is the one related to operations performed by commercial suborbital flights, whether aimed at space tourism or simply transporting things and/or passengers from one point to another on the Earth's surface. The traffic volumes are supposed to increase in next years and segregating airspace does not represent a sustainable solution for the future.The present paper will first assess the state of the art of the regulatory framework currently applicable to operators in order to obtain authorization to perform space missions for commercial use, then propose a comparison between the United State of America and European regulatory frameworks. Main challenges related to regulatory aspects will be identified and perspectives on possible higher airspace operations integration in the medium-long term will be derived. Finally, safety considerations deriving from a seamless accommodation of higher airspace operations in current Air Traffic Management will be derived for the medium-long term. In conclusion, this work reveals that neither the United States nor Europe has formally approved a legal framework establishing certification procedures for sub-orbital space transport systems. Currently, the US legislation is the most applicable as it has comprehensive rules to allow operators to obtain flight authorization ensuring compliance with requirements through a compliance matrix periodically updated.

Charting the Course: Considerations and Frameworks for Investigating and Regulating Commercial Spaceflight Safety

Charting the Course: Considerations and Frameworks for Investigating and Regulating Commercial Spaceflight Safety

Long-term space missions' effects on the human organism: what we do know and what requires further research.

Space has always fascinated people. Many years have passed since the first spaceflight, and in addition to the enormous technological progress, the level of understanding of human physiology in space is also increasing. The presented paper aims to summarize the recent research findings on the influence of the space environment (microgravity, pressure differences, cosmic radiation, etc.) on the human body systems during short-term and long-term space missions. The review also presents the biggest challenges and problems that must be solved in order to extend safely the time of human stay in space. In the era of increasing engineering capabilities, plans to colonize other planets, and the growing interest in commercial space flights, the most topical issues of modern medicine seems to be understanding the effects of long-term stay in space, and finding solutions to minimize the harmful effects of the space environment on the human body.

Regulatory Recognition of Commercial Space Flights

The author of the research article raises current legal issues regarding the regulatory challenges associated with the commercialization of outer space, with a particular focus on space tourism. The study aims to solve the legal dilemma of the lack of a legal framework that would define commercial spaceflight because this problem creates ambiguity in the understanding of the phenomenon of space tourism and raises concerns about the regulatory way of space exploration by private companies. The methods of analysis consist of the benefit of theoretical aspects of international space law for the designation of a mutual understanding between commercial interests and the principles of space exploration. The obtained results of the study lead to the conclusion that the main factor that inhibits the implementation of proper legal regulation of commercial space activity is uncertainty in the application of one or another law to regulate flights with space tourists, which, in the opinion of the author, should be eliminated employing regulatory direction on the proper legal regime, a clear definition of the boundary between outer space and air space, the weight of the norms of international law as opposed to the applications of states regarding the expediency of the norms of national law. The author's solution is the initiative for the governance of the unsettling areas through contractual arrangements. This idea is due to the results of the study about the predictability of the potential loss of relevance of international space law for the regulation of commercial space flights, therefore the auxiliary role of contract law is delivered. For its implementation, the author emphasizes the prospect of maintaining a regulatory course on (i) management of property rights, (ii) management of space resources in the direction of prohibition of appropriation and commercial colonization of celestial bodies; (iii) provisions for liability in the event of flight anomalies, safe rescue accidents, and the return of space tourists.

Ethically cleared to launch?

Rules are needed for human research in commercial spaceflight.

Reflection-based vision guide method for coarse alignment of vector measurement during the satellite assembly, integration, and test process.

Vector measurement is a vital measurement item during the satellite assembly, integration, and test (AIT) process. With the increasing popularity of commercial spaceflight, the development cycle of a satellite is shorter, and the number of satellites has been growing rapidly. The traditional on-site vector measurement method is inefficient and significantly affects the development cycle of the satellite. Therefore, it is of utter importance to propose an online high-precision automatic vector measurement system. The most challenging step of the online automatic vector measurement is coarse alignment because a cubic prism must be identified, and the normal direction of its surface must be calculated at a certain precision in the unstructured environment during the coarse alignment step. A reflection-based vision guide method was proposed to identify and calculate the normal direction of the cubic prism. The working principle and advantage of the proposed vision guide system were described in detail. What is more, the calibration and calculation methods of the proposed vision guide system were also presented. Finally, experiments were conducted to verify the effectiveness of the proposed method.

A Data Collection Programme for Improving Healthcare in UK Human Spaceflight Ventures

Over the next decade the number of humans venturing beyond Earth is projected to rapidly increase in both quantity and diversity.Humans will regularly fly to the International Space Station until it is decommissioned by 2031, will return to the Moon by 2025 via the Artemis programme, and will fly to space via commercial ventures. Spaceflight presents a hazardous environment for human health. To understand spaceflight-associated health risks further and to increase safety via advanced healthcare approaches, including personalised medicine, more data must be collected. Importantly, this data must be derived from a diverse cohort of participants and a range of mission formats. We propose that the UK should start to consider all citizens venturing into space as potential participants from which health and biological data could be consensually collected. Importantly, we believe that this routine data collection programme should adopt a similar strategy to the UK National Health Service and the UK Biobank, by including "omics" data for scientific and healthcare purposes. We consider how such a world-leading programme, kick-started via a pilot study, might be realised through appropriate policy design, including which measures to collect, when to collect them, and unique ethical considerations pertaining to the spacefaring population. Keywords: Omics, Astronaut, Ethics, Commercial Spaceflight, Biobank

Layperson Physiological Tolerance and Operational Performance in Centrifuge-Simulated Spaceflight.

INTRODUCTION: Prior study has indicated that individuals of varied age, medical history, and limited-to-no experience tolerate spaceflight conditions. We sought to expand upon the understanding of layperson response to hypergravity conditions expected in commercial spaceflight by exposing subjects, following minimal training, to centrifuge-simulated, high-fidelity commercial spaceflight profiles. We further explored how these individuals perform in simulated operational activities during and following hypergravity.METHODS: Volunteer subjects participated in up to five centrifuge runs (maximum +4.0 Gz, +4.5 Gx, 6.1 G resultant; onset rate <0.5 Gz · s-1, ≤1 Gx · s-1). Profiles included two winged spacecraft simulations with sequential and combined +Gx/+Gz and two capsule simulations representing nominal +Gx launch and reentry. The final profile simulated a capsule launch abort, with a more dynamic cycling of +Gx exposures and oscillatory multi-axis exposures simulating parachutes and water motion. Touchscreen tablets were used to administer pattern-replication tasks during and after profiles.RESULTS: A total of 46 subjects participated, including 4 diabetics and 9 with cardiac disease. There was increased frequency of motion sickness, subjectively associated with capsule-type profiles, and increased termination of participation compared to prior studies. There was no association between medical history, age, sex, or motion sickness history and tolerance or noncompletion. Tablet test errors were common; accuracy and time to completion were associated with age. There was no association between any time metric or accuracy and sex.DISCUSSION: This study improves understanding of layperson tolerance in commercial spaceflight analog conditions, and the capsular profiles broaden the applicability of the findings. The frequency of task errors highlights the potential for mistakes in operational activities when performed by laypersons.Blue RS, Ong KM, Ray K, Menon A, Mateus J, Auñón-Chancellor S, Shah R, Powers W. Layperson physiological tolerance and operational performance in centrifuge-simulated spaceflight. Aerosp Med Hum Perform. 2023; 94(8):584-595.

Space exploration as a catalyst for medical innovations.

Aerospace research has a long history of developing technologies with industry-changing applications and recent history is no exception. The expansion of commercial spaceflight and the upcoming exploration-class missions to the Moon and Mars are expected to accelerate this process even more. The resulting portable, wearable, contactless, and regenerable medical technologies are not only the future of healthcare in deep space but also the future of healthcare here on Earth. These multi-dimensional and integrative technologies are non-invasive, easily-deployable, low-footprint devices that have the ability to facilitate rapid detection, diagnosis, monitoring, and treatment of a variety of conditions, and to provide decision-making and performance support. Therefore, they are primed for applications in low-resource and remote environments, facilitating the extension of quality care delivery to all patients in all communities and empowering non-specialists to intervene early and safely in order to optimize patient-centered outcomes. Additionally, these technologies have the potential to advance care delivery in tertiary care centers by improving transitions of care, providing holistic patient data, and supporting clinician wellness and performance. The requirements of space exploration have created a number of paradigm-altering medical technologies that are primed to revitalize and elevate our standard of care here on Earth.

The appreciation of the jurisdiction of crimes committed during commercial space flights

The author examines the jurisdictional dilemma of determining the appropriate approach to be applied to a crime that could potentially be committed during a space flight with tourists on board by assessing the place of commission of the crime. In addition, the study is based on comparisons under such sources of international law as the Outer Space Treaty (OST) and the Antarctic Treaty (AT). Based on the analysis of certain articles of these documents, the authors propose to regulate commercial space flights by the example of distinguishing the “tourist element”. This approach is based on the fact that Article 8 of the Antarctic Treaty specifically refers to the tourist as a subject of liability and that a person with tourist purposes is protected by national law. Therefore, for the proper international regulation of space tourism and improvement of the Outer Space Treaty, it is recommended to legitimise tourist purposes and to distinguish the status of non-astronaut tourists in order to establish liability for certain criminal acts.&#x0D; To support these initiatives, two cases are cited as examples: that of astronaut Ann McClain and Dr. Rodney David Marks. Thus, the first case emphasises the restricted applicability of criminal jurisdiction on the international space station, which is usually decided by the law of the country of a person’s nationality. The second case demonstrates that although the Antarctic Treaty can serve as an example for regulating space tourism, the jurisdictional battles between states on the territory of the site of an incident with a criminal element have undermined its effectiveness. Consequently, the authors conclude that it is necessary to introduce specific international rules to regulate commercial space flights, where the aspect of jurisdiction in the investigation of a crime committed by a non-astronaut tourist should be of paramount importance.&#x0D; It is specified that each partner of a space flight, both the state (in the case of public interests) and/or certain flight authorities operating under the auspices of a particular country, and a space company and/or a provider of relevant services (in the case of private interests), must register a commercial space flight and its structural objects as flight elements.&#x0D; In this case, each of these partners retains jurisdiction and control over the registered components.

Nationwide survey of medical student interest in and exposure to aerospace medicine

Aerospace Medicine is experiencing a renaissance. Commercial spaceflight is now a reality, meaning that individuals with a variety of medical conditions will be flying in space. NASA has Mars plans, and SpaceX plans to send humans to Mars within the next decade, so today’s medical students may be future physicians on these crews. Considering these developments, we evaluated interest in and exposure to Aerospace Medicine among medical students in the United States (US). A 19-question anonymous multiple-choice questionnaire was emailed to current medical students throughout the US. Information about demographics, career and research interests in aerospace medicine, opportunities available at students’ respective institutions, and possible avenues for supporting students’ interests was collected and analyzed. One thousand two hundred forty-four students (490 men, 751 women, 3 other) with a mean age of 25.8 ± 3.0 years from 60 institutions completed the questionnaire. Most respondents expressed an interest in learning about aerospace medicine during their training. A strong interest in research, as well as career opportunities, exists despite the majority of students reporting minimal access to opportunities to get involved in the field at most of the surveyed institutions. With growing interest and an expected increase in demand for physicians with a background in aerospace medicine, medical schools may be able to support students by increasing access to opportunities.

27 Measuring Ocular Misalignment by Age at Space Center Houston to Inform Spaceflight Analysis

OBJECTIVES/GOALS: We developed a non-invasive test of ocular alignment (OA) as a measure of otolith asymmetry, which impacts vestibular function. This test has also been administered on commercial astronauts to study the effect of microgravity on vestibular function. We will assess OA test performance in ground subjects, which has not yet been characterized. METHODS/STUDY POPULATION: Subjects were recruited from visitors to Space Center Houston from June to October 2022. Participants wore red-blue glasses in a darkened room and aligned two vertically or torsionally misaligned line segments, one red and one blue, on a tablet. Each subject underwent 11 vertical and torsional trials. The remaining misalignment was used to calculate ocular misalignment. Subjects self-reported demographic and health data. We calculated descriptive statistics and explored the distribution of overall vertical and torsional OA and distributions by age. Next steps will establish the reliability of the outcome measures with intraclass correlation coefficients and analyze associations between demographic variables and health status with OA performance using linear regression analysis. RESULTS/ANTICIPATED RESULTS: A total of 143 participants (67 female) with a median age of 21 (range 5-74 years old) completed OA testing. Of participants, 64% identified as white, 10% as black, 14% as Asian, 3% as Native American, and 8% as unknown. This test battery was feasible to implement in this mixed-age sample, with a 95% completion rate. Median absolute vertical OA was 0.08 degrees (IQR = 0.17 degrees), and median absolute torsional OA was 0.80 degrees (IQR = 1.20 degrees). Visual analysis of plots of OA by trial number reveals no apparent learning effect within subjects, though some individuals had considerable variation in performance. Average absolute vertical ocular misalignment increased modestly when plotted by age (fitted regression line b = 0.0032 degrees per year of age, p = 0.004), unadjusted for potential confounders. DISCUSSION/SIGNIFICANCE: Ocular alignment testing was feasible in a mixed-age general population sample. Our findings will expand understanding of how OA varies with age. These results will be used to create a normative database to compare and inform analysis of OA results from commercial spaceflights, which include individuals of varying age and health statuses.

Challenges and Opportunities in Space Medicine, Space Flight, and Holoportation

Dr. Schmid will provide an overview of the NASA space medicine operations current spaceflight challenges and opportunities in the context of the environments of care including air, space and terrestrially in our domestic and international health systems. He will provide a worldwind tour of Space Medicine origins, space telemedicine, medical training required, extreme environmenta of care, NASA international and off the planet medical operations, mission planning, space physiology, longitudinal surveillance of astronaut health, current and future missions, commercial space flight and new vehicles. Dr. Schmid will introduce the Holoportation Project, the first Holographic Transportation of humans to space, new technologies and opportunities for collaboration and problem solving with NASA.

Acoustothermal phase change and acoustically driven atomization for cold liquid microthrusters

Over the years, a diverse range of physical and chemical phenomena have been explored and applied to devise reliable, small thrusters for stationkeeping and orientation of spacecraft. Commercial space flight is accelerating this need. Here, we consider acoustically driven melting of a frozen working fluid in the nozzle of an acoustic device, followed by acoustofluidic atomization from the nozzle to produce thrust. Fifty-five MHz acoustic waves generated by piezoelectric transducers couple into liquid and transfer energy in the form of both acoustic radiation and streaming, producing a directed atomized spray. A challenge in this system, as with most liquid-thrust systems, is the risk of phase change due to the extreme thermal environment in space, particularly in the freezing of the working fluid. Though acoustic energy is known to produce rapid and controllable heating, it so far has not been used to produce phase changes. The atomization produces capillary pressure sufficient to draw in fluid from a reservoir, though we do use a simple pressure-driven pump to support greater atomization rates. We provide a simple energy conservation model to explain the acoustothermal interaction and validate this with experiments. The specific impulse and thrust of this type of thruster are quite modest at 0.1–0.4 s and 12.3 μN, respectively, but the thruster component is small, light, and is without moving parts, a fascinating potential alternative to current technologies.

The environmental and moral implications of human space travel

Humans have long dreamed of traveling to space. In response to the recent increase in commercial space flight, this paper evaluates environmental impacts of human space travel, both past and present, to shed light on the large environmental footprint of such activities. This environmental impact also has a moral component, since most of the global population will never be able to participate in such activities, yet still must bear the cost. Ironically, instead of a space future acting as a relief valve on Earth's resources, few activities exact a heavier burden on our planet's resources than the space pursuit, for the number of people it serves.This analysis utilized the structure of life cycle assessment. Data on launch vehicles mass and propellant type and mass was taken from public sources. Combustion emission results were calculated using combustion analysis software. These data were then combined with data from life cycle inventory databases and impact assessment methods to evaluate midpoint impact indicators.The hourly impact from sustaining humans in space over 1500 kg CO2-eq per hour. To put this into context, this is 2000 times greater than the emission rate of the average person on the globe, which we term global citizen equivalents (GCE). This global warming impact is also 650 times greater than the average person in the U.S.In terms of familiar activities, this is equivalent to continuously supplying at least 4 MW of electricity from the U.S. grid; simultaneously driving over sixty diesel buses; or occupying twenty seats on a Boeing 747 that never lands. Clearly such impacts raise questions not only to the sustainability of such activities, but also to the moral and ethical implications where such travel is limited to only the very wealthiest, but the costs are borne by all with few benefits to show from the endeavour.

Spatial Volume Necessary to Perform Open Appendectomy in a Spacecraft.

BACKGROUND: With the increase in crewed commercial spaceflight and expeditions to the Moon and Mars, the risk of critical surgical problems and need for procedures increases. Appendicitis and appendectomy are the most common surgical pathology and procedure performed, respectively. The habitable volume of current spacecraft ranges from 4 m³ (Soyuz) to 425 m³ (International Space Station). We investigated the minimum volume required to perform an appendectomy and compared that to habitable spacecraft volumes.METHODS: The axes of a simulated operating room were marked and cameras placed to capture movements. An expert surgeon, chief surgical resident, junior surgical resident, and a nonsurgeon physician each performed a Focused Assessment with Sonography for Trauma and an appendectomy on a simulated patient. Dimensions and volume needed were collected and compared using unpaired t-tests.RESULTS: Mean volume (± SD) needed was 3.83 m³ ± 0.47 m³ for standing and 3.68 m³ ± 0.49 m³ for kneeling (P = 0.638). Minimal volume needed was 3.20 m³ for standing and 3.26 m³ for kneeling. Minimal theoretical volume was 2.99 m³ for standing and 2.87 m³ for kneeling.DISCUSSION: The unencumbered volume needed for an appendectomy is between 2.87 m³ and 4.3 m³. It may be technically feasible to perform an open appendectomy inside the smallest of currently operating spacecraft, at 4 m³ (Soyuz-MS). Space vessels operating without rapid evacuation to Earth will need to consider this volume for potential surgical emergencies. Additional investigation on microgravity and standardization of procedures for novices must be completed.Kamine TH, Siu M, Kramer K, Kelly E, Alouidor R, Fernandez G, Levin D. Spatial volume necessary to perform open appendectomy in a spacecraft. Aerosp Med Hum Perform. 2022; 93(10):760-763.

Retrospective analysis of somatic mutations and clonal hematopoiesis in astronauts

With planned deep space and commercial spaceflights, gaps remain to address health risks in astronauts. Multiple studies have shown associations between clonal expansion of hematopoietic cells with hematopoietic malignancies and cardiometabolic disease. This expansion of clones in the absence of overt hematopoietic disorders is termed clonal hematopoiesis (CH) of indeterminate potential (CHIP). Using deep, error-corrected, targeted DNA sequencing we assayed for somatic mutations in CH-driver genes in peripheral blood mononuclear cells isolated from de-identified blood samples collected from 14 astronauts who flew Shuttle missions between 1998–2001. We identified 34 nonsynonymous mutations of relatively low variant allele fraction in 17 CH-driver genes, with the most prevalent mutations in TP53 and DNMT3A. The presence of these small clones in the blood of relatively young astronaut cohort warrants further retrospective and prospective investigation of their clinical relevance and potential application in monitoring astronaut’s health.