Space Medicine Research Articles

The ESA Active Dosimeter (EAD) system onboard the International Space Station (ISS)

Ionizing radiation in general and mixed fields of space radiation in particular pose a risk of serious harm to human health. The risk of such adverse effects increases with the duration of the mission, and for all missions outside the protective properties of the Earth’s magnetic field and atmosphere. Accordingly, radiation protection is of central importance for all human spaceflight, which is recognized by all international space agencies. To date various systems, analyze and determine the exposure to ionizing radiation within the environment and to the crew onboard the International Space Station (ISS). In addition to this operational monitoring, experiments and technology demonstrations are carried out. This to further enhance systems capabilities, to prepare for exploratory missions, to the Deep Space Gateway and/or to enable for human presence at other celestial bodies. Subsequently the European Space Agency (ESA) decided early to support the development of an active personal dosimeter. Under the auspices of the European Space Research and Technology Center (ESTEC) together with the European Astronaut Center's (EAC) Medical Operations and Space Medicine (HRE-OM) team, a European industrial consortium was formed to develop, build, and test this system. To complete the ESA Active Dosimeter (EAD) Technology Demonstration in space, EAD components were delivered to ISS with the ESA’s space missions ‘iriss’ and ‘proxima’ in 2015 and 2016. This marked Phase 1 (2015) and 2 (2016–2017) of the EAD Technology Demonstration to which focus is given in this publication. All EAD systems and their functionalities, the different radiation detector, their properties, and calibrations procedures are described. Emphasis is first on the “iriss” mission of September 2015, that provided a complete set of data for an entire space mission from launch to landing, for the first time. Data obtained during Phase 2 in 2016–2017 are discussed thereafter. Measurements with the active radiation detectors of the EAD system provided data of the absorbed dose, dose equivalent, quality factor as well as the various dose contributions during the crossings of the South Atlantic Anomaly (SAA) and/or resulting from galactic cosmic radiation (GCR). Results of the in-flight cross-calibrations among the internal sensors of the EAD systems are discussed and alternative usage of the EAD Mobile Units as area monitors at various different locations inside the ISS is described.

Benefits of Space Medicine Research for Healthcare on Earth.

Space research has brought various discoveries and benefits in the fields of health, transportation, safety measures, industry, and many more. Additionally, space research has provided a large number of discoveries and inventions in the field of medicine. Many of these inventions benefit humanity in multiple ways, especially with regard to well-being. Research objectives range from the early detection of illnesses to statistical studies that help in epidemiology. Furthermore, there are potential future opportunities that might help in the development of mankind in general and Earth medicine in particular. This review presents some of the significant inventions that were made through the journey to space and elaborate on how those inventions helped develop Earth medicine and other fields.

Advancing Space Medicine and Astronomy in Chile for Health on Earth

The sky of Chile has the ideal conditions for astronomy worldwide, which has led to crucial scientific development for the country in this and other areas. In the coming years, several space missions will occur, the crew members' health being essential for their success. Space medicine studies the changes in human physiology in space, which is entirely altered. It is essential to understand the pathology in the space environment to develop countermeasures to mitigate the different risks, one of the main ones being space radiation, among others. The development of this area of medicine will allow new advances in health on Earth.

The Role of Nurses in the Reclassification Exercise of the Japan Disaster Relief Search and Rescue Team (the JDR Rescue Team)

Introduction:The JDR Rescue Team has successfully completed the INSARAG External Re-Classification (IER) process, which evaluates the operational capability and capacity of Urban Search and Rescue (USAR) teams and has achieved the highest “Heavy” reclassification in November 2022. Two nurses participated in the IER process as part of the medical unit of JDR Rescue Team. In addition, ten registered nurses cooperated as Exercise Control (EXCON).Method:Summarize the JDR Rescue Team and medical unit and make observations on what nurses did in the IER.Results:The JDR Rescue Team is dispatched by the Government of Japan in response to large-scale disasters overseas. The task force team has 75 members from various specialties, including the rescuer, and medical unit. The medical unit consists of one medical manager, 2 doctors, and two nurses. There are currently about 50 registered medical unit members in our team, and of these, a total of 23 nurses are registered. The role of nurses during the IER process, includes a 36-hour non-stop scenario-based exercise. The team nurses are involved in various roles, such as Confined Space Medicine (infusion for patients, assisting on-site amputation), caring or treating injured rescuers and search dogs, providing health and welfare monitoring and operating a decontamination system. The EXCON nurses were involved in managing the simulation. One of their key roles was to play as a victim realistically so as to provide a sense of tension for the simulation.Conclusion:The JDR Rescue Team has more medical unit members than those in other countries. In particular, teams with so many nurses are rare. nurses played a vital role in this IER. The contribution of nurses is identified in order to make the international USAR team more strong and more flexible.

Simulated microgravity altered the proliferation, apoptosis, and extracellular matrix formation of L929 fibroblasts and the transforming growth factor-β1/Smad3 signaling pathway.

Exposure to microgravity can adversely affect the fitness of astronauts. The integrity of the skin plays a crucial role in protecting against mechanical forces and infections, fluid imbalance, and thermal dysregulation. In brief, the skin wound may cause unknown challenges to the implementation of space missions. Wound healing is a physiological process that relies on the synergistic action of inflammatory cells, extracellular matrix (ECM), and various growth factors to maintain the integrity of skin after trauma. Fibroblasts are present almost throughout the entire process of wound repair, especially in the scar formation at the endpoint of wound healing. However, there is limited knowledge about the extent to which fibroblasts are affected by the lack of gravity during wound healing. In this study, we utilized the rotary cell culture system, a ground-based facility that mimics the weightless condition, to study the alterations of L929 fibroblast cells under simulated microgravity (SMG). Our results demonstrated that the SM condition exerted negative influences on the proliferation and ECM formation of the L929 fibroblast. Whereas, the apoptosis of fibroblast was significantly upregulated upon exposure to SMG conditions. Moreover, the transforming growth factor-β1/Smad3 (TGF-β1/smad3) signaling pathway of L929 fibroblast related to wound repair was also altered significantly under a weightless environment. Overall, our study provided evidence that fibroblasts are strongly sensitive to SMG and elucidated the potential value of the TGF-β1/Smad3 signaling pathway modulating wound healing in the future practice of space medicine.

Lab Medicine in Space.

As humanity continues to push towards interplanetary travel and beyond, short- and long-term adaptation of the human body to extreme environmental conditions in space remains a fundamental concern. An astronaut is subjected to physically and mentally enduring situations like microgravity, extreme heat or cold, radiation, isolation, and other unforeseen technical challenges. To manage the physiological impact of these situations, the use of real-time diagnostic laboratory medicine will be necessary for the health of the astronaut. With advancing technology, the recent implementation of point-of-care testing (POCT) on the International Space Station (ISS) provides a means to reduce the need to freeze and send specimens back to earth for analysis. However, the quality of these lab tests in a microgravity environment continues to be investigated. Similar to traditional laboratory medicine, there are laboratory analysis concerns during space travel such as pre-analytical errors, competency, interface issues, specimen type differences, reference intervals, and consumable storage. As the frequency and duration of human spaceflight increases, research in these areas of laboratory testing will be key for space travel and astronaut health. For this Q&A, we invited a diverse group of experts to explore the current and desired future state of laboratory medicine in space as well as innovations that will expand our current horizon within this area of interest.

“Science breathes only one air, the oxygen of facts”: On the 120th anniversary of the birth of Academician V.V. Parin

March 18, 2023, marks the 120th anniversary of the birth of Academician of the USSR Academy of Sciences and Academician of the USSR Academy of Medical Sciences Vasilii Vasil’evich Parin (1903–1971), an outstanding scientist, one of the founders of space physiology and medicine, who made a great contribution to circulatory physiology, space cardiology, medical cybernetics, and in the field of practical astronautics, to medical support for the first human flights into space. His achievements as an organizer of medical science, national health care, and higher medical education are also significant. Careful preservation and development of the experience and knowledge accumulated by predecessors, implementation of innovative ideas, and transfer of scientific heritage to students and followers—this is how Academician V.V. Parin saw the connection between generations of scientists. In the history of world science, his name is rightfully present not only thanks to his pioneering research work but also through his lifelong demonstration of humanity, dedication, and devotion to spiritual and moral values.

Effects of age on hypoxic tolerance in women

Effects of age on hypoxic tolerance in women

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.

Rehabilitation assisted by Space technology-A SAHC approach in immobilized patients-A case of stroke.

Introduction: The idea behind the presentation of this case relates to utilizing space technology in earth applications with mutual benefit for both patients confined to bed and astronauts. Deconditioning and the progressiveness of skeletal muscle loss in the absence of adequate gravity stimulus have been of physiological concern. A robust countermeasure to muscle disuse is still a challenge for both immobilized patients and astronauts in long duration space missions. Researchers in the space medicine field concluded that artificial gravity (AG) produced by short-radius centrifugation on a passive movement therapy device, combined with exercise, has been a robust multi-system countermeasure as it re-introduces an acceleration field and gravity load. Methods: A short-arm human centrifuge (SAHC) alone or combined with exercise was evaluated as a novel, artificial gravity device for an effective rehabilitation strategy in the case of a stroke patient with disability. The results reveal valuable information on an individualized rehabilitation strategy against physiological deconditioning. A 73-year-old woman was suddenly unable to speak, follow directions or move her left arm and leg. She could not walk, and self-care tasks required maximal assistance. Her condition was getting worse over the years, also she was receiving conventional rehabilitation treatment. Intermittent short-arm human centrifuge individualized protocols were applied for 5 months, three times a week, 60 treatments in total. Results: It resulted in significant improvement in her gait, decreased atrophy with less spasticity on the left body side, and ability to walk at least 100 m with a cane. Balance and muscle strength were improved significantly. Cardiovascular parameters improved responding to adaptations to aerobic exercise. Electroencephalography (EEG) showed brain reorganization/plasticity evidenced through functional connectivity alterations and activation in the cortical regions, especially of the precentral and postcentral gyrus. Stroke immobility-related disability was also improved. Discussion: These alterations were attributed to the short-arm human centrifuge intervention. This case study provides novel evidence supporting the use of the short-arm human centrifuge as a promising therapeutic strategy in patients with restricted mobility, with application to astronauts with long-term muscle disuse in space.

Building a One Country One Licensure Framework: Applications for the Future of Canadian Space Physicians

Space medicine provides care in the most extreme environment known to humankind. The global space economy is forecast to be a $1 trillion industry by 2040. Its increased utilization will require additional legal healthcare support frameworks. We reviewed the current Canadian medicolegal framework for the capability to adapt to this new demand. Currently, Canadian physicians are required to hold a license in each province they practice. As space medicine encompasses multiple medical specialties and its practice is beyond Canadian provincial jurisdictions, we identified medicolegal gaps in the Canadian ability to provide space healthcare. Geographical licensing restrictions have caused detriment to healthcare provision in remote communities, military medicine, and telemedicine, exacerbated by COVID-19. By examining similarities and solutions from these terrestrial situations, bi-directional translational licensing solutions may be found. Recommendations for an improved Canadian licensing framework targeting provision of space medicine may lead to improving healthcare access and universality for Canadians nationwide.

Medicine in Space: Taking What We Know, To Places We Don't

When was the last time you were faced with a problem that no one in the history of humankind has ever been able to define a clear solution? As humans venture further and further into space, we begin to encounter more and more challenges, with increasing levels of complexity. Just as the early explorers ventured past the horizon, we now attempt a similar adventure by reaching deeper and deeper into space. While there may be a myriad of unknown problems waiting ahead of us, we are called upon as professionals to solve the ones immediately ahead of us.

Development of a Digital Platform: A Perspective to Advance Space Telepharmacy.

Goal: Lessons learned from decades of human spaceflight have helped advance the delivery of healthcare in rural and remote areas of the globe. Inclusion of the public in spaceflights is not yet accompanied by technology capable of monitoring their physical and mental health, managing clinical conditions, and rapidly identifying medical emergencies. Telepharmacy is a practice prioritizing pharmacotherapeutic guidance and monitoring to help improve patient quality of life, and can potentially expand the field of space medicine. We seek to advance pharmaceutical care through telepharmacy by developing a digital platform. Objective: This study focuses on the development of a digital platform for teleassistance and pharmaceutical teleconsulting services that builds on lessons learned in delivering space medicine. Methods: The platform contains evidence-based information on various drugs grouped by medical specialty, and also records and saves patient appointments. It has specific service protocols for service standardization, including artificial intelligence, to allow agility in services and escalation. All data is protected by privacy and professional ethics guidelines. Results: The telepharmacy platform is ready and currently undergoing testing for ground applications through validation studies in hospitals or medical clinics. Conclusions: Although developed for use on Earth, this telepharmacy platform provides a good example of how terrestrial healthcare knowledge and technology can be transferred to space missions.

Enabling Human Space Exploration Missions Through Progressively Earth Independent Medical Operations (EIMO).

Goal: Current Space Medicine operations depend on terrestrial support to manage medical events. As astronauts travel to destinations such as the Moon, Mars, and beyond, distance will substantially limit this support and require increasing medical autonomy from the crew. This paper defines Earth Independent Medical Operations (EIMO) and identifies key elements of a conceptual EIMO system. Methods: The NASA Human Research Program Exploration Medical Capability Element held a 2-day conference at Johnson Space Center in Houston, TX with NASA experts representing all aspects of Space Medicine. Results: EIMO will be a process enabling progressively resilient deep space exploration systems and crews to reduce risk and increase mission success. Terrestrial assets will continue to provide pre-mission screening, planning, health maintenance, and prevention, while onboard medical care will increasingly be the purview of the crew. Conclusions: This paper defines and describes the key components of EIMO.

ДОНОЗОЛОГИЧЕСКАЯ ДИАГНОСТИКА КАК МЕТОДОЛОГИЯ ОЦЕНКИ ФУНКЦИОНАЛЬНЫХ СОСТОЯНИЙ ОРГАНИЗМА, ПОГРАНИЧНЫХ МЕЖДУ НОРМОЙ И ПАТОЛОГИЕЙ, И ЕЕ МЕСТО В КОСМИЧЕСКОЙ И ЗЕМНОЙ МЕДИЦИНЕ

A new concept of the health doctrine – prenosology – was conceived in space medicine. Roman M. Baevsky was one of the founders. The concept was built not on diagnostics of diseases but assessment of health quality by assigning to one of 4 adaptation states: good, strained, bad, and failure. Mass prenosological examinations of more than 25 thousand people in the period between 1975 and 2005 showed a high effectiveness of this approach in assessment of both personal and group health. It was found that about 20–30 % of people required medical care. In recent decades, the stress level and development of de-adaptation transiting to pathologies within six months have been growing catastrophically. Automated prenosological diagnostics system approved by the Russian Ministry of Health can be instrumental in prophylactic examination to triage the stream of people by the level of adaptation and need of medical care. In future, medicine will certainly be focused on the health of healthy people and prenosology will gain acceptance and progress.

How Space Operations Drive Innovation In Human Healthcare

Appropriate healthcare during human spaceflight necessitates adequate capabilities throughout the mission. This paper aims to raise awareness about how operations impact healthcare innovation. Future missions beyond low-Earth orbit will fundamentally alter healthcare, and advancements in space medicine will drive innovation in the field. Space agencies rely on evidence-based approaches to maximise the impact of innovation and make it safe for use in space. However, a lack of human readiness levels delays the inclusion of humans in the technology development process and can prevent the identification of human health hazards. This creates difficulties for the commercial space sector when attempting to apply the government's evidence-based approaches. As a result, medical capabilities for spaceflight could be developed independently of operations and vehicle/system design. Creating a safety framework necessitates alignment between these domains and may promote improved technology transfer of spaceflight medical capability to terrestrial medical needs.

Vinci Power Nap® Synchronization Technology - Neuroarchitecture for better sleep, adding Energy for Life, Reducing Stress and Jet Lag, Improving Wellbeing and Body-Mind Regeneration. Helpful for Leaders, Doctors, Soldiers, Children, Drivers, Pilots, Astronauts, People Traveling On Earth And Beyond

The Vinci Power Nap® neurotechnological system created for energy naps, which can benefits mankind on Earth and in space travels. This cutting edge tool helping to reduce stress, jet lag, regulating the circadian rhythm, improving focus, efficiency, reaction times, preventing losing bone mass, the quality of sleep, health and human wellbeing in future smart cities and Lunar, Martian habitats. The remarkable results can be found in studies on UN Delegates at COP24, UNICEF project for war traumatized refugees women and children, soldiers with PTSD, pilots and analog astronauts, showing the healing power of touching, frequency of rocking, napping in a zero gravity position. Good sleep is needed to reset, recover, strengthen the immune system, also avoid errors resulting from fatigue and jet lag, which is especially important for business leaders, doctors, drivers, athletes, students, soldiers, pilots, astronauts and tourists. The frequency of the VPN technology pendulum movement is a revolution in the synchronization of breathing, heartbeat, delta waves in the brain, during which the best regeneration of the body and mind occurs. Moreover, the pulsating pressure on the skin increase the level of hormones: dopamine, oxytocin, serotonin, etc. All this contributes to the regeneration of sleep and energy, improving human’s psychophysical condition, longevity and advances in sleep and space medicine.

Transfer learning as an AI-based solution to address limited datasets in space medicine

The advent of artificial intelligence (AI) has a promising role in the future long-duration spaceflight missions. Traditional AI algorithms rely on training and testing data from the same domain. However, astronaut medical data is naturally limited to a small sample size and often difficult to collect, leading to extremely limited datasets. This significantly limits the ability of traditional machine learning methodologies. Transfer learning is a potential solution to overcome this dataset size limitation and can help improve training time and performance of a neural networks. We discuss the unique challenges of space medicine in producing datasets and transfer learning as an emerging technique to address these issues.

Clinical Education Innovation Enabled by XR Space Medicine Technology

Clinical Education Innovation Enabled by XR Space Medicine Technology

ВЛИЯНИЕ СОВЕТСКО-КИТАЙСКОГО СОТРУДНИЧЕСТВА НА РАЗВИТИЕ ПРЕВЕНТИВНОЙ МЕДИЦИНЫ В КИТАЕ

The Soviet healthcare system had a special influence on the development of Chinese preventive medicine. In the XX century transfer of Soviet experience to the PRC contributed to the fact that modern preventive health care in China has become a symbiosis of traditional medicine and achievements of advanced Western science. The article discusses the main of preventive medicine where scientific and technical assistance from the USSR was carried out. At present, expanding the sphere of interaction between Russia and China in the field of epidemiology, the fight against global biopolitical threats, the development of space medicine programs, genetic-molecular and nuclear medical engineering involves studying historical experience of cooperation between two states on the problem under study.