The race is on for NASA to land astronauts on the Moon by 2024, as a testing-bed for the agency’s long-term vision of launching a human mission to Mars in the early 2030s. The political discourse centers on funding and international cooperation. The strategic and tactical planning focuses on acquisition vehicles, commercial suppliers, and viable technologies. Behind the scenes, a small army of medical researchers are looking at the human factors inherent in space exploration and creating the medical procedures and technology needed to counter the physical and mental health hazards posed by space travel.
WELCOME TO SPACE HEALTH NEWS, our monthly briefing of opportunities and advances in deep space medicine and health care.
“TWINS STUDY”: NASA’s Twins Study results were published in the peer-reviewed journal Science on April 12, 2019. The study follows the health trajectories of two identical twins, Scott Kelly and Mark Kelly, both former NASA astronauts, one of which (Scott Kelly) spent a year-long mission on the International Space Station (ISS). The purpose of the study was to compare the impact of the spaceflight environment on one twin to the simultaneous impact of the Earth environment on the other twin. The investigation, organized by NASA in collaboration with 80 researchers, was based on physiological, telomeric, transcriptomic, epigenetic, proteomic, metabolomic, immune, microbiomic, cardiovascular, vision-related, and cognitive data collected over 25 months, starting in 2015 – when astronaut Scott Kelly started his sojourn on the ISS together with Russian cosmonaut Mikhail Kornienko.
The study found several changes in Scott’s gene expression, telomeres, gut bacteria, DNA methylation, thickness of carotid artery wall and inflammation, and protein levels – most of which returned to preflight levels by the end of the study. The results of the study demonstrated the human body’s adaptability to spaceflight conditions, proving that the body can remain robust and resilient even after spending a year in space. The study also helped identify key genes for monitoring the health of future astronauts for possible personalized treatments and countermeasures.
Additional reading: NASA Twins Study Provides New Insight Into How Space Travel Affects Human Health, by Shelly Fan, SingularityHub, April 14, 2019.
Robotic Surgery: For astronauts on long-term spaceflight missions, a simple case of appendicitis can wreak havoc if the spacecraft/space station is not equipped for surgeries (and none of them are!). Moreover, as we move towards an era of commercial spaceflight, where space travelers will presumably be less fit and well-trained than present-day astronauts are, the odds of injury and trauma will go up. Though not used in outer space yet, robotic procedures such as the ones developed by the Mayo Clinic as an alternative to laparoscopic surgeries lead to a faster recovery, less pain during recovery, and fewer post-op complications. Robotic surgery guided by a human expert located on Earth, perform via telehealth technology, is likely to be the first step towards providing trauma care onboard a spacecraft. Given that surgery is a fine-motor task, adding haptic sensors to robotic surgery devices, as the engineers at UCLA are experimenting with, will better feedback and greater precision to remote-driven surgical procedures.
Additional reading: Surgery in Space: Medicine’s Final Frontier, by Sandip S. Panesar, Scientific American Blogs, October 12, 2018.
Watertight, In-Space Surgery: For surgeries of any type to be successful in an environment with low or zero gravity, researchers are looking for ways to contain the blood and fluids pooling from an incision or wound. Without gravity, blood leaking from the surgery forms into domes that can fragment into bubbles of blood that can disperse throughout the cabin. To counter this phenomenon, biomedical researchers such as James Antaki, professor of biomedical engineering at the Carnegie Mellon University, and George Pantalos, professor of surgery and bioengineering at the same university, are working on a watertight surgery system to isolate the wound and control bleeding by creating a pressurized environment filled with a saline solution.
TRISH Awards: The Translational Research Institute for Space Health (TRISH) at Baylor College of Medicine is a cooperative agreement between NASA’s Human Research Program (HRP) and a consortium of academic centers led by Baylor College of Medicine. TRISH’s goal is to lead a national effort in translating cutting-edge biomedical research and technology development into applied human risk mitigation strategies for space exploration missions. On April 1st, 2019, TRISH awarded accelerator grants of $250,000 each to PlenOptika, Emerald Innovations Inc., Empatica, Inc. and VisualDx, and $100,000 validation grants to Rizlab Health Inc., InnaMed, Inc., Ativa Medical, Z3VR and Synlife, Inc.- for projects aimed at developing technologies for predicting and protecting astronauts’ health. More details here.
University of Texas Medical Branch (UTMB): Through partnership with the National Aeronautics and Space Administration (NASA) at Johnson Space Center, UMTB now offers the only Aerospace/Internal Medicine combined residency in the United States. UMTB’s program is geared towards training physicians to become experts with knowledge and experience in space medicine, space biomedical research, aerospace medicine, and manned space flight. Residents train to provide medical care in austere environments, under high gravity-stress, hyper- and hypobaric environments, sub-zero temperature, and radiation exposure.
Astronaut Karen Nyberg, STS-124 mission specialist, floats in the newly installed Kibo Japanese Pressurized Module while Space Shuttle Discovery is docked with the station. NASA Images.
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