Probability of hypobaric decompression sickness including extreme exposures.

INTRODUCTION: The fitting of probabilistic decompression sickness (DCS) models is more effective when data encompass a wide range of DCS incidence. We obtained such data from the Air Force Research Laboratory Altitude Decompression Sickness Research Database. The data are results from 29 tests comprising 708 human altitude chamber exposures (536 men and 172 women). There were 340 DCS outcomes with per-test DCS incidence ranging from 0 to 88%. The tests were characterized by direct ascent at a rate of 5000 ft x min(-1) (1524 m x min(-1)) to a range of altitudes (226 to 378 mmHg) for 4 h after prebreathe times of varying length and with varying degrees of physical activity while at altitude. METHODS: Logistic regression was used to develop an expression for the probability of DCS [P(DCS)] using the Hill equation with decompression dose as the main predictor. Here, decompression dose is defined in terms of either the tissue ratio (TR) or a bubble growth index (BGI). Other predictors in the model were gender and peak exercise intensity at altitude. RESULTS: All three predictors (decompression dose, gender, and exercise intensity) were important contributions to the model for P(DCS). DISCUSSION: Higher TR or BGI, male gender, and higher exercise intensity at altitude all increased the modeled decompression dose. Using either TR or BGI to define decompression dose provided comparable results, suggesting that a simple TR is adequate for simple altitude exposures as an abstraction of the true decompression dose. The model is primarily heuristic and limits estimates of P(DCS) to only a 4-h exposure.

The Partial Pressure of Inspired Carbon Dioxide Exposure Levels in the Extravehicular Mobility Unit.

BACKGROUND: NASA has been making efforts to assess the carbon dioxide (CO2) washout capability of spacesuits using a standard CO2 sampling protocol. This study established the methodology for determining the partial pressure of inspired CO2 (PIco2) in a pressurized spacesuit. We applied the methodology to characterize PIco2 for the extravehicular mobility unit (EMU).METHODS: We suggested an automated and mathematical algorithm to find the end-tidal CO2 and the end of inspiration. We provided objective and standardized guidelines to identify acceptable breath traces, which are essential to accurate and reproducible calculation of the in-suit inhaled and exhaled partial pressure of CO2 (Pco2). The mouth guard-based method for measurement of inhaled and exhaled dry-gas Pco2 was described. We calculated all individual concentrations of PIco2 inhaled by 19 healthy subjects classified into 3 fitness groups. The transcutaneous Pco2 was monitored as a secondary measure to validate washout performance.RESULTS: Mean and standard deviation values for the data collection performance and the CO2 metrics were presented (e.g., minimum time weighted average Pco2 at suited workloads of resting, 1000, 2000, and 3000 (BTU h1) were 4.75 1.03, 8.09 1.39, 11.39 1.26, and 14.36 1.29 (mmHg s1). All CO2 metrics had a statistically significant association and all positive slopes with increasing metabolic rate. No significant differences in CO2 metrics were found between the three fitness groups.DISCUSSION: A standardized and automated methodology to calculate PIco2 exposure level is presented and applied to characterize CO2 washout in the EMU. The EMU has been operated successfully in over 400 extravehicular activities (EVAs) and is considered to provide acceptable CO2 washout performance. Results provide a basis for establishing verifiable Pco2 requirements for current and future EVA spacesuits.Kim KJ, Bekdash OS, Norcross JR, Conkin J, Garbino A, Fricker J, Young M, Abercromby AFJ. The partial pressure of inspired carbon dioxide exposure levels in the extravehicular mobility unit. Aerosp Med Hum Perform. 2020; 91(12):923931.

Bridging the gap between military prolonged field care monitoring and exploration spaceflight: the compensatory reserve.

The concept of prolonged field care (PFC), or medical care applied beyond doctrinal planning timelines, is the top priority capability gap across the US Army. PFC is the idea that combat medics must be prepared to provide medical care to serious casualties in the field without the support of robust medical infrastructure or resources in the event of delayed medical evacuation. With limited resources, significant distances to travel before definitive care, and an inability to evacuate in a timely fashion, medical care during exploration spaceflight constitutes the ultimate example PFC. One of the main capability gaps for PFC in both military and spaceflight settings is the need for technologies for individualized monitoring of a patient's physiological status. A monitoring capability known as the compensatory reserve measurement (CRM) meets such a requirement. CRM is a small, portable, wearable technology that uses a machine learning and feature extraction-based algorithm to assess real-time changes in hundreds of specific features of arterial waveforms. Future development and advancement of CRM still faces engineering challenges to develop ruggedized wearable sensors that can measure waveforms for determining CRM from multiple sites on the body and account for less than optimal conditions (sweat, water, dirt, blood, movement, etc.). We show here the utility of a military wearable technology, CRM, which can be translated to space exploration.

Using Science-Driven Analog Research to Investigate Extravehicular Activity Science Operations Concepts and Capabilities for Human Planetary Exploration.

Biologic Analog Science Associated with Lava Terrains (BASALT) is a science-driven exploration program seeking to determine the best tools, techniques, training requirements, and execution strategies for conducting Mars-relevant field science under spaceflight mission conditions. BASALT encompasses Science, Science Operations, and Technology objectives. This article outlines the BASALT Science Operations background, strategic research questions, study design, and a portion of the results from the second field test. BASALT field tests are used to iteratively develop, integrate, test, evaluate, and refine new concepts of operations (ConOps) and capabilities that enable efficient and productive science. This article highlights the ConOps investigated during BASALT in light of future planetary extravehicular activity (EVA), which will focus on scientific exploration and discovery, and serves as an introduction to integrating exploration flexibility with operational rigor, the value of tactical and strategic science planning and execution, and capabilities that enable and enhance future science EVA operations.

A Low-Diversity Microbiota Inhabits Extreme Terrestrial Basaltic Terrains and Their Fumaroles: Implications for the Exploration of Mars.

A major objective in the exploration of Mars is to test the hypothesis that the planet hosted life. Even in the absence of life, the mapping of habitable and uninhabitable environments is an essential task in developing a complete understanding of the geological and aqueous history of Mars and, as a consequence, understanding what factors caused Earth to take a different trajectory of biological potential. We carried out the aseptic collection of samples and comparison of the bacterial and archaeal communities associated with basaltic fumaroles and rocks of varying weathering states in Hawai'i to test four hypotheses concerning the diversity of life in these environments. Using high-throughput sequencing, we found that all these materials are inhabited by a low-diversity biota. Multivariate analyses of bacterial community data showed a clear separation between sites that have active fumaroles and other sites that comprised relict fumaroles, unaltered, and syn-emplacement basalts. Contrary to our hypothesis that high water flow environments, such as fumaroles with active mineral leaching, would be sites of high biological diversity, alpha diversity was lower in active fumaroles compared to relict or nonfumarolic sites, potentially due to high-temperature constraints on microbial diversity in fumarolic sites. A comparison of these data with communities inhabiting unaltered and weathered basaltic rocks in Idaho suggests that bacterial taxon composition of basaltic materials varies between sites, although the archaeal communities were similar in Hawai'i and Idaho. The taxa present in both sites suggest that most of them obtain organic carbon compounds from the atmosphere and from phototrophs and that some of them, including archaeal taxa, cycle fixed nitrogen. The low diversity shows that, on Earth, extreme basaltic terrains are environments on the edge of sustaining life with implications for the biological potential of similar environments on Mars and their exploration by robots and humans.

The BASALT Research Program: Designing and Developing Mission Elements in Support of Human Scientific Exploration of Mars.

The articles associated with this Special Collection focus on the NASA BASALT (Biologic Analog Science Associated with Lava Terrains) Research Program, which aims at answering the question, "How do we support and enable scientific exploration during human Mars missions?" To answer this the BASALT team conducted scientific field studies under simulated Mars mission conditions to both broaden our understanding of the habitability potential of basalt-rich terrains on Mars and examine the effects of science on current Mars mission concepts of operations. This article provides an overview of the BASALT research project, from the science, to the operational concepts that were tested and developed, to the technical capabilities that supported all elements of the team's research. Further, this article introduces the 12 articles that are included in this Special Collection.

A Systematic Review and Meta-Analysis of Decompression Sickness in Altitude Physiological Training.

INTRODUCTION: A review of decompression sickness (DCS) cases associated with the NASA altitude physiological training (APT) program at the Johnson Space Center (JSC) motivated us to place our findings into the larger context of DCS prevalence from other APT centers.METHODS: We reviewed JSC records from 1999 to 2016 and 14 publications from 1968 to 2004 about DCS prevalence in other APT programs. We performed a meta-analysis of 15 APT profiles (488 cases / 385,116 exposures). We used meta-regression to evaluate the relation between estimated exposures and probability of DCS in a test group, accounting for the heterogeneity between studies.RESULTS: Our in-house review identified 6 Type I DCS (1 from an inside observer) and 1 Type II DCS. There were 6 cases in 9560 student hypobaric exposures from 3 NASA training flights; a student pooled prevalence rate of 0.44 cases / 1000 exposures compared to 1.44 cases / 1000 from 12 published APT profiles. The overall pooled DCS prevalence rate was 1.16 cases / 1000 exposures. There was substantial heterogeneity in DCS prevalence across studies. Denitrogenation time, exposure pressure, and exposure time were associated with probability of DCS in the meta-regression model.CONCLUSIONS: While the overall DCS prevalence rate is relatively low, there is marked heterogeneity among profiles. The pooled DCS prevalence rate estimate for the NASA profiles was lower than the overall rate. Variability in APT profile DCS prevalence could be further explained given student level and additional test-level covariates.Conkin J, Sanders RW, Koslovsky MD, Wear ML, Kozminski AG, Abercromby AFJ. A systematic review and meta-analysis of decompression sickness in altitude physiological training. Aerosp Med Hum Perform. 2018; 89(11):941-951.

Objective Metrics Quantifying Fit and Performance in Spacesuit Assemblies.

INTRODUCTION: Human-spacesuit fit is not well understood, especially in relation to operational performance and injury risk. Current fit decisions use subjective feedback. This work developed and evaluated new metrics for quantifying fit and assessed metric sensitivity to changes in padding between the human and hip brief assembly (HBA).METHODS: Three subjects donned the Mark III (MKIII) spacesuit with three padding thicknesses between the lower body and HBA. Subjects performed a walking task with inertial measurement units on the thigh and shin of both the human and suit. For each step, cadence, human knee task range of motion (tRoM), difference in human and suit tROM (ΔtRoM), and the relative coordination metric (ρ) between the human-suit femur and tibia were computed.RESULTS: The MKIII significantly reduced user cadence by 20.4% and reduced tRoM by 16.5% during walking with subject-dependent changes due to added padding. In general, the addition of padding significantly altered ΔtRoM; however, variability did exist between subjects. Mixed-effect regressions of dynamic fit (ρ) reflect distinct positive spikes in ρ around heel strike (human-dominated motion) and negative dips following toe off (suit-dominated motion).DISCUSSION: There were mixed effects of padding on gait performance and dynamic fit measures. Differences in dynamic fit between subjects may be more reliant on alternate aspects of fit, such as suit component sizes and designs, than padding level. Subjective feedback supported quantitative observations, highlighting metric utility. Future work will explore the effects of suit sizing components on measures of fit and performance.Fineman RA, McGrath TM, Kelty-Stephen DG, Abercromby AFJ, Stirling LA. Objective metrics quantifying fit and performance in spacesuit assemblies. Aerosp Med Hum Perform. 2018; 89(11):985-995.

Variation in neuromuscular responses during acute whole-body vibration exercise.

PURPOSE: Leg muscle strength and power are increased after whole-body vibration (WBV) exercise. These effects may result from increased neuromuscular activation during WBV; however, previous studies of neuromuscular responses during WBV have not accounted for motion artifact. METHODS: Sixteen healthy adults performed a series of static and dynamic unloaded squats with and without two different directions of WBV (rotational vibration, RV; and vertical vibration, VV; 30 Hz; 4 mmp-p). Activation of unilateral vastus lateralis, biceps femoris, gastrocnemius, and tibialis anterior was recorded using EMG. During RV and VV, increases in EMG relative to baseline were compared over a range of knee angles, contraction types (concentric, eccentric, isometric), and squatting types (static, dynamic). RESULTS: After removing large, vibration-induced artifacts from EMG data using digital band-stop filters, neuromuscular activation of all four muscles increased significantly (P

Vibration exposure and biodynamic responses during whole-body vibration training.

PURPOSE: Excessive, chronic whole-body vibration (WBV) has a number of negative side effects on the human body, including disorders of the skeletal, digestive, reproductive, visual, and vestibular systems. Whole-body vibration training (WBVT) is intentional exposure to WBV to increase leg muscle strength, bone mineral density, health-related quality of life, and decrease back pain. The purpose of this study was to quantitatively evaluate vibration exposure and biodynamic responses during typical WBVT regimens. METHODS: Healthy men and women (N = 16) were recruited to perform slow, unloaded squats during WBVT (30 Hz; 4 mm(p-p)), during which knee flexion angle (KA), mechanical impedance, head acceleration (Ha(rms)), and estimated vibration dose value (eVDV) were measured. WBVT was repeated using two forms of vibration: 1) vertical forces to both feet simultaneously (VV), and 2) upward forces to only one foot at a time (RV). RESULTS: Mechanical impedance varied inversely with KA during RV (effect size, eta(p)(2): 0.668, P < 0.01) and VV (eta(p)(2): 0.533, P < 0.05). Ha(rms) varied with KA (eta(p)(2): 0.686, P < 0.01) and is greater during VV than during RV at all KA (P < 0.01). The effect of KA on Ha(rms) is different for RV and VV (eta(p)(2): 0.567, P < 0.05). The eVDV associated with typical RV and VV training regimens (30 Hz, 4 mm(p-p), 10 min.d(-1)) exceeds the recommended daily vibration exposure as defined by ISO 2631-1 (P < 0.01). CONCLUSIONS: ISO standards indicate that 10 min.d(-1) WBVT is potentially harmful to the human body; the risk of adverse health effects may be lower during RV than VV and at half-squats rather than full-squats or upright stance. More research is needed to explore the long-term health hazards of WBVT.

Hemoglobin Oxygen Saturation with Mild Hypoxia and Microgravity.

INTRODUCTION: Microgravity (µG) exposure and even early recovery from µG in combination with mild hypoxia may increase the alveolar-arterial oxygen (O2) partial pressure gradient. METHODS: Four male astronauts on STS-69 (1995) and four on STS-72 (1996) were exposed on Earth to an acute sequential hypoxic challenge by breathing for 4 min 18.0%, 14.9%, 13.5%, 12.9%, and 12.2% oxygen-balance nitrogen. The 18.0% O2 mixture at sea level resulted in an inspired O2 partial pressure (PIo2) of 127 mmHg. The equivalent PIO2 was also achieved by breathing 26.5% O2 at 527 mmHg that occurred for several days in µG on the Space Shuttle. A Novametrix CO2SMO Model 7100 recorded hemoglobin (Hb) oxygen saturation through finger pulse oximetry (Spo2, %). There were 12 in-flight measurements collected. Measurements were also taken the day of (R+0) and 2 d after (R+2) return to Earth. Linear mixed effects models assessed changes in Spo2 during and after exposure to µG. RESULTS: Astronaut Spo2 levels at baseline, R+0, and R+2 were not significantly different from in flight, about 97% given a PIo2 of 127 mmHg. There was also no difference in astronaut Spo2 levels between baseline and R+0 or R+2 over the hypoxic challenge. CONCLUSIONS: The multitude of physiological changes associated with µG and during recovery from µG did not affect astronaut Spo2 under hypoxic challenge.Conkin J, Wessel JH III, Norcross JR, Bekdash OS, Abercromby AFJ, Koslovsky MD, Gernhardt ML. Hemoglobin oxygen saturation with mild hypoxia and microgravity. Aerosp Med Hum Perform. 2017; 88(6):527-534.

Spatial factors and muscle spindle input influence the generation of neuromuscular responses to stimulation of the human foot.

Removal of the mechanical pressure gradient on the soles leads to physiological adaptations that ultimately result in neuromotor degradation during spaceflight. We propose that mechanical stimulation of the soles serves to partially restore the afference associated with bipedal loading and assists in attenuating the negative neuromotor consequences of spaceflight. A dynamic foot stimulus device was used to stimulate the soles in a variety of conditions with different stimulation locations, stimulation patterns and muscle spindle input. Surface electromyography revealed the lateral side of the sole elicited the greatest neuromuscular response in ankle musculature, followed by the medial side, then the heel. These responses were modified by preceding stimulation. Neuromuscular responses were also influenced by the level of muscle spindle input. These results provide important information that can be used to guide the development of a "passive" countermeasure that relies on sole stimulation and can supplement existing exercise protocols during spaceflight.

Hypobaric Decompression Sickness Treatment Model.

INTRODUCTION: The Hypobaric Decompression Sickness (DCS) Treatment Model links a decrease in computed bubble volume from increased pressure (ΔP), increased oxygen (O2) partial pressure, and passage of time during treatment to the probability of symptom resolution [P(SR)]. The decrease in offending volume is realized in two stages: 1) during compression via Boyles law; and 2) during subsequent dissolution of the gas phase via the oxygen window. METHODS: We established an empirical model for the P(SR) while accounting for multiple symptoms within subjects. The data consisted of 154 cases of hypobaric DCS symptoms with ancillary information from tests on 56 men and 18 women. RESULTS: Our best estimated model is P(SR)=1/(1+exp(-(ln(ΔP)-1.510+0.795×AMB-0.00308×Ts)/0.478)), where ΔP is pressure difference (psid); AMB=1 if ambulation took place during part of the altitude exposure, otherwise AMB=0; and Ts is the elapsed time in minutes from the start of altitude exposure to recognition of a DCS symptom. DISCUSSION: Values of ΔP as inputs to the model would be calculated from the Tissue Bubble Dynamics Model based on the effective treatment pressure: ΔP=P2-P1|=P1×V1/V2-P1, where V1 is the computed volume of a bubble at low pressure P1 and V2 is computed volume after a change to a higher pressure P2. If 100% ground-level oxygen was breathed in place of air, then V2 continues to decrease through time at P2 at a faster rate.