Microgravity and Neurotrauma: Implications for Space Medicine and Human Space Exploration

From outer space to Earth—The social significance of isolated and confined environment research in human space exploration

As an emerging interdiscipline, space life science, generated and developed with human space, especially manned space exploration,, covering very wide research fields. In the past more than half a century, many significant findings and achievements have been achieved in this field, which not only supports the missions of manned space exploration, but also provides service for the life on the earth. With the continuous development of Chinese manned space and deep space exploration activities, especially the startup of Chinese manned space station project, the next two decades will be the prime time for the development of Chinese space life science. To conduct space life science, obtain new knowledge and innovative technology and provide further service for human space exploration, national economic and social development basing on Chinese manned space station and return type scientific satellite experiment platform, which need us to study and thinking systematically from the strategic perspective of subject development. By reviewing the historical and current development of space life science at home and abroad, this essay analyzes and prospects the strategic needs, key scientific problems and development direction of Chinese space life science, in order to provide inspiration and reference for its development.

Our ability to deliver adequate and necessary healthcare during human space flight is a vital component of getting to space, living and working in space, and coming home safely. There are many facets to the delivery of healthcare in support of this endeavor. Each of these facets has evolved over the past six decades. Our collective experience on mission profiles (scope and duration), NASA’s evolving medical requirements to support short- and long-duration space missions, and the rapid advancement in space flight and medical technology have provided no shortage of lessons learned. The knowledge gained through repeated space flight missions and the revolutionary steps in terrestrial medicine over the past several decades provides ample reason to explore better ways of improving healthcare, especially if we are to venture to locations farther away from Earth. The facets of healthcare delivery are influenced by challenges in system design, constraints in systems and resources, crew selection, space craft, and mission duration. The human in the system is just as critical as the space craft and rocketry for human space flight. So the crew must be healthy over the entire duration to support any space and planetary missions. The systems that support crew health include medical kits that contain diagnostic and therapeutic components, medical imaging device(s), telemedicine capability, and all life support systems within the space craft as well as ground-based programs that include occupational surveillance, longitudinal studies of astronauts, and an effective health stabilization program. Throughout human space flight, these medical resources have always been limited, and therefore, the approach has been tempered with risk assessment and utilization of efficient systems and protocols. This chapter describes the many facets of healthcare delivery in space. It describes the crew selection process from the earliest missions through the International Space Station Program. It summarizes the evolution of medical standards for crew selection in the U.S. with concomitant comparison to those of the Russian Space Program. The aspects of pre-flight, in-flight, and post-flight healthcare and activities are presented. In addition, this chapter also describes the evolution and current status of NASA’s crew healthcare programs from the perspective of preventive and occupational medicine under the auspices of Health and Medical Technical Authority. Specific descriptions of the risk-management program, the in-flight medical systems, and integration of technology are provided. This includes a discussion on smart/intelligent systems, informatics, autonomous care, and telemedicine. This chapter closes with a discussion about long distance missions away from the Earth and the future initiatives in space medicine.

航天医学是随着载人航天事业的发展而兴起的一门特种医学学科.随着人类对太空的不断探索,从学科创建至今的短短几十年时间取得了巨大的发展.我国的载人航天工程于20世纪90年代初启动,但航天医学发展的历史却可追溯到50年代末.特别是近10年来,我国载人航天工程的启动为航天医学的发展带来了重大机遇.目前,我国首次载人航天飞行已获圆满成功,首飞航天员也已安全、健康地重返地球,航天医学专家们与航天员一同经受住了首次载人航天飞行的考验.本文简要介绍了我国航天医学的基础研究和应用研究,以及取得的进展,并展望了今后将面临的挑战和机遇.

Space medicine is an essential medical discipline that focuses on safe and healthy human space travel by incorporating medical information and practices from a number of relevant medical specialties to address the challenges and hazards of human spaceflight. With increasing global space activities, there is a growing demand for trained professionals in this field. We propose a cascade of educational and training programs: A short course (2–4 weeks) about space medicine, its roles, its accomplishments, and recommendations for further education; postgraduate diploma (6 months) that includes structured teaching, assessments, and practical components, covering critical areas in the practice of space medicine; master’s degree (1 to 2 years) covering the fundamental of space medicine with a rigorous research component to improve the safety and health of space-farers; and a residency program (2–4 years) that trains physicians to become certified space medicine specialists. This paper advocates for establishing comprehensive education and training programs in space medicine globally, emphasizing the Middle East due to its burgeoning space ambitions.

During the summer of 2009, a flexible path scenario for human and robotic space exploration was developed that enables frequent, measured, and publicly notable human exploration of space beyond low-Earth orbit (LEO). The formulation of this scenario was in support of the Exploration Beyond LEO subcommittee of the Review of U.S. Human Space Flight Plans Committee that was commissioned by President Obama. Exploration mission sequences that allow humans to visit a wide number of inner solar system destinations were investigated. The scope of destinations included the Earth-Moon and Earth-Sun Lagrange points, near-Earth objects (NEOs), the Moon, and Mars and its moons. The missions examined assumed the use of Constellation Program elements along with existing launch vehicles and proposed augmentations. Additionally, robotic missions were envisioned as complements to human exploration through precursor missions, as crew emplaced scientific investigations, and as sample gathering assistants to the human crews. The focus of the flexible path approach was to gain ever-increasing operational experience through human exploration missions ranging from a few weeks to several years in duration, beginning in deep space beyond LEO and evolving to landings on the Moon and eventually Mars.

Space medicine is key to the human exploration of outer space and pushes the boundaries of science, technology, and medicine. Because of harsh environmental conditions related to microgravity and other factors and hazards in outer space, astronauts and spaceflight participants face unique health and medical challenges, including those related to the heart. In this review, we summarize the literature regarding the effects of spaceflight on cardiac structure and function. We also provide an in-depth review of the literature regarding the effects of microgravity on cardiac calcium handling. Our review can inform future mechanistic and therapeutic studies and is applicable to other physiological states similar to microgravity such as prolonged horizontal bed rest and immobilization.

Understanding the nature of the space environment is as important for physicians, astronauts, life scientists, and aeronautical engineers, as it is for planetary and physical scientists. Designing spacecraft, safe crew living quarters, personal protective systems, work procedures, and exploration systems has and will continue to benefit from robotic exploratory missions. Robotic missions inform aerospace engineers as to the function, design and performance of crewed systems for future exploration missions. The complexity of planetary human space missions will continue to increase in the future as we venture farther and for longer periods of time into our Solar System. Practitioners of space medicine must be prepared to use the knowledge gathered from robotic missions to identify challenges and hazards to address the health risks for future human expeditions and potential settlements beyond the confines of the biosphere. Future crews’ exposure to space hazards, notably radiation, and possibly to new ecosystems, require special and careful planning. The future of human space exploration is coupled with scientific curiosity based on robotic missions and also by the direction provided by the U.S. President’s space policy. Commercial aspirations for exploring and prospecting for resources of our Solar System are poorly defined and will require international agreements to be addressed by the United Nations. Astrobiology, planetary protection, and ethical considerations are also discussed. This chapter provides a short review of our Solar System, and discusses prospective destinations, intended to inform physicians, biomedical engineers, and mission planners interested in space medicine. Some of the mentioned destinations are in the planning stages by different space agencies, and by commercial entities. The fields of planetary sciences and space physics continue to make newer discoveries, which might not have been captured in this chapter. For a more in-depth scientific and technical review of our Solar System and the Universe, interested readers should consult appropriate scientific publications.

Space medicine innovation and telehealth concept implementation for medical care during exploration-class missions

Major accomplishments in nutritional sciences for support of human space travel have occurred over the past 40 y. This article reviews these accomplishments, beginning with the early Gemini program and continuing through the impressive results from the first space station Skylab program that focused on life sciences research, the Russian contributions through the Mir space station, the US Shuttle life sciences research, and the emerging International Space Station missions. Nutrition is affected by environmental conditions such as radiation, temperature, and atmospheric pressures, and these are reviewed. Nutrition with respect to space flight is closely interconnected with other life sciences research disciplines including the study of hematology, immunology, as well as neurosensory, cardiovascular, gastrointestinal, circadian rhythms, and musculoskeletal physiology. These relationships are reviewed in reference to the overall history of nutritional science in human space flight. Cumulative nutritional research over the past four decades has resulted in the current nutritional requirements for astronauts. Space-flight nutritional recommendations are presented along with the critical path road map that outlines the research needed for future development of nutritional requirements.

This essay begins with a critique of the vision of human space exploration that is based on the "metaphorical projection" of the European voyages of discovery in the 15th and 16th centuries and the Western American frontier. By incorrectly using these historical analogs and imposing their associated symbols onto the efforts to develop and maintain human exploration of the solar system, the space proponents are narrowing their political and technical options that can be used to carry out their aspirations. Following this critique, the basis for a new perspective on human space exploration is presented. This new perspective, based on the idea of a human metamorphosis, stems from a change in consciousness brought about by embracing the transcendental nature of spaceflight and a more connective human relationship with the Earth. Following this, it is suggested that the cis-lunar region of space be used as a research and development area for human space operations, and that this region is a place to cultivate the cultural, spiritual, and technological evolution that will be necessary to explore and eventually settle the solar system.

Space medicine studies health challenges related to human spaceflight, focusing on the physiological and psychological effects of altered gravity. As humanity plans settlements on the Moon, Mars, and beyond, understanding space medicine is crucial. Healthcare professionals must be trained to handle medical crises and mitigate health risks during space missions. However, there is a global gap in standardized training programs, particularly as space travel becomes commercialized. Space medicine advancements also benefit Earth, such as research on amyloid fibrils aiding Alzheimer's treatment. Barriers to space medicine education persist, especially in low-income countries, where programs are limited or costly. This chapter addresses these barriers and discusses efforts to ensure inclusive, comprehensive space medicine education for future missions.

Human Space Exploration Supported by Space Medicine -From Low Earth Orbit to Moon and Mars-

NASA has not undertaken development of a large human spaceflight system since the design of the Space Shuttle System. While recent events have refocused human space flight with the goal of sending humans to Mars, the effort to synthesize a new human space flight architecture has been ongoing for the past five years. With a beginning as NASA's "Space Transportation Architecture Study" (STAS), through the final Orbital Space Plane (OSP) Program, the goals of human space flight have been evolving

The main biological and medical problems of manned space flight are considered. The variety and complexity of space biology and medicine are discussed. The basic factors of space flight and some trends of experimental investigations are characterized. Brief results of flights aboard the space ships “Vostok1” and “Vostok2” are presented, as well as those of a group flight of the space ships “Vostok3” and “Vostok4”, which demonstrated the possibility of a four-day manned space flight without harm to working ability or basic physiological functions. General problems of providing for safety in space flights are discussed, as well as the maintenance of physiological functions, high working ability, and good health of the astronaut.