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By NASA
6 min read
Preparations for Next Moonwalk Simulations Underway (and Underwater)
In-person participants L-R standing: Dave Francisco, Joanne Kaouk, Dr. Richard Moon, Dr. Tony Alleman, Dr. Sean Hardy, Sarah Childress, Kristin Coffey, Dr. Ed Powers, Dr. Doug Ebersole, Dr. Steven Laurie, Dr. Doug Ebert; L-R seated: Dr. Alejandro Garbino, Dr. Robert Sanders, Dr. Kristi Ray, Dr. Mike Gernhardt, Dr. Joseph Dervay, Dr. Matt Makowski). Not pictured: Dr. Caroline Fife In June 2024, the NASA Office of the Chief Health and Medical Officer (OCHMO) Standards Team hosted an independent assessment working group to review the status and progress of research and clinical activities intended to mitigate the risk of decompression sickness (DCS) related to patent foramen ovale (PFO) during spaceflight and associated ground testing and human subject studies.
Decompression sickness (DCS) is a condition which results from dissolved gases (primarily nitrogen) forming bubbles in the bloodstream and tissues. It is usually experienced in conditions where there are rapid decreases in ambient pressure, such as in scuba divers, high-altitude aviation, or other pressurized environments. The evolved gas bubbles have various physiological effects and can obstruct the blood vessels, trigger inflammation, and damage tissue, resulting in symptoms of DCS. NASA presently classifies DCS into two categories: Type I DCS, which is less severe, typically leads to musculoskeletal symptoms including pain in the joints or muscles, or skin rash. Type II DCS is more severe and commonly results in neurological, inner ear, and cardiopulmonary symptoms. The risk of DCS in spaceflight presents during extravehicular activities (EVAs) in which astronauts perform mission tasks outside the spaceflight vehicle while wearing a pressurized suit at a lower pressure than the cabin pressure. DCS mitigation protocols based on strategies to reduce systemic nitrogen load are implemented through the combination of habitat environmental parameters, EVA suit pressure, and breathing gas procedures (prebreathe protocols) to achieve safe and effective mission operations. The pathophysiology of DCS has still not been fully elucidated since cases occur despite the absence of detected gas bubbles but includes right to left shunting of venous gas emboli (VGE) via several potential mechanisms, one of which is a Patent Foramen Ovale (PFO).
From: Dr. Schochet & Dr. Lie, Pediatric Pulmonologists
Reference OCHMO-TB-037 Decompression Sickness (DCS) Risk Mitigation technical brief for additional information.
A PFO is a shunt between the right atrium and the left atrium of the heart, which is a persisting remnant of a physiological communication present in the fetal heart. Post-natal increases in left atrial pressure usually force the inter-septal valve against the septum secundum and within the first 2 years of life, the septae permanently fuse due to the development of fibrous adhesions. Thus, all humans are born with a PFO and approximately 75% of PFOs fuse following childbirth. For the 25% of the population’s whose PFOs do not fuse, ~6% have what is considered by some to be a large PFO (> 2 mm). PFO diameter can increase with age. The concern with PFOs is that with a right to left shunt between the atria, venous emboli gas may pass from the right atrium (venous) to the left atrium (arterial) (“shunt”), thus by-passing the normal lung filtration of venous emboli which prevent passage to the arterial system. Without filtration, bubbles in the arterial system may lead to a neurological event such as a stroke. Any activity that increases the right atrium/venous pressure over the left atrium/arterial pressure (such as a Valsalva maneuver, abdominal compression) may further enable blood and/or emboli across a PFO/shunt.
From: Nuffield Department of Clinical Neurosciences
The purpose of this working group was to review and provide analysis on the status and progress of research and clinical activities intended to mitigate the risk of PFO and DCS issues during spaceflight. Identified cases of DCS during NASA exploration atmosphere ground testing conducted in pressurized chambers led to the prioritization of the given topic for external review. The main goals of the working group included:
Quantification of any increased risk associated with the presence of a PFO during decompression protocols utilized in ground testing and spaceflight EVAs, as well as unplanned decompressions (e.g., cabin depressurization, EVA suit leak). Describe risks and benefits of PFO screening in astronaut candidates, current crewmembers, and chamber test subjects. What are potential risk reduction measures that could be considered if a person was believed to be at increased risk of DCS due to a PFO? What research and/or technology development is recommended that could help inform and/or mitigate PFO-related DCS risk? The working group took place over two days at NASA’s Johnson Space Center and included NASA subject matter experts and stakeholders, as well as invited external reviewers from areas including cardiology, hypobaric medicine, spaceflight medicine, and military occupational health. During the working group, participants were asked to review past reports and evidence related to PFOs and risk of DCS, materials and information regarding NASA’s current experience and practices, and case studies and subsequent decision-making processes. The working group culminated in an open-forum discussion where recommendations for current and future practices were conferred and subsequently summarized in a final summary report, available on the public NASA OCHMO Standards Team website.
The following key findings are the main take-aways from the OCHMO independent assessment:
In an extreme exposure/high-risk scenario, excluding individuals with a PFO and treating PFOs does not necessarily decrease the risk of DCS or create a ‘safe’ environment. It may create incremental differences and slightly reduce overall risk but does not make the risk zero. There are other physiological factors that also contribute to the risk of DCS that may have a larger impact (see 7.0 Other Physiological Factors in the findings section). Based on the available evidence and the risk of current decompression exposures (based on current NASA protocols and NASA-STD-3001 requirements to limit the risk of DCS), it is not recommended to screen for PFOs in any spaceflight or ground testing participants. The best strategy to reduce the risk of DCS is to create as safe an environment as possible in every scenario, through effective prebreathe protocols, safety, and the capability to rapidly treat DCS should symptoms occur. Based on opinion, no specific research is required at this time to further characterize PFOs with DCS and altitude exposure, due to the low risk and preference to institute adequate safe protocols and ensuring treatment availability both on the ground and in spaceflight. For engineering protocols conducted on the ground, it should be ensured that the same level of treatment capability (treatment chamber in the immediate vicinity of the testing) is provided as during research protocols. The ability to immediately treat a DCS case is critical in ensuring the safety of the test subjects. The full summary report includes detailed background information, discussion points from the working group, and conclusions and recommendations. The findings from the working group and resulting summary report will help to inform key stakeholders in decision-making processes for future ground testing and spaceflight operations with the main goal of protecting crew health and safety to ensure overall mission success.
Summary Report About the Author
Sarah D. Childress
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Last Updated Dec 31, 2024 Related Terms
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During the keynote remarks, Gen. Stephen Whiting emphasized the joint functions and the importance of operating across the joint team using a common playbook to enable joint force commanders to synchronize, integrate, and execute joint operations.
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By NASA
Many team members at NASA’s Johnson Space Center in Houston may recognize Alicia Baker as the talented flutist in the Hispanic Employee Resource Group’s Mariachi Celestial band. Or, they may have worked with Baker in her role as a spacesuit project manager, testing NASA’s prototype spacesuits and preparing Johnson’s test chambers to evaluate vendor spacesuits.
Alicia Baker in a spacesuit test chamber at Johnson Space Center.NASA/David DeHoyos They might be surprised to learn that Baker juggled these responsibilities and more while also caring for her late husband, Chris, as he fought a terminal illness for 16 years.
“It was hard taking care of a loved one with cancer and working full-time,” Baker said. “My husband was also disabled from a brain tumor surgery, so I had to help him with reading, writing, walking, and remembering, while managing the household.”
Baker worked closely with her manager to coordinate schedules and get approval to telework so that she could work around her husband’s medical appointments and procedures. She also took medical leave when her husband entered hospice care in 2020. Baker said her manager’s flexibility “saved her job” and allowed her to continue providing for her family. She was even able to advance from project engineer to test director to project manager during this time period.
Alicia Baker and her husband Chris on their wedding day. Image courtesy of Alicia Baker Baker is one of the many Johnson employees who are or have been a caregiver for a loved one. These caregivers provide help to a person in need who often has a medical condition or injury that affects their daily functioning. Their needs may be temporary or long-term, and they could be physical, medical, financial, or domestic in nature.
Recognizing the challenging and critical role caregivers play in their families, the Johnson community provides a variety of resources to support team members through the Employee Assistance Program. Additionally, Johnson’s No Boundaries Employee Resource Group (NoBo) supports caregivers through its programs and initiatives.
Baker participates in both the support group and NoBo activities and takes comfort in sharing her and her husband’s story with others. “I would do it all over again,” she said of her caregiver role.
Now she looks forward to future missions to the Moon, when NASA astronauts will conduct spacewalks on the lunar surface while wearing new spacesuits. “Then I can say I helped make that possible!” Throughout all of her experiences, Baker has learned to never give up. “If you have a dream, keep fighting for it,” she said.
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By NASA
2 min read
Preparations for Next Moonwalk Simulations Underway (and Underwater)
ESI24 Haghighi Quadchart
Azadeh Haghighi
University of Illinois, Chicago
In-space manufacturing and assembly are vital to NASA’s long-term exploration goals, especially for the Moon and Mars missions. Deploying welding technology in space enables the assembly and repair of structures, reducing logistical burdens and supply needs from Earth. The unique challenges and extreme conditions of space–high thermal variations, microgravity, and vacuum–require advanced welding techniques and computational tools to ensure reliability, repeatability, safety, and structural integrity in one-shot weld scenarios. For the first time, this project investigates these challenges by focusing on three key factors: (1) Very low temperatures in space degrade the weldability of high thermal conductivity materials, like aluminum alloys, making it harder to achieve strong, defect-free welds. (2) The extreme vacuum in space lowers the boiling points of alloying elements, altering the keyhole geometry during welding. This selective vaporization changes the weld’s final chemical composition, affecting its microstructure and properties. (3) Microgravity nearly eliminates buoyancy-driven flow of liquid metal inside the molten pool, preventing gas bubbles from escaping, which leads to porosity and defects in the welds. By examining these critical factors using multi-scale multi-physics models integrated with physics-informed machine learning, and forward/inverse uncertainty quantification techniques, this project provides the first-ever real-time digital twin platform to evaluate welding processes under extreme space/lunar conditions. The models are validated through Earth-based experiments, parabolic flight tests, and publicly available data from different databases and agencies worldwide. Moreover, the established models will facilitate extendibility to support in-situ resource utilization on the Moon, including construction and repair using locally sourced materials like regolith. The established fundamental scientific knowledge will minimize trial-and-error, enable high-quality one-shot welds in space, and reduce the need for reworks, significantly reducing the costs and time needed for space missions.
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By Space Force
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