Short Title: FE Strength Cutoff II

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:
1) Develop a dataset of FE hip strengths from human subjects: with ages covering the age
range of the astronauts and for which fracture outcome data have been collected.
a. The Rochester Bone Health Study will provide QCT scans from 408 persons to
Dr. Joyce Keyak who will estimate hip bone strength using her developed FEM at
UCI (Keyak, 2005).
b. FE data from 1a (above) will be combined with FE data generated from other
applications of Keyak FEM to QCT scans of study cohorts, which includes ISS
astronauts.

2) Determine FE strength cutoffs from to be used as a decision-tool by Space Medicine for
the following scheduled decision points (a-d):
a. to qualify an applicant for astronaut candidacy
b. to qualify an astronaut for a long-duration (LD) mission
c. to qualify a veteran LD astronaut for a second LD mission
d. to establish responsibility by occupational space medicine for a post-mission
fracture or osteoporosis diagnosis.

3) Review and finalize generated FE strength cutoffs with FE Task Group (along with the
inclusion of cohort biostatisticians) to recommend to Human Health Countermeasures as
a deliverable to Space Medicine and Office of Chief Health and Medical Officer.

Integration/Unique Aspects:
This task convened a "Bone Summit" -- an expert panel comprised of policy-makers in the International Society of Clinical Densitometry (ISCD), World Health Organization (WHO) and practitioners in the field of osteoporosis -- to review NASA’s assessment of skeletal integrity in astronauts and make recommendations on how best to assess skeletal integrity in astronauts.

Short Title: Hip QCT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

This study will describe in each astronaut:

1. How the QCT-measured changes in hip bone BMD and in the cross-sectional areas of cortical and trabecular bone correspond to different mitigating approaches to bone loss, i.e., biochemical or biomechanical, either in combination or singly. 
2. How the above QCT-measured changes in hip bone morphology translate to hip bone fracture loads (aka, “hip bone strength”) as determined by FE Modeling of QCT data.
3. How QCT-measured changes in hip bone morphology during postflight period translate to the recovery of baseline (i.e., preflight) FEM-derived hip bone strength after a mission on-board the International Space Station.

Integration/Unique Aspects:
Task will contribute to standard update in NASA-STD-3001.

Short Title: Bone Epidemiologic Analysis

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. To investigate the risk of microgravity exposure on long-term changes in bone health and fracture risk.
2. To provide a summary of the current evidence available on potential risk factors for bone loss, recovery and fracture following long-duration space exploration.

Integration/Unique Aspects:
This task is expected to inform Health Standards and recommend update if supported by data –to-date; to Inform other elements (HHC, SD) by recommending research tasks and clinical tests for medical operations based upon risk factor analyses; and determines if long-duration astronauts are at earlier risk for fragility fractures compared to terrestrial population and to peer-group (i.e., short-duration astronauts) in which no increase in fracture risk is hypothesized.

Generated information will be shared with the Space Medicine Division for their Conditions List.

Short Title: Bone Epidemiologic Analysis II

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:

Integration/Unique Aspects:
On-going data mining analyses as astronaut data accumulate.

Short Title: Hip QCT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

This study will describe in each astronaut:

1. How the QCT-measured changes in hip bone BMD and in the cross-sectional areas of cortical and trabecular bone correspond to different mitigating approaches to bone loss, i.e., biochemical or biomechanical, either in combination or singly. 
2. How the above QCT-measured changes in hip bone morphology translate to hip bone fracture loads (aka, “hip bone strength”) as determined by FE Modeling of QCT data.
3. How QCT-measured changes in hip bone morphology during postflight period translate to the recovery of baseline (i.e., preflight) FEM-derived hip bone strength after a mission on-board the International Space Station.

Integration/Unique Aspects:
Task will contribute to standard update in NASA-STD-3001.

Short Title: VCF-MRID

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Direct Contract

Aims:

Understand the association of long-duration missions with atraumatic fractures of the spine by the surveillance of vertebral compression fractures with lateral DXA scanning of the spine (Vertebral Fracture Assessment [VFA]) coincident with DXA MRID and triennials in returning long-duration astronauts. 

Integration/Unique Aspects:
This task is being conducted as part of Medical Requirement-035L Bone Densitometry. 

Short Title: Hip QCT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

This study will describe in each astronaut:

1. How the QCT-measured changes in hip bone BMD and in the cross-sectional areas of cortical and trabecular bone correspond to different mitigating approaches to bone loss, i.e., biochemical or biomechanical, either in combination or singly. 
2. How the above QCT-measured changes in hip bone morphology translate to hip bone fracture loads (aka, “hip bone strength”) as determined by FE Modeling of QCT data.
3. How QCT-measured changes in hip bone morphology during postflight period translate to the recovery of baseline (i.e., preflight) FEM-derived hip bone strength after a mission on-board the International Space Station.

Integration/Unique Aspects:
Task will contribute to standard update in NASA-STD-3001.

Short Title: VCF-MRID

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Direct Contract

Aims:

Understand the association of long-duration missions with atraumatic fractures of the spine by the surveillance of vertebral compression fractures with lateral DXA scanning of the spine (Vertebral Fracture Assessment [VFA]) coincident with DXA MRID and triennials in returning long-duration astronauts. 

Integration/Unique Aspects:
This task is being conducted as part of Medical Requirement-035L Bone Densitometry. 

Short Title: Bone Measures Add-On

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Unfunded - Task not within current budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:

Integration/Unique Aspects:
Bone Measures study placeholder -- to be identified during Occupant Protection Deconditioning Summit (June 2012).

Short Title: Bone Epidemiologic Analysis

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. To investigate the risk of microgravity exposure on long-term changes in bone health and fracture risk.
2. To provide a summary of the current evidence available on potential risk factors for bone loss, recovery and fracture following long-duration space exploration.

Integration/Unique Aspects:
This task is expected to inform Health Standards and recommend update if supported by data –to-date; to Inform other elements (HHC, SD) by recommending research tasks and clinical tests for medical operations based upon risk factor analyses; and determines if long-duration astronauts are at earlier risk for fragility fractures compared to terrestrial population and to peer-group (i.e., short-duration astronauts) in which no increase in fracture risk is hypothesized.

Generated information will be shared with the Space Medicine Division for their Conditions List.

Short Title: Bone Epidemiologic Analysis II

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:

Integration/Unique Aspects:
On-going data mining analyses as astronaut data accumulate.

Short Title: Hip QCT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

This study will describe in each astronaut:

1. How the QCT-measured changes in hip bone BMD and in the cross-sectional areas of cortical and trabecular bone correspond to different mitigating approaches to bone loss, i.e., biochemical or biomechanical, either in combination or singly. 
2. How the above QCT-measured changes in hip bone morphology translate to hip bone fracture loads (aka, “hip bone strength”) as determined by FE Modeling of QCT data.
3. How QCT-measured changes in hip bone morphology during postflight period translate to the recovery of baseline (i.e., preflight) FEM-derived hip bone strength after a mission on-board the International Space Station.

Integration/Unique Aspects:
Task will contribute to standard update in NASA-STD-3001.

Short Title: FE Strength Cutoff II

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:
1) Develop a dataset of FE hip strengths from human subjects: with ages covering the age
range of the astronauts and for which fracture outcome data have been collected.
a. The Rochester Bone Health Study will provide QCT scans from 408 persons to
Dr. Joyce Keyak who will estimate hip bone strength using her developed FEM at
UCI (Keyak, 2005).
b. FE data from 1a (above) will be combined with FE data generated from other
applications of Keyak FEM to QCT scans of study cohorts, which includes ISS
astronauts.

2) Determine FE strength cutoffs from to be used as a decision-tool by Space Medicine for
the following scheduled decision points (a-d):
a. to qualify an applicant for astronaut candidacy
b. to qualify an astronaut for a long-duration (LD) mission
c. to qualify a veteran LD astronaut for a second LD mission
d. to establish responsibility by occupational space medicine for a post-mission
fracture or osteoporosis diagnosis.

3) Review and finalize generated FE strength cutoffs with FE Task Group (along with the
inclusion of cohort biostatisticians) to recommend to Human Health Countermeasures as
a deliverable to Space Medicine and Office of Chief Health and Medical Officer.

Integration/Unique Aspects:
This task convened a "Bone Summit" -- an expert panel comprised of policy-makers in the International Society of Clinical Densitometry (ISCD), World Health Organization (WHO) and practitioners in the field of osteoporosis -- to review NASA’s assessment of skeletal integrity in astronauts and make recommendations on how best to assess skeletal integrity in astronauts.

Short Title: Nutrition SMO

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

1) include inflight blood and urine collection

2) expand nominal testing to include makers of normative markers of nutritional assessment

3) add an R+30 session to allow evaluation of postflight nutrition and implications for rehabilitation

Integration/Unique Aspects:
Nutrition SMO includes measures of factors that influence, mediate or reflect bone mineral metabolism, e.g. vitamins, minerals, oxidative damage markers, markers of iron and calcium metabolism, bone- and calcium-regulating hormones, stress hormones and urinary markers of bone turnover.  These measures increase the understanding of and cellular/biochemical etiology underlying skeletal adaptation in space.

Short Title:

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Direct Contract

Aims:
Optimization and minimization of exercise hardware is an iterative process. Lessons learned from the SPRINT study will be used to examine the extent to which exercise countermeasures can be minimized while maintaining or improving overall effectiveness.

1. This study should evaluate new exploration class exercise hardware. Proof of concept will be performed in bed rest followed by a flight evaluation. These studies specifically address gaps related to minimization of crew time spent exercising.

Integration/Unique Aspects:

Short Title: Musculoskeletal LDLM

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

NSBRI

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1)  Construct an exercise device that integrates aerobic, neurovestibular and resistive training in a compact design to fit the requirements for installation in a planetary base or landing module.

2) Conduct an exercise training study to demonstrate that cardiovascular and resistive exercise on the combined exercise device could improve measures of muscle strength and endurance in the 1-g environment.

3) Integrate the balance training component to the combined countermeasure device and develop an exercise regimen of aerobic exercise, neurovestibular training and resistive exercises aimed at reducing fall risk and proximal femoral bone loss by loading the hip and leg.

4) Conduct an experiment at the UTMB Flight Analog Research Unit where human test subjects (n=30, 15 Males, 15 females), with age, height and BMI representative of the astronaut corps, are randomized into intervention (integrated countermeasure regimen) and control (no exercise) groups in the spaceflight analog.  The aim of the experiment is to validate the ability of the combined exercise device to significantly reduce the risk for fall and subsequent injury by maintaining pre-bed rest physiological status. 

Integration/Unique Aspects:

Short Title: Pro-K

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. To determine if the ratio of acid (animal protein) to base (potassium) precursors in the diet is correlated with markers of bone formation and bone resorption during spaceflight.  Specifically, this aim will be addressed by controlling the ratio of animal protein to potassium intake during short-duration spaceflight.
2. To determine the influence of urinary calcium excretion on the predictability of changes in bone metabolism from acid and base precursors in the diet.
3. To determine if the ratio of acid to base precursors in the diet is related to length of time required for recovery from bone mineral loss after spaceflight.  This aim will be addressed during recovery from long-duration spaceflight. 

Integration/Unique Aspects:
Informs multiple disciplines and future work in nutrition.

Short Title: n-3 Fatty Acids

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Flight Analogs Project

Funding Status: Unfunded - Task not within current budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Determine whether n-3 fatty acid (either through diet or supplements) can mitigate bone loss during bed rest or spaceflight.

Integration/Unique Aspects:
TBD

Short Title: Bisphosphonates SMO

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

1. Obtain preflight and postflight Quantitative Computed Tomography (QCT) scans of the hip. The QCT scans will provide volumetric bone density information of both cortical and trabecular (spongy) bone regions of the hip. This study aims to show that bisphosphonates will significantly reduce bone mineral density loss and the increased risk of renal stone formation documented previously on untreated ISS crewmembers.
2. Perform: preflight and postflight Dual-energy X-Ray Absorptiometry (DXA) scans of the whole body, spine, hip, and heel; preflight and postflight scans of the tibia using peripheral Quantitative Computed Tomography (pQCT); preflight and postflight abdominal/retroperitoneal Ultrasound scans; preflight and postflight blood draws to measure serum markers of bone metabolism, and preflight, in-flight, and postflight urine collections to measure urinary markers of bone metabolism. Urine measurements will also be used to look at the risk for developing renal stones before, during and after flight.

Integration/Unique Aspects:
The decalcification of bone during skeletal adaptation to spaceflight is a major contributing risk factor for renal stone formation.

Short Title: Bone Model

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

Integration/Unique Aspects:

Short Title: Nervous system & bone loss

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. To determine if VBX causes bone loss by activation of the sympathetic nervous system in the VBX model using b-blocker-treated mice and mice lacking the b2AR globally or specifically in osteoblasts.
2. To analyze the bone phenotype of mice devoid of vestibular gravity sensor (Het-/- mice).
3. To determine if vestibular stimulation by centrifugation could be used as a countermeasure to bone loss under microgravity.

Integration/Unique Aspects:

Short Title: Bone strength recovery

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. Address the observed "discordant recovery dynamic" reported for astronaut data (Lang et al., JBMR 21:1224, 2006) by characterizing bone mass, bone mineral density (BMD), and bone strength relationships after HU and during various periods of recovery.
2. Examine multiple mission scenarios using HU, recovery for a period, and then a second HU exposure.
3. Follow the two-exposure protocol but with exercise (both aerobic and resistive) added during the recovery period.

Integration/Unique Aspects:
Proximal tibia micro-CT:  results are being generated from a collaboration with another HRP-funded investigator Dr. Stefan Judex at Stony Brook University. The data provide results with much higher resolution and greater insight into the details of the effects of hindlimb unloading and recovery upon the proximal tibia metaphysis, including both trabecular bone and the cortical shell.

Short Title: Sclerostin Mice

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

NSBRI

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

Integration/Unique Aspects:

Short Title: Early Arthritis

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

NSBRI

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

This project’s goal is to investigate the effects of microgravity on cartilage homeostasis by exposing two chondrocyte cell lines to a modeled microgravity environment using a rotating wall vessel bioreactor. Cells exposed to microgravity will be compared to cells incubated under normal gravitational conditions as a control, as well as an arthritic-like cell model induced by treating chondrocytes with pro-inflammatory cytokines such as IL-1B and oncostatin M (OSM). Disruptions in cell-matrix interactions, changes in cytoskeletal morphology and gene up-regulation will be evaluated to determine changes in chondrocyte metabolism.

Integration/Unique Aspects:

Short Title: SPRINT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

1)   Develop an evidence-based approach to maintain physiological function while simultaneously decreasing total exercise time and volume by development of a novel exercise prescription for use on ISS.  The exercise regimen will use higher intensity resistance exercises and interval aerobic exercise according to the Intramural and extramural experts convened for two workshops held in 2008: the NASA Muscle Workshop in June 2008 and the NASA International Space Station Exercise Prescription Workshop in October 2008.  

2) Include an increase in the intensity and a reduction in the volume of resistance exercises, include very short, but high intensity interval-type aerobic exercises, and start the exercise countermeasures as early as possible in the flight, preferably in the first week. 

Integration/Unique Aspects:
Evaluate the efficacy of new integrated resistance and aerobic training (SPRINT) program designed to minimize loss of muscle, bone and cardiovascular function during ISS missions.

Short Title: Musculoskeletal Health

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

NSBRI

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1) Does partial weight bearing (~1/6 g) mitigate losses observed with full unloading (~ 0 g)? 

2) Does low-dose radiation exposure change the bone or muscle response to partial gravity? 

Integration/Unique Aspects:
Coordination of radiation exposures with Brookhaven National Laboratory and NASA Space Radiation Space Laboratory (NSRL).

Short Title: Radiation Damage in Mice

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Space Radiation

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:
The aims of this pilot study are to examine the sensitivity of bone cells and tissue of C57BL/6 mice to acute high dose gamma radiation (6Gy dose of Cs-137 gamma rays) and the ability of low dose (50 mGy) radiation to mediate the effects of radioprotection.

Aim 1: Characterize the effect of a low, high and combined dose exposures in bone marrow tissue of vertebral bodies and proximal tibia, two tissues of different turnover rates.  Measured indices include: cancellous bone volume, trabecular bone architecture, bone marrow cell density, bone cell numbers(osteoclasts and osteoblasts) and/or surface-based indices of bone turnover.

Aim 2: Characterize the effects of Aim 1 for varying time periods following exposure to high dose.

Integration/Unique Aspects:
This pilot study "Radioadaptive response in animals: A pilot study to evaluate effects in bone tissue" is an add-on to a DOD-funded proposal awarded to Dr. Honglu-Wu in Radiation Element.

Short Title: Musculoskeletal Recovery

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. Determine whether the total exposure time to weightlessness or the number of repetitive exposures is the primary determinant of skeletal morphology and strength.
2. Determine the musculoskeletal consequences of altering the length and distribution of the recovery periods between multiple exposures to weightlessness.

Integration/Unique Aspects:

This task, using an animal model, is expected to provide knowledge to Elements (Human Health and Countermeasures) as to the impact of prolonged spaceflight on long-term bone health which may help direct the development and application of appropriate countermeasures.

Short Title: Testosterone

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

Long duration space flight is associated with loss of muscle mass and strength and loss of bone mass. To date exercise countermeasures have not been fully effective. Current evidence suggests that the combination of testosterone, amino acids, and exercise will optimize the effectiveness of the existing exercise and nutritional countermeasures. This intervention may improve exercise effectiveness or allow for a reduced volume of required exercise.

The specific aims of this study are to:

1. Determine the effect of monthly cycled testosterone replacement in conjunction with resistance exercise on muscle mass, muscle strength, bone mass and markers of bone metabolism in men aged 35-55.
2. Determine the effect of daily leucine supplementation in conjunction with resistance exercise on muscle mass, muscle strength, bone mass and markers of bone metabolism in women aged 35-55.

Integration/Unique Aspects:
This study is one of several potential pharmaceutical or nutritional countermeasures that if promising could be selected for flight validation (see Flight validation studies of pharmaceutical or nutritional supplements).

Short Title: Inflammatory Response

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Unfunded - Task not within current budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:

This placeholder is for evaluation of issues related to systemic inflammation during spaceflight.  

Integration/Unique Aspects:
TBD

Short Title:

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Aims:
Refinement of an exercise prescription using an isoinertial flywheel system will be performed in bed rest and / or flight. Prescription aims to protect muscle, bone and aerobic system agains long duration spaceflight using a small flywheel device.

Integration/Unique Aspects:

Short Title:

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Aims:

1. Exercise hardware concepts will be developed for maintaining fitness during deep space exploration. The best candidate device based on ground-based testing will be tested for effectiveness aboard ISS.

Integration/Unique Aspects:

Short Title: BioSurveillance

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Unfunded - Task not within current budget

Procurement Mechanism(s):

Direct Contract

Aims:

1. Includes in-flight blood and urine collection
2. To provide an ongoing repository of biochemical data to allow operational and research assessments of astronauts on ISS missions.
3. To determine the time course of changes during and after space flight in a broad-based biochemical profile to include biomarkers of nutritional, cardiovascular, musculoskeletal, pharmacological, immunological, and endocrine/general chemistry indices of health and physiology.
4. To evaluate countermeasure effectiveness during and after space flight.
   
   

Integration/Unique Aspects:

The dataset from the Nutrition SMO has been used by numerous groups to help identify or explain medical, scientific, and even engineering issues that have occurred during or after ISS missions.  The data have been used by Medical Operations to confirm the effectiveness of 800-IU/d vitamin D supplementation, to determine whether nutrient toxicities existed (secondary to supplement use), to evaluate renal stone risk in crew members who had experienced renal stones post flight, and to evaluate the effects of exercise device use on bone and calcium metabolism.  The ISS Program Office used data from this experiment to determine factors contributing to the Urine Processor Assembly (UPA) failure, and subsequently to make operational decisions for defining forward risk determinations and hardware constraints.  Perhaps most strikingly, the data provide evidence that folate-dependent 1-carbon metabolism may be altered in crew members who experienced vision changes post flight.  These vision changes have been described as the single biggest clinical issue to arise from space flight to date, and the relationships with 1-carbon metabolism intermediates never would have been discovered if a research surveillance protocol was not being conducted.  In this case, data from the Nutrition SMO may guide future countermeasure research and ultimately operational recommendations to minimize risk of vision changes in future crew members. The impact of the data collected to date provide the rationale for continuing this protocol, eliminating some tests while expanding to provide a repository of data to other scientific Disciplines.

Short Title: Integrated Bone & Muscle Metabolism

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

NSBRI

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:
understand the structural and functional relationship between muscle atrophy (i.e., sarcopenia) and bone loss (i.e., osteopenia) which occurs as a result of extended exposure to the spaceflight environment. The specific objectives of this proposal are to: 1) Examine the time course for structural, functional, and molecular changes occurring in muscle and bone in response to mechanical unloading; 2) Examine the effect of inhibiting, or exaggerating, unloading-induced muscle loss on unloading-induced bone loss; 3) Examine the effect of inhibiting, or exaggerating, unloading-induced bone loss on unloading-induced muscle loss and 4) Evaluate potential therapeutic strategies for prevention of muscle and bone loss during unloading. Upon completion of our specific aims, and based on our experimental approaches, we will recommend specific therapeutic strategies and countermeasures that target muscle and bone as an integrated unit and respect their inherent interdependency. To accomplish these objectives, we will use hindlimb suspension (HLS), a well established in vivo model of simulated microgravity unloading. Our overall hypothesis is that unloading-induced osteopenia is at least partially dependent on unloading-induced sarcopenia and, conversely, unloading induced sarcopenia is at least partially dependent on unloading-induced osteopenia. The rationale for this proposed research is that there has not been a comprehensive and simultaneous examination of the effects of unloading on both muscle and bone. Understanding how these two systems respond to simulated microgravity will allow for the development of effective countermeasures to preserve astronaut health during missions and upon return to Earth.

Integration/Unique Aspects:
Project funding begins 10/1/2012.

Short Title: Vascular-bone Coupling and Skeletal Health

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

NSBRI

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

AIM 1: Determine the functional and structural consequences of prolonged weightlessness and space radiation (simulated spaceflight) for bone and skeletal vasculature in the context of bone cell function and oxidative stress.

AIM 2: Determine the extent to which an anti-oxidant protects against weightlessness and space radiation-induced bone loss and vascular dysfunction.

AIM 3: Determine how space radiation influences later skeletal and vascular recovery from prolonged weightlessness and the potential of anti-oxidants to improve or prevent this recovery.

Integration/Unique Aspects:

Short Title: Nutrition SMO

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

1) include inflight blood and urine collection

2) expand nominal testing to include makers of normative markers of nutritional assessment

3) add an R+30 session to allow evaluation of postflight nutrition and implications for rehabilitation

Integration/Unique Aspects:
Nutrition SMO includes measures of factors that influence, mediate or reflect bone mineral metabolism, e.g. vitamins, minerals, oxidative damage markers, markers of iron and calcium metabolism, bone- and calcium-regulating hormones, stress hormones and urinary markers of bone turnover.  These measures increase the understanding of and cellular/biochemical etiology underlying skeletal adaptation in space.

Short Title: FUS – Bone Measures

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:

Integration/Unique Aspects:
Coordination of HHC measures with ExMC Flexible Ultrasound System (FUS) task.

Short Title: Animal Bone Microarchitecture

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Direct Contract

Aims:
Validate a non-invasive technology (non-ionizing radiation) to quantify disruptions in bone microarchitecture in an animal model of skeletal unloading.

Integration/Unique Aspects:
Develop non-invasive hardware or technology that can be used to detect disruptions in bone microarchitecture in an animal model for eventual use in ground-based and flight validation studies.

Short Title: Ground Bone Microarchitecture

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Direct Contract

Aims:
Validate a non-invasive technology (non-ionizing radiation) to be used in a ground-based human model of skeletal unloading to quantify disruptions in bone microarchitecture of the hip.

Integration/Unique Aspects:

Short Title: Flight Bone Microarchitecture

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project NSBRI

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Aims:
Applying a non-invasive technology (non-ionizing radiation) to quantify the effect size of spaceflight on parameters of hip bone microarchitecture of the long-duration astronauts. 

Integration/Unique Aspects:
Software/technology will have been validated in animal and ground-based models.

Short Title: Hip QCT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

This study will describe in each astronaut:

1. How the QCT-measured changes in hip bone BMD and in the cross-sectional areas of cortical and trabecular bone correspond to different mitigating approaches to bone loss, i.e., biochemical or biomechanical, either in combination or singly. 
2. How the above QCT-measured changes in hip bone morphology translate to hip bone fracture loads (aka, “hip bone strength”) as determined by FE Modeling of QCT data.
3. How QCT-measured changes in hip bone morphology during postflight period translate to the recovery of baseline (i.e., preflight) FEM-derived hip bone strength after a mission on-board the International Space Station.

Integration/Unique Aspects:
Task will contribute to standard update in NASA-STD-3001.

Short Title: Sweat

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Introduction: This task will investigate the rate and extent of bone loss in humans by monitoring the levels of two bone resorption markers in sweat, namely calcium and a collagen breakdown product, using a novel, micro-fabricated fluid collection capillary array, known as the micro-fabricated sweat patch (MSP) device. This device was developed specifically for use in microgravity.

Specific Aims:
The device will be tested in three populations that have different constitutive levels of bone remodeling:  young normal healthy individuals, air-force cadets undergoing regular heavy resistance training and healthy elderly individuals.  
Groups will include both male and female participants to evaluate sex-specific effects.
Samples will be obtained while subjects are at rest and during activity to evaluate effect sizes with skeletal loading.    

Integration/Unique Aspects:
Several different sweat collection techniques will be investigated to determine the most appropriate and efficient means of sample collection suitable for deployment during a space flight mission. Biomarker concentration will be determined in contemporaneous samples of sweat, blood and urine collected during both short (24 hr) and long-term studies (six months) to define the relationship between biomarkers levels in the respective biological samples. Bone mineral density (BMD) measures will be incorporated in the long-term studies to test the predictive value of sweat biomarkers to overall changes in bone mass. Future testing will utilize subjects undergoing bedrest simulations of micro- or partial gravity loading conditions.

Short Title: Calcium Isotope Study

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. Determine how quickly changes in skeletal loading produces detectable changes in urinary and blood Ca isotope composition
2. Begin to estimate how these changes vary between individuals
3. Resolve diurnal changes and other variations in urinary and blood Ca isotope composition., we will be able to
4. Reconstruct the isotopic composition of each subjects’ dietary Ca on a meal by meal basis (by measuring the isotopic composition of all dietary items containing significant Ca and obtaining the detailed records of what each subject ate)
5. Disentangle the dietary signal in urinary and blood Ca isotope composition from the endogenous physiological signal that reflects changes in bone mineral balance.

Integration/Unique Aspects:

Short Title: Ultrasound-Bone Quality

Responsible HRP Element: Exploration Medical Capability

Supporting Org(s):

NSBRI

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Development of a combined diagnostic and treatment ultrasound technology for early prediction of bone impairments and guided acceleration of fracture healing, using SCAD imaging and low-intensity pulse ultrasound.

Integration/Unique Aspects:

ExMC gaps supported by this task: ExMC 4.02, ExMC 4.06

Short Title: Wideband Bone

Responsible HRP Element: Exploration Medical Capability

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Small Business Innovation Research Phase II

Aims:

1. Demonstrate pulse-echo performance capability of Nautilus transducer through ex vivo tissue to simulate operation for spine or hip measurements with a single probe.
2. Demonstrate the advantage of the prove over conventional probes through bandwidth capability and collection of multiple relevant ultrasound parameters with a single probe.
3. Provide quantitative correlation between the trabecular micro-structure and received ultrasound signal through comparative analysis with other direct physiological measurements.
4. Complete packaging and electrical tuning of probe for integration with current NASA ultrasound systems to show adaptability.

Integration/Unique Aspects:

Short Title: BioSurveillance

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Unfunded - Task not within current budget

Procurement Mechanism(s):

Direct Contract

Aims:

1. Includes in-flight blood and urine collection
2. To provide an ongoing repository of biochemical data to allow operational and research assessments of astronauts on ISS missions.
3. To determine the time course of changes during and after space flight in a broad-based biochemical profile to include biomarkers of nutritional, cardiovascular, musculoskeletal, pharmacological, immunological, and endocrine/general chemistry indices of health and physiology.
4. To evaluate countermeasure effectiveness during and after space flight.
   
   

Integration/Unique Aspects:

The dataset from the Nutrition SMO has been used by numerous groups to help identify or explain medical, scientific, and even engineering issues that have occurred during or after ISS missions.  The data have been used by Medical Operations to confirm the effectiveness of 800-IU/d vitamin D supplementation, to determine whether nutrient toxicities existed (secondary to supplement use), to evaluate renal stone risk in crew members who had experienced renal stones post flight, and to evaluate the effects of exercise device use on bone and calcium metabolism.  The ISS Program Office used data from this experiment to determine factors contributing to the Urine Processor Assembly (UPA) failure, and subsequently to make operational decisions for defining forward risk determinations and hardware constraints.  Perhaps most strikingly, the data provide evidence that folate-dependent 1-carbon metabolism may be altered in crew members who experienced vision changes post flight.  These vision changes have been described as the single biggest clinical issue to arise from space flight to date, and the relationships with 1-carbon metabolism intermediates never would have been discovered if a research surveillance protocol was not being conducted.  In this case, data from the Nutrition SMO may guide future countermeasure research and ultimately operational recommendations to minimize risk of vision changes in future crew members. The impact of the data collected to date provide the rationale for continuing this protocol, eliminating some tests while expanding to provide a repository of data to other scientific Disciplines.

Short Title: Hip QCT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

This study will describe in each astronaut:

1. How the QCT-measured changes in hip bone BMD and in the cross-sectional areas of cortical and trabecular bone correspond to different mitigating approaches to bone loss, i.e., biochemical or biomechanical, either in combination or singly. 
2. How the above QCT-measured changes in hip bone morphology translate to hip bone fracture loads (aka, “hip bone strength”) as determined by FE Modeling of QCT data.
3. How QCT-measured changes in hip bone morphology during postflight period translate to the recovery of baseline (i.e., preflight) FEM-derived hip bone strength after a mission on-board the International Space Station.

Integration/Unique Aspects:
Task will contribute to standard update in NASA-STD-3001.

Short Title: Bone Epidemiologic Analysis

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. To investigate the risk of microgravity exposure on long-term changes in bone health and fracture risk.
2. To provide a summary of the current evidence available on potential risk factors for bone loss, recovery and fracture following long-duration space exploration.

Integration/Unique Aspects:
This task is expected to inform Health Standards and recommend update if supported by data –to-date; to Inform other elements (HHC, SD) by recommending research tasks and clinical tests for medical operations based upon risk factor analyses; and determines if long-duration astronauts are at earlier risk for fragility fractures compared to terrestrial population and to peer-group (i.e., short-duration astronauts) in which no increase in fracture risk is hypothesized.

Generated information will be shared with the Space Medicine Division for their Conditions List.

Short Title: Bone Epidemiologic Analysis II

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:

Integration/Unique Aspects:
On-going data mining analyses as astronaut data accumulate.

Short Title: FE Strength Cutoff II

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:
1) Develop a dataset of FE hip strengths from human subjects: with ages covering the age
range of the astronauts and for which fracture outcome data have been collected.
a. The Rochester Bone Health Study will provide QCT scans from 408 persons to
Dr. Joyce Keyak who will estimate hip bone strength using her developed FEM at
UCI (Keyak, 2005).
b. FE data from 1a (above) will be combined with FE data generated from other
applications of Keyak FEM to QCT scans of study cohorts, which includes ISS
astronauts.

2) Determine FE strength cutoffs from to be used as a decision-tool by Space Medicine for
the following scheduled decision points (a-d):
a. to qualify an applicant for astronaut candidacy
b. to qualify an astronaut for a long-duration (LD) mission
c. to qualify a veteran LD astronaut for a second LD mission
d. to establish responsibility by occupational space medicine for a post-mission
fracture or osteoporosis diagnosis.

3) Review and finalize generated FE strength cutoffs with FE Task Group (along with the
inclusion of cohort biostatisticians) to recommend to Human Health Countermeasures as
a deliverable to Space Medicine and Office of Chief Health and Medical Officer.

Integration/Unique Aspects:
This task convened a "Bone Summit" -- an expert panel comprised of policy-makers in the International Society of Clinical Densitometry (ISCD), World Health Organization (WHO) and practitioners in the field of osteoporosis -- to review NASA’s assessment of skeletal integrity in astronauts and make recommendations on how best to assess skeletal integrity in astronauts.

Short Title: VCF-MRID

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

Direct Contract

Aims:

Understand the association of long-duration missions with atraumatic fractures of the spine by the surveillance of vertebral compression fractures with lateral DXA scanning of the spine (Vertebral Fracture Assessment [VFA]) coincident with DXA MRID and triennials in returning long-duration astronauts. 

Integration/Unique Aspects:
This task is being conducted as part of Medical Requirement-035L Bone Densitometry. 

Short Title: Bisphosphonates SMO

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

1. Obtain preflight and postflight Quantitative Computed Tomography (QCT) scans of the hip. The QCT scans will provide volumetric bone density information of both cortical and trabecular (spongy) bone regions of the hip. This study aims to show that bisphosphonates will significantly reduce bone mineral density loss and the increased risk of renal stone formation documented previously on untreated ISS crewmembers.
2. Perform: preflight and postflight Dual-energy X-Ray Absorptiometry (DXA) scans of the whole body, spine, hip, and heel; preflight and postflight scans of the tibia using peripheral Quantitative Computed Tomography (pQCT); preflight and postflight abdominal/retroperitoneal Ultrasound scans; preflight and postflight blood draws to measure serum markers of bone metabolism, and preflight, in-flight, and postflight urine collections to measure urinary markers of bone metabolism. Urine measurements will also be used to look at the risk for developing renal stones before, during and after flight.

Integration/Unique Aspects:
The decalcification of bone during skeletal adaptation to spaceflight is a major contributing risk factor for renal stone formation.

Short Title: Ultrasound-Bone Quality

Responsible HRP Element: Exploration Medical Capability

Supporting Org(s):

NSBRI

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Development of a combined diagnostic and treatment ultrasound technology for early prediction of bone impairments and guided acceleration of fracture healing, using SCAD imaging and low-intensity pulse ultrasound.

Integration/Unique Aspects:

ExMC gaps supported by this task: ExMC 4.02, ExMC 4.06

Short Title: Hip QCT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

This study will describe in each astronaut:

1. How the QCT-measured changes in hip bone BMD and in the cross-sectional areas of cortical and trabecular bone correspond to different mitigating approaches to bone loss, i.e., biochemical or biomechanical, either in combination or singly. 
2. How the above QCT-measured changes in hip bone morphology translate to hip bone fracture loads (aka, “hip bone strength”) as determined by FE Modeling of QCT data.
3. How QCT-measured changes in hip bone morphology during postflight period translate to the recovery of baseline (i.e., preflight) FEM-derived hip bone strength after a mission on-board the International Space Station.

Integration/Unique Aspects:
Task will contribute to standard update in NASA-STD-3001.

Short Title: Bisphosphonates SMO

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

1. Obtain preflight and postflight Quantitative Computed Tomography (QCT) scans of the hip. The QCT scans will provide volumetric bone density information of both cortical and trabecular (spongy) bone regions of the hip. This study aims to show that bisphosphonates will significantly reduce bone mineral density loss and the increased risk of renal stone formation documented previously on untreated ISS crewmembers.
2. Perform: preflight and postflight Dual-energy X-Ray Absorptiometry (DXA) scans of the whole body, spine, hip, and heel; preflight and postflight scans of the tibia using peripheral Quantitative Computed Tomography (pQCT); preflight and postflight abdominal/retroperitoneal Ultrasound scans; preflight and postflight blood draws to measure serum markers of bone metabolism, and preflight, in-flight, and postflight urine collections to measure urinary markers of bone metabolism. Urine measurements will also be used to look at the risk for developing renal stones before, during and after flight.

Integration/Unique Aspects:
The decalcification of bone during skeletal adaptation to spaceflight is a major contributing risk factor for renal stone formation.

Short Title: DMab Analogue

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Flight Analogs Project NSBRI

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Determine if Denosumab can prevent skeletal deconditioning as characterized by bone measures (bone mass and bone turnover markers) in bed rest subjects.

Integration/Unique Aspects:
Validate use of Denosumab in bed rest with goal of eventual validation/use in flight

Short Title: DMab Flight

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project NSBRI

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Determine if Denosumab can prevent skeletal deconditioning as characterized by bone measures (bone mass and bone turnover markers) in astronauts.

Integration/Unique Aspects:

Short Title:

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Flight Analogs Project

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Determine if emerging drug (tbd) can prevent skeletal deconditioning as characterized by bone measures (bone mass and bone turnover markers) in bed rest subjects.

Integration/Unique Aspects:
Validate use of emerging drug (tbd) in bed rest with goal of eventual use in flight.

Short Title:

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

International Space Station Medical Project

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Determine if emerging drug (tbd) can prevent skeletal deconditioning as characterized by bone measures (bone mass and bone turnover markers) in astronauts.

Integration/Unique Aspects:

Short Title: Nutrition SMO

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

1) include inflight blood and urine collection

2) expand nominal testing to include makers of normative markers of nutritional assessment

3) add an R+30 session to allow evaluation of postflight nutrition and implications for rehabilitation

Integration/Unique Aspects:
Nutrition SMO includes measures of factors that influence, mediate or reflect bone mineral metabolism, e.g. vitamins, minerals, oxidative damage markers, markers of iron and calcium metabolism, bone- and calcium-regulating hormones, stress hormones and urinary markers of bone turnover.  These measures increase the understanding of and cellular/biochemical etiology underlying skeletal adaptation in space.

Short Title: SPRINT

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Human Health Countermeasures

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

Direct Contract

Aims:

1)   Develop an evidence-based approach to maintain physiological function while simultaneously decreasing total exercise time and volume by development of a novel exercise prescription for use on ISS.  The exercise regimen will use higher intensity resistance exercises and interval aerobic exercise according to the Intramural and extramural experts convened for two workshops held in 2008: the NASA Muscle Workshop in June 2008 and the NASA International Space Station Exercise Prescription Workshop in October 2008.  

2) Include an increase in the intensity and a reduction in the volume of resistance exercises, include very short, but high intensity interval-type aerobic exercises, and start the exercise countermeasures as early as possible in the flight, preferably in the first week. 

Integration/Unique Aspects:
Evaluate the efficacy of new integrated resistance and aerobic training (SPRINT) program designed to minimize loss of muscle, bone and cardiovascular function during ISS missions.

Short Title: Exercise Training on Compact Equipment

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

NSBRI

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:

This proposal aims to validate in an analog setting a small compact exercise device for the

protection of cardiovascular, muscle, and bone health. This study leverages both currently funded

NSRBRI and NASA work to bring together for the first time, a promising new exercise device and

exercise prescription thus placing this study at a high countermeasure readiness level (moving

from 6-7). More specifically, the NSBRI funded M-MED device uses a flywheel to provide loading for

either high force-low repetition resistance exercise or low force-high repetition, endurance exercise

(rowing). Recent data support M-MED training effectiveness in both ambulatory subjects and over

10 days of muscle unloading using unilateral lower limb suspension model. Accordingly, a new

NASA funded exercise prescription study integrating resistance and aerobic training (iRAT) has

been effective in the preservation of muscle and cardiovascular function over 14 days of bedrest,

but requires the use of 5 different exercise machines. This proposal will combine the M-MED

exercise device and the iRAT exercise prescription into a 70 day bedrest study. Outcome

measurements related to cardiovascular, muscle and bone health will be obtained and integrated to

assess countermeasure effectiveness.

Integration/Unique Aspects:
Task to start 10/1/2012.

Short Title: Bone Epidemiologic Analysis

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Active - Task currently funded

Procurement Mechanism(s):

NASA Research Announcement

Aims:

1. To investigate the risk of microgravity exposure on long-term changes in bone health and fracture risk.
2. To provide a summary of the current evidence available on potential risk factors for bone loss, recovery and fracture following long-duration space exploration.

Integration/Unique Aspects:
This task is expected to inform Health Standards and recommend update if supported by data –to-date; to Inform other elements (HHC, SD) by recommending research tasks and clinical tests for medical operations based upon risk factor analyses; and determines if long-duration astronauts are at earlier risk for fragility fractures compared to terrestrial population and to peer-group (i.e., short-duration astronauts) in which no increase in fracture risk is hypothesized.

Generated information will be shared with the Space Medicine Division for their Conditions List.

Short Title: Bone Epidemiologic Analysis II

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Funding Status: Planned - Task expected to be within budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:

Integration/Unique Aspects:
On-going data mining analyses as astronaut data accumulate.

Short Title: n-3 Fatty Acids

Responsible HRP Element: Human Health Countermeasures

Supporting Org(s):

Flight Analogs Project

Funding Status: Unfunded - Task not within current budget

Procurement Mechanism(s):

NASA Research Announcement

Aims:
Determine whether n-3 fatty acid (either through diet or supplements) can mitigate bone loss during bed rest or spaceflight.

Integration/Unique Aspects:
TBD

Short Title:

Responsible HRP Element: Human Health Countermeasures