Space exploration is embedded into the foundation of our past, exists at the forefront of the present and is inevitable in our society’s future. We, as a species, first set our sights on the closest celestial body, the Moon. Since then, society’s ambitions have extended far beyond the confines of the Moon, with the Martian surface becoming an extra-terrestrial target location for space exploration, data collection and potential colonization. History is known to repeat itself, whilst this common saying is often overlooked, its application is rather fitting when the details of this instance are examined. We, as an internationally divided species, have entered into a contemporary space race. In direct comparison to ascendant events of the Cold War, this modern contest is more attributed to an expression of technological prowess rather than a show of the superior ideology. Mars colonization would irrefutably be the crowning achievement of the century thus far. But beyond the technical intricacy of the task, the attributes and implications of becoming a multi-planetary species provide compelling rationales that argue in favour for crewed interplanetary exploration. With the prospect of advances in astronautical engineering, medicine and robotics, both the United States and China have become prominent figureheads of this contemporary space race to Mars. However, in pursuit of becoming the pioneering claimant of technological superiority, these two nations have perhaps overlooked the pre-existing issues that perpetually plague society. Many societal imperfections that exist are decipherable; including poverty, overpopulation and climate change. This list is not easily exhaustible, but a concentrated focus of inputs (namely capital, labour, natural resources and time) could lead to a more idealistic society. The overarching implications of the opportunity costs associated with space exploration are visualized by these issues. Thus, by dissecting the components of Mars exploration, this report seeks to evaluate the significance of the space industry and to ultimately evaluate how we, as a collective, should look to develop our civilisation going into the future.
The authors present aeromedical implications from COVID-19 disruptions on the civil aviation sector, consider mental health impacts on pilots, and discuss possible helpful responses to support pilot mental health. A multiple database review investigated articles from January 2002 to May 2021 on severe commercial aviation disruptions impacting pilot mental health and on pilot mental health coping or treatment. Fifteen papers were identified. During the COVID-19 pandemic, airline flights were severely reduced. By January 2021, airlines shed thousands of jobs and 24 airlines no longer existed. General population surveys found 13% of individuals had "serious distress" from the pandemic. In two aviation focused surveys, 40–66% of pilots agreed or strongly agreed that their mental health worsened since the COVID-19 pandemic. Compared to past Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) patients, more COVID-19 patients have mental health symptoms in the acute phase of illness; while about 10% of COVID-19 patients appear to have chronic or "long haul" symptoms. Mental Health treatment and coping strategies found helpful to pilots are discussed. Pilots remain at risk for mental health symptoms and illness due to the COVID-19 pandemic. For those who develop severe distress or mental illness from the effects of the pandemic (or COVID-19 infection), early treatment with psychotherapy and/or approved medications may be warranted. This may decrease the likelihood of persistent physical or cognitive or mental health symptoms that would delay a return to flying status.
Health issues typical of the expected commercial space tourism (CST) population are considered manageable, but less is known about the impact of psychological conditions on spaceflight participant (SFP) wellbeing and safety during spaceflight. Plans to detect and prepare SFP for potential effects of psychological conditions emerging during spaceflight are unknown and may be inadequate. The purpose of this integrative literature review was to identify CST operators’ plans for SFP psychological assessment and training. Forty-four (44) articles met inclusion criteria and were largely composed of grey and popular literature sourced online. Plans for SFP psychological assessment and training prior to CST were not found, although vague descriptions of training for specific CST opportunities and limited medical assessment information was located. An undisclosed or possibly non-existent psychological support approach will likely be insufficient to ensure SFP safety and optimal performance during emergencies. Instead, detailed and focused intentional screening of SFP should be completed by appropriate members of a transdisciplinary healthcare team at various phases of the spaceflight experience. Following assessment, collaborative decision making to develop training, interventions, and mitigation strategies in support of individual SFP psychological needs should occur before, during and after spaceflight. The strategies should align with standards of care and inform urgently-needed SFP research. Knowledge gained from future research will contribute to appropriate, effective SFP psychological assessments, intervention and training development, testing, and implementation, and overall management of SFP programs and strategy development aimed at optimizing the CST experience and goals.
During the ISS4Mars workshops in 2020–2021, personnel from the International Space Station (ISS) partner agencies convened to reflect on scenarios for how the ISS could be used and its operations possibly modified to simulate aspects of a human mission to Mars. Scientific leaders, operations experts, crewmembers, managers, and flight surgeons discussed the five hazards of human spaceflight—gravity transitions, radiation, isolation and confinement, distance from Earth, and hostile closed environments—and considered how an ISS-based analog of Mars transit could benefit assessments and mitigations of these hazards. A focused writing team then discussed the advantages and disadvantages of each approach identified by the workshop participants before developing a set of eight use cases to consider the feasibility of implementing on the ISS. The writing team also identified the prerequisites needed, including ground analog studies simulating a mission to Mars required to verify measurements and procedures, before testing could begin on the ISS. Five of the use cases were considered feasible to assess in simulations using an ISS-based analog of Mars transit if some ground rules and assumptions were met. These five use cases were Earth-independent medical operations, Earth-independent integrated operations, life support and food for a one year duration, lower-body negative pressure as a countermeasure against the effects of exposure to microgravity, and fitness levels after landing. In addition, three more extensive interventions—extended Mars surface operations, a small-volume transit analog, and artificial gravity—were deemed unfeasible for testing on the ISS. Experience gained from the five use cases executed on the ISS may help answer some of the questions in the deferred scenarios, or it may be possible to complete them on another platform (e.g. commercial space station, lunar habitat). Simulating conditions during a Mars mission on the ISS will afford higher fidelity for assessing multiple integrated hazards of human spaceflight, however, ground analogs of Mars missions can be used to ensure effective measures and experimental design before testing begins on the ISS. The strategic concepts refined as part of these workshops were brought to a multilateral forum, Mulitlateral Human Research Planel for Exploration (MHRPE), where ISS partner agencies are now discussing implementation plans to provide new opportunities to use the ISS to prepare for deep space exploration over the coming decade. In this publication we present a summary of the international strategic plans for future research that will enable operations, software, and countermeasures to be developed that will reduce the risk to humans during future crewed missions to Mars.
The review is exploring the improvement of medical proficiencies needed for health support of crewmembers in explorative manned missions to Lunar and Martian surfaces, in which is effectively crucial for missions success. This article implores the latest research developments and publications in order to understand the progress made by global scientific communities in the race of landing human on extraterrestrial planets in the near future. It dissects through the medical event rates and level of expertise projected for such missions, summary of recent physiological update, the Crew Health Habitation System profiling, and the advancement of diagnostic and interventional aptitudes.
Management of menstruation, pregnancy prevention, and mitigation of gynecologic-related pathology in the space environment with or without the use of hormonal modalities requires thorough counseling and complex decision-making. Factors that must be considered by astronauts and their physician teams range from desirability of contraception and/or menstrual suppression to weighing the risk and benefit profiles of various formularies of progesterone or combination estrogen and progesterone-containing hormonal modalities on various pathologies, including abnormal uterine bleeding, ovarian cyst production and risk of torsion, bone mineral density and osteopenia, venous thromboembolism, and cancer. Simultaneously, the choice to use or abstain from one of these modalities may also impact onboard mass, volume, and engineering considerations relating to stowage of onboard resources and sanitation products as well as impacting the design or function of waste management systems. While significant gynecological morbidity has not been reported during spaceflight, the objective of this review is to untangle these interrelated complexities to empower astronauts, physician and pharmacy teams, and engineering teams to enable the development of systems and protocols that support astronaut autonomy in reproductive decision-making and optimally mitigate future gynecologic risk.
Heart disease is the #1 cause of disease-related death in pilots & astronauts in the world and coronary artery disease (CAD) is found in 85% of pilot autopsies after fatal accidents [1], [2], [3]. Acute cardiovascular incidents in flight crew can result in in-flight emergencies requiring emergency diversion, or at worst a major aircraft accident. When including passengers, emergency landings, to include airport diversion, occur in 1 out of every 604 flights at an average cost of $38,000 and are most commonly caused by cardiovascular processes including myocardial infarction and syncope [4]. Medical flying standards in aviators with coronary artery disease (CAD) are well established by the United States Air Force and other military branches such as the Army, Navy, and Coast Guard as well as the Federal Aviation Administration (FAA), National Aeronautics and Space Administration (NASA), and United States NATO allies. However, CAD screening standards vary widely from one aviation organization to another and are strikingly absent in some. In this article, the authors propose an evidence-based CAD screening algorithm based on published literature from 70 years of aircrew specific cardiac data gathered from nearly 1.3 million studies performed on over 300,000 aircrew. Given the advancement of space flight and the commencement of high performance recreational flight opportunities, there is a new era of passengers that will need baseline medical screening and clearance prior to embarking on their adventures. The following proposed screening and disposition algorithms offer evidence-based models for this need.
•Space presents ample opportunities for a wide range of highly innovative applications.•Patents are an excellent barometer of innovation.•Major innovations in healthcare are a result of space medical research.•The rapid advancements in human space exploration endeavors boost the demand for research and innovation in space medicine.
•Saudi Arabia aims to become an integral country in the space medicine field.•Advancements will require strong research focuses and social opportunities.•Current goals include funding and opportunities for medical students and doctors.
Abstract Many space agencies have recently agreed on the Moon as the next step in human space exploration, and impressive progress is being made with regard to transportation, particularly launch and lander technologies. Meanwhile, a number of simulation habitats have been built and occupied by volunteer crews in order to study the human factors involved with life on the Moon or on Mars. The number of such habitats is ever increasing, and we believe it to be both necessary and helpful to provide an overview of what is already existing and what lessons in habitat design have already been learned from tests with human inhabitants. In this paper, we therefore review (1) the active analog habitats published in the English-speaking literature, (2) a selection of inactive, but pioneering analog habitats, and (3) a selection of research bases in extreme environments such as Antarctica that have not primarily been built for spaceflight simulations but provide interesting insights nonetheless. Specifically, we explore the architectural concepts incorporated and tested in existing habitats, technologies already implemented, and the scientific questions addressed. Our goals are twofold: (1) provide a guideline to researchers who seek a simulation facility for their research questions, and (2) advise the construction of future habitats for simulations and, ultimately, for missions to the surface of the Moon or Mars.
Astronauts are prone to a condition known as disuse osteoporosis as the microgravity environment negates the need for skeletal weight bearing. Recently, the development of new strategies to study bone loss in microgravity has been advancing at a rapid pace. As a result, several emerging technologies have paved the way for new research into the cellular and physiological mechanisms involved in disuse osteoporosis. In this review, we discuss the most impactful and current methodologies and technologies for both in vivo and in vitro studies of bone loss in space and with simulators on Earth from the past decade. We cover research performed on the International Space Station, uncrewed satellites, head-down tilt bed rest, rodent hindlimb unloading, and 2D/3D clinorotation for cell culture which are all established methods to mechanically unload the skeleton and/or bone cells. We also summarize the experimental findings documenting the changes that occur following exposure to unloading on a macroscopic scale, such as morphometric changes to the bone structure, and on the microscopic scale, such as effects on bone-forming osteoblasts, bone-resorbing osteoclasts, and mechanical stress-sensing osteocytes.
Defects in signaling networks that regulate cellular activities, such as growth and survival can lead to cancer development. Space environment affects signal molecules and genes involve in DNA damage response, cell proliferation, cell metabolism, and cytoskeleton signaling among others. Reduced gravity and exposure to harmful radiation are the main stress factors encountered in space. While a potential risk of tumor initiation has been extensively investigated for space-radiation, research efforts on the effects of microgravity on cancer cells have focused mainly on tumor progression and migration. However, the space environment comprises both cosmic radiation and reduced gravity, and, therefore, potential additive or synergistic effects need to be considered. For instance, impaired DNA repair processes due to lack of gravity can compromise the cellular response to radiation, which in turn leads to accumulation of DNA damage and increase of the risk of tumor initiation and progression. In this review, recent research aiming at identifying the association between space radiation, microgravity or the combination of both with tumor development and the possible underlying cellular mechanisms is summarized. Furthermore, space-associated stress factors, such as psychological stress, sleep disturbances or the potential role of the immune system in tumor initiation and development in space are discussed.
The circadian clock is an endogenous time-generating system accountable for the synchrony between the internal and the geophysical time. In recent years, chronobiology research has demonstrated that the circadian regulation of numerous molecular and cellular processes leads to a temporal control of physiology and behaviour. These findings alert to the negative impact on health caused by a disrupted internal timing. In this review we address the relation between atypical external factors in long-term space flights (or other extreme environments) and circadian clock misalignment, stressing the need of establishing preventive measures to minimize the effect on human health and performance. For this purpose, daily activities of astronauts (or humans living in extreme environments) could be planned according to the individual's internal biological time, which can be achieved through the synergy between the molecular characterization of the circadian clock and computational predictive mathematical models.
Purpose The fascia receives more and more attention as functional component of the body in fundamental and applied human life sciences on Earth. As shaping element of the human body movement apparatus the fascia comprises a multicellular three dimensional layer of connective tissue components (collagens, fibrocytes/-blasts, extracellular matrix), more specialized fibroblast-derived cells (fascia-, telocytes), contracting myofibroblasts, mechano- and propriosensors, and nociceptors. Fascia is a multicellular/multicomponent biological material for human body structural and functional integration as well as serving as a sensation organ in terms of movement and performance adjustment, body awareness and control. Methods The present scoping review elaborates on structure, function and biomechanical properties (tone, stiffness, viscoelasticity) of fascia mainly selected from recent literature data in order to highlight the role of the loading-sensitive i.e. structural and biomechanical support mechanisms of this ensheathment structure that can influence shape, body motions and performance on Earth. Results Superficial and deep fascia of skeletal musculature is a continuum structure thus linking muscle, tendon and bone to provide a unique tensional support system that stores about 20 percent of total muscle force production. First own studies on the normal healthy human body showed that equally to muscle and tendon fascia is susceptible to disuse conditions on Earth. Like muscle, fascia can be re-enforced by high-load physical exercise as countermeasure in laboratory set-ups (i.e. bed rest) on the ground. If and to what magnitude fascia structure and property are affected in microgravity is an open issue that warrants further investigations on fascial adaptation in real spaceflight. Conclusion Elucidation of the fascia conundrum in human performance requires improved assessment tool development for interdisciplinary investigations under normal conditions, in clinical rehabilitation on Earth, and following de-/reconditioning of astronaut́s performance in environmental and space medicine.
•A comprehensive summary of Neuropeptide Y (NPY) phylogeny, structure, and NPY receptors.•NPY is increasingly released in human subjects exposed to extreme environments (Space, Antarctic region).•Physical exercise increases the release of NPY and seems to influence the success, and higher levels appear to strengthen stress resistance and resilience.•NPY’s physiological functions and impact as a key neuropeptide in stress reaction and homeostasis, such as energy expenditure, sleep, and thermoregulation.
•Proteome changes during the space flights correlate with experiments on Earth.•Molecular protein-interaction networks revealed adaptation to the space flight.•OMICs technologies as a new tool to study human adaptation to the space flight.
Aside2Section Authors: Gordon Roesler, Robots in Space LLC, President; and David Kornuta, United Launch Alliance, CisLunar Project Lead.2 from Earth, the inner solar system is like a vast desert where water and other volatiles are scarce. An old saying is, “In the desert, gold is useless and water is priceless.” While water is common on Earth, it is of very high value in space. Science missions to the Moon have provided direct evidence that regions near the lunar poles, which are permanently in shadow, contain substantial concentrations of water ice. On the lunar surface, water itself is critical for human consumption and radiation shielding, but water can also be decomposed into hydrogen and oxygen via electrolysis. The oxygen thus produced can be used for life support, and hydrogen and oxygen can be combusted for rocket propulsion. Due to the Moon’s shallow gravity well, its water-derived products can be exported to fuel entirely new economic opportunities in space.
•Sarcopenia and microgravity account for similar pathophysiological factors.•Sarcopenia models serve to investigate muscle deconditioning in microgravity.•Anabolic resistance partly impairs responsiveness to therapeutic stimulation.•REDD1 may contribute to molecular dysregulations in anabolic resistance.•Analog research is needed to counteract detrimental effects of space travel.
The very thought of life on other planets has enticed the human minds to broaden horizon of his thoughts both out of shear curiosity, and to explore various life forms those may exist on these planets. While we look for these answers, human race is equally challenged at different levels by every space ventures that are being undertaken worldwide. Of these, the health and physiology is of prime importance, owing to potentially variable effects, the very stakeholder may experience at the helm of all explorations. Among many factors, the environment during space flight specifically due to the microgravity, astronauts experience many health difficulties. Understanding such health related issues necessitate knowing how does microgravity influence behavior of the functional unit of the human tissues, the cells. Present review focuses on analyzing the impact of microgravity on behavior of primitive cells types, the stem cells, present in almost all adult tissues providing much needed support against routine wear and tear of body by targeted differentiation. During space flights, it is believed that some of the cells are very sensitive to mechanical unloading which might be the potential cause of health problems faced by astronauts during and after space travel. To understand such intricacies and how stem cells are affected, the present review has been compiled to discuss the effects of microgravity on the stem cells and to understand pathophysiology associated during space travel.
