Predicting Exploration Crew Medical Officer Training Needs: Applying Evidence-Based Predictive Analytics to Space Medicine Training.

Introduction: Predictive analytics may be a useful adjunct to identify training needs for exploration class medical officers onboard deep space vehicles.

Methods: This study used a preliminary version of NASA's newest medical predictive analytics tool, the Medical Extensible Database Probabilistic Risk Assessment Tool (MEDPRAT), to test the application of predictive analytics to exploration crew medical officer curriculum design for 5 distinct design reference mission (DRM) profiles. Partial and fully treated paradigms were explored.

Comparison of Camera-Acquired Vital Signs to Conventional Vital Signs in a Space-Analog Environment.

Introduction: Vital sign acquisition is a key component of modern medical care. In wilderness and space medical settings, vital sign acquisition can be a difficult process because of limitations on available personnel or lack of access to the patient. Camera-acquired vital signs could address each of these difficulties.

Long Round-Trip Time Delay Effects on Performance of a Simulated Appendectomy Task.

No current astronauts have surgical training, and medical capabilities for future missions do not account for it. We sought to determine the effect of communication delays and text-based communication on emergency medicine physician (EMP) performance of a simulated surgical procedure and the ideal training paradigm for remote surgery. In this study, 12 EMPs performed an appendectomy on a virtual reality laparoscopic simulator after tutorial.

A Method to Determine Capabilities and Resources for Spacecraft Medical Systems.

This paper describes the method for assigning medical diagnostic and treatment capabilities and resources to the database which assists with an updated probabilistic risk analysis (PRA) tool for exploration class medical system planning. The National Aeronautics and Space Administration has used PRA since 2011 to inform mission medical system design, but existing tools are designed only for low Earth orbit. An updated PRA tool was needed to assist with exploration class missions.

Enabling Human Space Exploration Missions Through Progressively Earth Independent Medical Operations (EIMO).

Current Space Medicine operations depend on terrestrial support to manage medical events. As astronauts travel to destinations such as the Moon, Mars, and beyond, distance will substantially limit this support and require increasing medical autonomy from the crew. This paper defines Earth Independent Medical Operations (EIMO) and identifies key elements of a conceptual EIMO system.

A 3D-Printed Portable Sterilizer to Be Used During Surgical Procedures in Spaceflight.

During spaceflight, it is important to consider the mechanisms by which surgeries and medical procedures can be safely and efficiently conducted. Instruments used to carry out these processes need to be sterilized. Thus, we have designed and tested a three-dimensional-printed (3D-printed) portable sterilizer that implements far ultraviolet-C (Far UV-C) light radiation to disinfect bacteria and microorganisms from surgical instruments.

Selecting Medical Conditions Relevant to Exploration Spaceflight to Create the IMPACT 1.0 Medical Condition List.

Medical conditions occurring in spaceflight pose risks to the crew and the mission and these risks will be exacerbated during exploration-class missions. Probabilistic risk assessment is a method used at NASA to quantify this risk for low-Earth orbit operations. Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) is a next-generation tool suite that will perform these assessments for exploration-class missions.

The value of a spaceflight clinical decision support system for earth-independent medical operations.

As NASA prepares for crewed lunar missions over the next several years, plans are also underway to journey farther into deep space. Deep space exploration will require a paradigm shift in astronaut medical support toward progressively earth-independent medical operations (EIMO). The Exploration Medical Capability (ExMC) element of NASA's Human Research Program (HRP) is investigating the feasibility and value of advanced capabilities to promote and enhance EIMO.

Lessons Learned on a High-Altitude Expedition to Mount Kilimanjaro.

High-altitude expeditions expose teams to particular medical, environmental, and social challenges that can have unintended and severe consequences for crew members. In June 2017, the 9-d Equal Playing Field (EPF) expedition to Mount Kilimanjaro to set a world record for the highest-altitude soccer match ever played demonstrated the variety of challenges that may arise during these types of trips. This trip included a full-length soccer match at 5714 m (18,746 ft), leading to additional challenges for expedition members participating in the athletic event.

Prophylactic Splenectomy and Hyposplenism in Spaceflight.

There is debate whether astronauts traveling to space should undergo a prophylactic splenectomy prior to long duration spaceflight. Risks to the spleen during flight include radiation and trauma. However, splenectomy also carries significant risks.

Time Cost of Provider Skill: A Pilot Study of Medical Officer Occupied Time By Knowledge, Skill, and Ability Level.

On space missions one must consider the operating cost of the medical system on crew time. Medical Officer Occupied Time (MOOT) may vary significantly depending on provider skill. This pilot study assessed the MOOT Skill Effect (MOOTSkE).

Spatial Volume Necessary to Perform Open Appendectomy in a Spacecraft.

With the increase in crewed commercial spaceflight and expeditions to the Moon and Mars, the risk of critical surgical problems and need for procedures increases. Appendicitis and appendectomy are the most common surgical pathology and procedure performed, respectively. The habitable volume of current spacecraft ranges from 4 m³ (Soyuz) to 425 m³ (International Space Station).

Preliminary Evidence-Based Method of Medical Kit Design for Wilderness Expeditions Modeled by a High-Altitude Expedition to Mount Kilimanjaro.

Background: Wilderness expeditions require extensive planning and the correct medical supplies to ensure clinical care is possible in the event of illness or injury. There are gaps in the literature regarding evidence-based methods for medical kit design.

Objectives: This report describes a preliminary method for predicting medical events to determine medical supply requirements for a wilderness expedition.

McLeod Syndrome in a Commercial Airline Pilot.

The following case report describes the first known case of McLeod Syndrome in a commercial airline pilot. The case describes a 56-yr-old experienced pilot who showed a slow and subtle decline in cognitive function and muscle control in the cockpit. On further examination, the pilots erratic behavior and movement along with lab abnormalities pointed toward McLeod Syndrome.

Unmet Healthcare Need Due to Cost Concerns among U.S. Transgender and Gender-Expansive Adults: Results from a National Survey.

This study examines past-year unmet healthcare need due to cost experienced by transgender and gender-expansive (TGE) adults in the United States in the context of the Patient Protection and Affordable Care Act (ACA). It also aims to estimate the importance of having health insurance among TGE Americans (transgender men, transgender women, nonbinary/genderqueer people, and cross-dressers). Data were from the 2015 U.

A Randomized Controlled Trial of a 6-Month Low-Carbohydrate Intervention on Disease Progression in Men with Recurrent Prostate Cancer: Carbohydrate and Prostate Study 2 (CAPS2).

Purpose: Both weight loss and low-carbohydrate diets (LCD) without weight loss prolong survival in prostate cancer models. Few human trials have tested weight loss or LCD on prostate cancer.

Experimental Design: We conducted a multi-site randomized 6-month trial of LCD versus control on PSA doubling time (PSADT) in patients with prostate cancer with biochemical recurrence (BCR) after local treatment.

Prophylactic Acetaminophen or Ibuprofen Results in Equivalent Acute Mountain Sickness Incidence at High Altitude: A Prospective Randomized Trial.

Objective: Recent trials have demonstrated the usefulness of ibuprofen in the prevention of acute mountain sickness (AMS), yet the proposed anti-inflammatory mechanism remains unconfirmed. Acetaminophen and ibuprofen were tested for AMS prevention. We hypothesized that a greater clinical effect would be seen from ibuprofen due to its anti-inflammatory effects compared with acetaminophen's mechanism of possible symptom reduction by predominantly mediating nociception in the brain.

Graduate Social Work Faculty's Support for Educational Content on Women and on Sexism.

Social work faculty play an important role in preparing students to address sexism and engage in culturally competent practice with women. This study examines the nature of U.S.

Tolerance of centrifuge-simulated suborbital spaceflight in subjects with implanted insulin pumps.

Introduction: With commercial spaceflight comes the possibility of spaceflight participants (SFPs) with significant medical conditions. Those with previously untested medical conditions, such as diabetes mellitus (DM) and the use of indwelling medical devices, represent a unique challenge. It is unclear how SFPs with such devices will react to the stresses of spaceflight.

Will it help? Identifying socialization discourses that promote sexual risk and sexual health among African American youth.

Because much of the existing research examining sexual communication to African American youth focuses on demographic and parental factors predicting sexual risk behaviors, less is known about factors predicting sexual health, and little is understood about the contributions of peer communications. The current study aimed to expand existing approaches by assessing which socialization discourses communicated by parents and peers contribute to sexual risk and health outcomes (sexual assertiveness, positive sexual affect, and condom self-efficacy). Participants were 631 African American undergraduates (73% female) who indicated the extent to which they had received from their parents and peers each of 28 messages representing four cultural discourses: abstinence, relational sex, sex positive, and gendered sexual roles.

Contributions of divergent peer and parent sexual messages to Asian American college students' sexual behaviors.

Receiving more parent sexual communication is generally linked to a later age of first sexual intercourse and less sexual risk taking. However, Asian American youth report minimal parent sexual communication, later sexual initiation, and fewer sexual risks than their counterparts. What contributes to this unexpected pattern of sexual communication and sexual behaviors? To answer this question, we surveyed 312 Asian American college students ages 17 to 22 on their sexual behaviors, parent sexual communication, and peer sexual communication.