Challenges in Clinical Management of Radiation-Induced Illnesses During Exploration Spaceflight

2019 ◽  
Vol 90 (11) ◽  
pp. 966-977
Author(s):  
Rebecca S. Blue ◽  
Jeffery C. Chancellor ◽  
Rahul Suresh ◽  
Lisa S. Carnell ◽  
David P. Reyes ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Clinical Management ◽  
Space Station ◽  
Clinical Manifestations ◽  
Low Earth Orbit ◽  
Acute Radiation ◽  
Mission Design ◽  
Prodromal Symptom ◽  
Solar Particle Events ◽  
Radiation Induced

INTRODUCTION: Analysis of historical solar particle events (SPEs) provides context for some understanding of acute radiation exposure risk to astronauts who will travel outside of low-Earth orbit. Predicted levels of radiation exposures to exploration crewmembers could produce some health impacts, including nausea, emesis, and fatigue, though more severe clinical manifestations are unlikely. Using current models of anticipated physiological sequelae, we evaluated the clinical challenges of managing radiation-related clinical concerns during exploration spaceflight.METHODS: A literature review was conducted to identify terrestrial management standards for radiation-induced illnesses, focusing on prodromal symptom treatment. Terrestrial management was compared to current spaceflight medical capabilities to identify gaps and highlight challenges involved in expanding capabilities for future exploration spaceflight.RESULTS: Current spaceflight medical resources, such as those found on the International Space Station, may be sufficient to manage some aspects of radiation-induced illness, although effective treatment of all potential manifestations would require substantial expansion of capabilities. Terrestrial adjunctive therapies or more experimental treatments are unavailable in current spaceflight medical capabilities but may have a role in future management of acute radiation exposure.DISCUSSION: Expanded medical capabilities for managing radiation-induced illnesses could be included onboard future exploration vehicles. However, this would require substantial research, time, and funding to reach flight readiness, and vehicle limitations may restrict such capabilities for exploration missions. The benefits of including expanded capabilities should be weighed against the likelihood of significant radiation exposure and extensive mission design constraints.Blue RS, Chancellor JC, Suresh R, Carnell LS, Reyes DP, Nowadly CD, Antonsen EL. Challenges in clinical management of radiation-induced illnesses during exploration spaceflight. Aerosp Med Hum Perform. 2019; 90(11):966–977.

scholarly journals Multiphase Trajectory Optimization of a Lunar Return Mission to an LEO Space Station

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Luyi Yang ◽  
Haiyang Li ◽  
Jin Zhang ◽  
Yazhong Luo
Keyword(s):  
Trajectory Optimization ◽  
Space Station ◽  
Low Earth Orbit ◽  
Hybrid Optimization ◽  
Target Space ◽  
Mission Design ◽  
Optimization Scheme ◽  
Initial State ◽  
Bank Angle ◽  
Entire Trajectory

Lunar exploration architecture can be made more flexible and reliable with the support of a low-Earth orbit (LEO) space station. This study therefore evaluated a proposed hybrid optimization scheme to design the entire trajectory of a reusable spacecraft starting from trans-Earth injection (EI) at the perilune and ending at an LEO space station. As such a trajectory has multiple constraints and multiple dynamical models, it is divided into the trans-Earth phase, aerocapture phase, and postatmospheric phase. The optimization scheme is performed at two levels: sublevel and top level. At the sublevel, two novel pseudo rules are proposed to optimize the trans-Earth trajectory so that it satisfies the coplanar constraints of the space station. Then, in the aerocapture phase, the bank angle is optimized to satisfy the mission constraints, and in the atmospheric phase, the one-impulsive maneuver is performed and optimized to insert the spacecraft into the target space station orbit. The multiple phases are connected to each other by boundary conditions where the terminal state of the previous phase is transformed into the initial state of the following phase. At the top level, the vacuum perigee height is selected as the mission design variable based on problem characteristics analysis and a hybrid optimization scheme is conducted to minimize the total velocity increment. The simulation results demonstrate that the proposed hybrid optimization method is effective for the design of an entire trajectory with acceptable velocity cost which is less than that in the previous study. The coplanar constraints of the space station and other mission constraints in each phase are also satisfied. Furthermore, the proposed trajectory design method is shown to be applicable to a reusable spacecraft returning to an LEO space station parked in any arbitrary orbital plane.

scholarly journals Long term variations of galactic cosmic radiation on board the International Space Station, on the Moon and on the surface of Mars

2020 ◽  
Author(s):  
Thomas Berger ◽  
Daniel Matthiä ◽  
Sönke Burmeister ◽  
Cary Zeitlin ◽  
Ryan Rios ◽  
...  
Keyword(s):  
Solar Cycle ◽  
Radiation Exposure ◽  
International Space Station ◽  
Free Space ◽  
Cosmic Radiation ◽  
Space Station ◽  
Low Earth Orbit ◽  
Radiation Environment ◽  
International Space ◽  
Cycle 24

<div class="abstract"> <p> <div>&lt;div class="abstract"&gt; &lt;div&gt;&lt;p&gt;The radiation environment in free space and the related radiation exposure is seen as one of the main health detriments for future long-duration human exploration missions beyond Low Earth Orbit (LEO). The steady flux of energetic particles in the galactic cosmic radiation (GCR) produces&amp;nbsp; a low dose-rate radiation exposure, which is heavily influenced by several factors including the solar cycle, the presence of an atmosphere, relevant magnetic fields (as on Earth) and of course by the relevant spacecraft shielding. Investigations of the GCR variations over the course of a solar cycle provide valuable data for exploration mission planning and for the determination of the radiation load received due to the GCR environment. Within the current work these investigations have been performed applying three datasets generated on board the International Space Station (ISS) with the DOSTEL instruments in the frame of the DOSIS and DOSIS-3D projects, with the CRaTER instrument in a Moon orbit and with the MSL-RAD instrument on the way to and on the surface of Mars. To derive GCR dose contributions on board the ISS two procedures have been developed separating the contributions from GCR from passing&amp;rsquo;s through the South Atlantic Anomaly (SAA), as well as ways to extrapolate the GCR dose measured on board the ISS to free space based on various ranges of the McIlwain &lt;em&gt;L&lt;/em&gt;-shell parameter. At the end we provide a dataset spanning the timeframe for GCR measurements on the ISS (2009 &amp;ndash; 2011 &amp;amp; 2012 &amp;ndash; 2019), Moon (2009 &amp;ndash; 2019) and Mars (2012 &amp;ndash; 2019), thereby covering the time span from the deep minimum of solar cycle 23, the ascending phase and maximum of solar cycle 24, and the descending phase of cycle 24, which is ongoing at the time of this writing.&lt;/p&gt; &lt;/div&gt; &lt;/div&gt;</div> </p> </div>

scholarly journals 2021 Update on the Clinical Management and Diagnosis of Kawasaki Disease

2021 ◽  
Vol 23 (3) ◽  
Author(s):  
Frank Zhu ◽  
Jocelyn Y. Ang
Keyword(s):  
High Risk ◽  
Kawasaki Disease ◽  
Corticosteroid Therapy ◽  
Clinical Management ◽  
Treatment Guidelines ◽  
Day Treatment ◽  
Significant Proportion ◽  
Clinical Manifestations ◽  
Heart Association ◽  
Ivig Resistance

Abstract Purpose of Review Provide an updated review of the clinical management and diagnosis of Kawasaki disease with inclusion of potential diagnostic difficulties with multisystem inflammatory syndrome in children (MIS-C) given the ongoing COVID-19 pandemic. Recent Findings Adjunctive corticosteroid therapy has been shown to reduce the rate of coronary artery dilation in children at high risk for IVIG resistance in multiple Japanese clinical studies (most notably RAISE study group). Additional adjunctive therapies (etanercept, infliximab, cyclosporin) may also provide limited benefit, but data is limited to single studies and subgroups of patients with cardiac abnormalities. The efficacy of other agents (atorvastatin, doxycycline) is currently being investigated. MIS-C is a clinically distinct entity from KD with broad clinical manifestations and multiorgan involvement (cardiac, GI, hematologic, dermatologic, respiratory, renal). MIS-C with Kawasaki manifestations is more commonly seen in children < 5 years of age. Summary The 2017 American Heart Association (AHA) treatment guidelines have included changes in aspirin dosing (including both 80–100 mg/kg/day and 30–50 mg/kg/day treatment options), consideration of the use of adjuvant corticosteroid therapy in patients at high risk of IVIG resistance, and the change in steroid regimen for refractory KD to include both pulse-dose IVMP and longer course of prednisolone with an oral taper. A significant proportion of children diagnosed with MIS-C, a post-infectious syndrome of SARS-CoV-2 infection, meet criteria for Kawasaki disease. Further investigation is warranted to further delineate these conditions and optimize treatment of these conditions given the ongoing COVID-19 pandemic.

scholarly journals Clinical Management of Hypertension, Inflammation and Thrombosis in Hospitalized COVID-19 Patients: Impact on Survival and Concerns

2021 ◽  
Vol 10 (5) ◽  
pp. 1073
Author(s):  
Patricia Martínez-Botía ◽  
Ángel Bernardo ◽  
Andrea Acebes-Huerta ◽  
Alberto Caro ◽  
Blanca Leoz ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Clinical Management ◽  
Cox Regression ◽  
Angiotensin Receptor Blockers ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Hospitalized Patients ◽  
Thrombosis Prophylaxis ◽  
The Impact

The most severe clinical manifestations of the Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are due to an unbalanced immune response and a pro-thrombotic hemostatic disturbance, with arterial hypertension or diabetes as acknowledged risk factors. While waiting for a specific treatment, the clinical management of hospitalized patients is still a matter of debate, and the effectiveness of treatments to manage clinical manifestations and comorbidities has been questioned. In this study, we aim to assess the impact of the clinical management of arterial hypertension, inflammation and thrombosis on the survival of COVID-19 patients. The Spanish cohorts included in this observational retrospective study are from HM Hospitales (2035 patients) and from Hospital Universitario Central de Asturias (72 patients). Kaplan Meier survival curves, Cox regression and propensity score matching analyses were employed, considering demographic variables, comorbidities and treatment arms (when opportune) as covariates. The management of arterial hypertension with angiotensin-converting enzyme 2 (ACE2) inhibitors or angiotensin receptor blockers is not detrimental, as was initially reported, and neither was the use of non-steroidal anti-inflammatory drugs (NSAIDs). On the contrary, our analysis shows that the use on itself of corticosteroids is not beneficial. Importantly, the management of COVID-19 patients with low molecular weight heparin (LMWH) as an anticoagulant significantly improves the survival of hospitalized patients. These results delineate the current treatment options under debate, supporting the effectiveness of thrombosis prophylaxis on COVID-19 patients as a first-line treatment without the need for compromising the treatment of comorbidities, while suggesting cautiousness when administering corticosteroids.

Metaphase-Based Cytogenetic Approach Identifies Radiation-Induced Chromosome and Chromatid Aberrations in Zebrafish Embryos

2021 ◽  
Author(s):  
Halida Thanveer Asana Marican ◽  
Hongyuan Shen
Keyword(s):  
Animal Model ◽  
Radiation Exposure ◽  
Progenitor Cells ◽  
Chromosome Aberrations ◽  
Structural Changes ◽  
Current Knowledge ◽  
Living Organism ◽  
Zebrafish Embryos ◽  
Radiation Induced

Metaphase-based cytogenetic methods based on scoring of chromosome aberrations for the estimation of the radiation dose received provide a powerful approach for evaluating the associated risk upon radiation exposure and form the bulk of our current knowledge of radiation-induced chromosome damages. They mainly rely on inducing quiescent peripheral lymphocytes into proliferation and blocking them at metaphases to quantify the damages at the chromosome level. However, human organs and tissues demonstrate various sensitivity towards radiation and within them, self-proliferating progenitor/stem cells are believed to be the most sensitive populations. The radiation-induced chromosome aberrations in these cells remain largely unknown, especially in the context of an intact living organism. Zebrafish is an ideal animal model for research into this aspect due to their small size and the large quantities of progenitor cells present during the embryonic stages. In this study, we employ a novel metaphase-based cytogenetic approach on zebrafish embryos and demonstrate that chromosome-type and chromatid-type aberrations could be identified in progenitor cells at different cell-cycle stages at the point of radiation exposure. Our work positions zebrafish at the forefront as a useful animal model for studying radiation-induced chromosome structural changes in vivo.

Changes in the Cortex Neurons in Single and Fractional Gamma Radiation

2021 ◽  
Vol 66 (4) ◽  
pp. 18-24
Author(s):  
I. Ushakov ◽  
Vladimir Fyodorov
Keyword(s):  
Nervous System ◽  
Cerebral Cortex ◽  
Radiation Exposure ◽  
Comparative Assessment ◽  
Male Rats ◽  
Fractionated Irradiation ◽  
Radiation Induced ◽  
Post Radiation ◽  
Induced Changes ◽  
The Brain

Purpose: Comparative assessment of radiation-induced changes in neurons of the cerebral cortex after a single and fractionated exposure to ionizing radiation in doses of 0.1 – 1.0 Gy. Material and methods. The study was carried out in compliance with the rules of bioethics on 180 white outbred male rats at the age of 4 months. by the beginning of the experiment, exposed to a single or fractionated exposure to γ-quanta of 60Co in total doses of 0.1; 0.2; 0.5 and 1.0 Gy. Neuromorphological and histochemical methods were used to assess morphometric and tinctorial parameters of nerve cells, as well as changes in the content of protein and nucleic acids in neurons in the early and late periods of the post-radiation period. Using one-way analysis of variance, a comparative assessment of neuromorphological indicators under various modes of radiation exposure is given. Results: In the control and irradiated animals throughout their life, undulating changes in the indicators of the state of the neurons of the brain occur with a gradual decrease by the end of the experiment. Despite a number of features of the dynamics of neuromorphological parameters, these irradiation regimes do not cause functionally significant changes in the neurons of the cortex. However, in some periods of the post-radiation period, the changes under the studied irradiation regimes were multidirectional and did not always correspond to age control. Significant differences in the response of neurons to these modes of radiation exposure in the sensory and motor areas of the cerebral cortex have not been established. Conclusion: No functionally significant radiation-induced changes in neurons were found either with single or fractionated irradiation. At the same time, different modes of irradiation in general caused the same type of changes in neurons. However, in some periods of observation, changes in neuromorphological parameters under the studied irradiation regimes were not unidirectional and differed from age control, which indicates a possible risk of disturbances in the functioning of the nervous system against the background of other harmful and dangerous factors.

Re-Examination of the Exacerbating Effect of Inflammasome Components during Radiation Injury

2021 ◽  
Author(s):  
W. June Brickey ◽  
Michael A. Thompson ◽  
Zhecheng Sheng ◽  
Zhiguo Li ◽  
Kouros Owzar ◽  
...  
Keyword(s):  
Cellular Response ◽  
Radiation Injury ◽  
Therapeutic Benefit ◽  
Acute Radiation ◽  
Cellular Damage ◽  
Inflammatory Factors ◽  
Experimental Conditions ◽  
Acute Radiation Injury ◽  
Radiation Induced

Radiation can be applied for therapeutic benefit against cancer or may result in devastating harm due to accidental or intentional release of nuclear energy. In all cases, radiation exposure causes molecular and cellular damage, resulting in the production of inflammatory factors and danger signals. Several classes of innate immune receptors sense the released damage associated molecules and activate cellular response pathways, including the induction of inflammasome signaling that impacts IL-1β/IL-18 maturation and cell death. A previous report indicated inflammasomes aggravate acute radiation syndrome. In contrast, here we find that inflammasome components do not exacerbate gamma-radiation-induced injury by examining heterozygous and gene-deletion littermate controls in addition to wild-type mice. Absence of some inflammasome genes, such as caspase-1/11 and Nlrp3, enhance susceptibility of treated mice to acute radiation injury, indicating importance of the inflammasome pathway in radioprotection. Surprisingly, we discover that the survival outcome may be sex-dependent as more inflammasome-deficient male mice are susceptible to radiation-induced injury. We discuss parameters that may influence the role of inflammasomes as radioprotective or radioexacerbating factors in recovery from radiation injury including the use of littermate controls, the sex of the animals, differences in microbiota within the colonies and other experimental conditions. Under the conditions tested, inflammasome components do not exacerbate radiation injury, but rather provide protective benefit.

Response to Bieko re: Risk of Radiation-Induced Cataracts: Investigation of Radiation Exposure to the Eye Lens During Endourological Procedures

2018 ◽  
Vol 32 (10) ◽  
pp. 905-906
Author(s):  
Florian Distler ◽  
Josefin Hartmann ◽  
Sascha Pahernik ◽  
Michael Wucherer
Keyword(s):  
Radiation Exposure ◽  
Eye Lens ◽  
Radiation Induced
Sign in / Sign up

Export Citation Format

Share Document