Developing, Implementing, and Applying Novel Techniques During Systematic Reviews of Primary Space Medicine Data

BACKGROUND: The Aerospace Medicine Systematic Review Group was set up in 2016 to facilitate high quality and transparent synthesis of primary data to enable evidence-based practice. The group identified many research methods specific to space medicine that need consideration for systematic review methods. The group has developed space medicine specific methods to address this and trialed usage of these methods across seven published systematic reviews. This paper outlines evolution of space medicine synthesis methods and discussion of their initial application.METHODS: Space medicine systematic review guidance has been developed for protocol planning, quantitative and qualitative synthesis, sourcing gray data, and assessing quality and transferability of space medicine human spaceflight simulation study environments.RESULTS: Decision algorithms for guidance and tool usage were created based on usage. Six reviews used quantitative methods in which no meta-analyses were possible due to lack of controlled trials or reporting issues. All reviews scored the quality and transferability of space simulation environments. One review was qualitative. Several research gaps were identified.CONCLUSION: Successful use of the developed methods demonstrates usability and initial validity. The current space medicine evidence base resulting in no meta-analyses being possible shows the need for standardized guidance on how to synthesize data in this field. It also provides evidence to call for increasing use of controlled trials, standardizing outcome measures, and improving minimum reporting standards. Space medicine is a unique field of medical research that requires specific systematic review methods.Winnard A, Caplan N, Bruce-Martin C, Swain P, Velho R, Meroni R, Wotring V, Damann V, Weber T, Evetts S, Laws J. Developing, implementing, and applying novel techniques during systematic reviews of primary space medicine data. Aerosp Med Hum Perform. 2021; 92(8):681688.

Bellagio II Report: Terrestrial Applications of Space Medicine Research

INTRODUCTION: For over 50 yr, investigators have studied the physiological adaptations of the human system during short- and long-duration spaceflight exposures. Much of the knowledge gained in developing health countermeasures for astronauts onboard the International Space Station demonstrate terrestrial applications. To date, a systematic process for translating these space applications to terrestrial human health has yet to be defined.METHODS: In the summer of 2017, a team of 38 international scientists launched the Bellagio ll Summit Initiative. The goals of the Summit were: 1) To identify space medicine findings and countermeasures with highest probability for future terrestrial applications; and 2) To develop a roadmap for translation of these countermeasures to future terrestrial application. The team reviewed public domain literature, NASA databases, and evidence books within the framework of the five-stage National Institutes of Health (NIH) translation science model, and the NASA two-stage translation model. Teams then analyzed and discussed interdisciplinary findings to determine the most significant evidence-based countermeasures sufficiently developed for terrestrial application.RESULTS: Teams identified published human spaceflight research and applied translational science models to define mature products for terrestrial clinical practice.CONCLUSIONS: The Bellagio ll Summit identified a snapshot of space medicine research and mature science with the highest probability of translation and developed a Roadmap of terrestrial application from space medicine-derived countermeasures. These evidence-based findings can provide guidance regarding the terrestrial applications of best practices, countermeasures, and clinical protocols currently used in spaceflight.Sides MB, Johnston SL III, Sirek A, Lee PH, Blue RS, Antonsen EL, Basner M, Douglas GL, Epstein A, Flynn-Evans EE, Gallagher MB, Hayes J, Lee SMC, Lockley SW, Monseur B, Nelson NG, Sargsyan A, Smith SM, Stenger MB, Stepanek J, Zwart SR; Bellagio II Team. Bellagio II report: terrestrial applications of space medicine research. Aerosp Med Hum Perform. 2021; 92(8):650669.

Microgravity and Space Medicine

This Special Issue (SI), “Microgravity and Space Medicine”, covers research articles and reviews focusing on gravitational biology, cancer research and space medicine. It includes publications investigating the effects of altered gravity conditions on mammalian cells and humans during real microgravity (r-μg) on the International Space Station (ISS) and parabolic flights (PFs) [...]

Andean Man & the Astronaut

In 1958, Bruno Balke, a former German Luftwaffe doctor working for the United States Air Force (USAF), led a team of airmen up Colorado’s Mount Evans. Could acclimatization to the thin mountain air boost the oxygen efficiency of future astronauts living in artificial low-pressure spacecraft environments? To judge their improvement, Balke, an expert in the nascent field of space medicine, compared their performance not with military test-pilots, but with high-altitude Indigenous people he had studied in the Peruvian Andes. This article expands discussions of race in space history beyond Black scientists, mathematicians, and pilots in the Civil Rights era to this earlier case of the permanent residents of Morococha, Peru, who participated in efforts to define an ideal spacefaring body. More than recovering the story of a nearly forgotten group of astronaut-adjacent test-subjects, this article shows how racial discrimination in space medicine functioned by inclusion. Balke studied and even celebrated the bodies of Morocochans, but never considered them potential astronauts. This article begins with Balke’s participation in the 1938 Nazi-funded expedition to summit Nanga Parbat in the Himalayas, and his follow-on work acclimatizing Luftwaffe pilots during World War Two. Then it focuses on his USAF work in the 1950s studying miners living and working in Morococha, Peru, and his attempt to replicate their altitude tolerance in American airmen on Mount Evans. Recovering Balke’s work places the high-altitude Indigenous person and the mountaineer alongside the familiar figure of the pilot in the genealogy of the early American astronaut.

Advances in Space Medicine Applied to Pandemics on Earth

Preparation and planning are critical when facing an epidemic or pandemic. Timely solutions must be incorporated in addition to existing guidelines in the case of a fast-spreading epidemic. Advances in space health have been driven by the need to preserve human health in an austere environment, in which medical assistance or resupply from the ground is not possible. This paper speculates on the similarities between human spaceflight and epidemics, extended to pandemics, identifying implementable solutions for immediate use by healthcare personnel and healthcare systems. We believe aerospace medical research can be seen as a resource to improve terrestrial medical care and the management of patients on Earth.