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Project Title:  Bracelet Investigation Reduce
Fiscal Year: FY 2012 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 07/01/2008  
End Date: 12/31/2011  
Task Last Updated: 04/03/2012 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dulchavsky, Scott A. M.D., Ph.D. / Henry Ford Health System 
Address:  Surgery 
2799 W. Grand Boulevard, CFP-1 
Detroit , MI 48202-2608 
Email: sdulcha1@hfhs.org 
Phone: 313 916 9306  
Congressional District: 13 
Web:  
Organization Type: PUBLIC SERVICE 
Organization Name: Henry Ford Health System 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Sargsyan, Ashot  Wyle Laboratories 
Hamilton, Douglas  Wyle Laboratories 
Ebert, Douglas  Wyle Laboratories 
Project Information: Grant/Contract No. NCC 9-58-SMST01602 
Responsible Center: NSBRI 
Grant Monitor:  
Center Contact:   
Solicitation / Funding Source: 2007 Crew Health NNJ07ZSA002N 
Grant/Contract No.: NCC 9-58-SMST01602 
Project Type: GROUND 
Flight Program:  
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) Arrhythmia:Risk of Cardiac Rhythm Problems
(2) VIIP:Risk of Spaceflight-Induced Intracranial Hypertension/Vision Alterations (IRP Rev E)
Human Research Program Gaps: (1) CV07:How are fluids redistributed in flight?
Task Description: Significant changes to the cardiovascular system occur during long duration spaceflight; a reduction in cardiac reserve could impact the ability of a crew-member to fulfill mission requirements or respond to a contingency. Cardiovascular fluid redistribution occurs during equilibration to microgravity and may be partially responsible for changes in cardiovascular performance. The Russian Bracelet-M device is currently manifested on the International Space Station (ISS) to reduce venous return to the heart and simulate a microgravity hypo-volemic state. This system may reduce cardiac preload and increase lower extremity venous pressure causing interstitial fluid shifts and changes in venous compliance. Although subjective improvement has been seen in some users, a quantitative measurement of the cardiovascular and venous effects of this device have not been extensively investigated on the ground or in space. Using the Onboard Proficiency Enhancement (OPE) program developed by the ADUM team and exploiting recent advances in ultrasound technology, the investigation of the acute effects of Bracelet device is possible. We hypothesized that the device increases fluid sequestration in the lower extremities inducing a relative hypo-volemia in the central circulation compared to what is typically observed in a microgravity environment.

This proposal enhanced the collaboration of an international team of experts (Russia/USA) in conducting ground, simulated microgravity, and flight experiments to answer three specific aims:

1. Evaluate the vascular and cardiac effects of the Bracelet-M device in ground based studies using ultrasound in combination with the current system of device calibration, user training, and application.

2. Investigate the human factors, level of experience, and training necessary to perform focused vascular and echocardiography exams in a ground and microgravity environment using real-time remote guidance of inexperienced ultrasound operators.

3. Determine the physiologic effects of the Bracelet-M device on the cardiovascular system during simulated microgravity and flight experiment with recommendations for optimal use protocols with a predictable effect and an increased margin of safety.

Ultrasound is a terrestrial standard of care for assessing cardiovascular function. This proposal developed just-in-time training methodologies, combined with remote guidance, to allow non-expert operators to use ultrasound to evaluate the cardiovascular system and the effects of the Bracelet device on venous loading, vascular capacitance and cardiac performance. This proposal provided essential medical information and capabilities to facilitate exploration class missions. Specifically this proposal developed and validated procedures for the expanded diagnostic use of ultrasound for cardiovascular medical conditions which may occur on the International Space Station and future exploration class missions.

Two primary objectives of this proposal were to obtain baseline information regarding the use of ultrasound to monitor cardiovascular alterations which occur during microgravity exposure and to evaluate the physiologic effects of the Bracelet device. The experimental team developed a rapid training program to allow minimally trained operators to obtain high quality ultrasound images of the cardiac and vascular system, with or without maneuvers to assess the effects of the Braslet device on the vascular system. There was a significant and profound effect of Braslet occlusion on the peripheral and vascular system which caused alterations in cardiac function. This countermeasure device may have therapeutic potential for space adaptation, treatment of vascular disorders in a microgravity environment, and potentially to improve readaptation to a gravity environment.

Research Impact/Earth Benefits: PROJECT IMPACT: The medical hazards which are unique to the space environment require the development of novel strategies to maintain crew member health and performance. The ultrasonic diagnostic investigations described in this proposal, which involve the peripheral arterial and venous system as well as focused echocardiography, will provide a clinically relevant increased understanding of cardiovascular physiology and patho-physiology as well as significant advances in space medical capabilities to facilitate exploration-class space missions. Terrestrial benefits of this study are also anticipated including enhanced understanding of the cardiovascular effects of venous occlusion in normal and pathologic states. Development of the high fidelity, CD ROM based training program in cardiovascular ultrasound for use by non-medical personnel will have direct educational application to a broad audience including ultrasound technicians, students, and the lay population. These techniques are readily transferable to training in basic and advanced cardiopulmonary care and CPR training as well as other public health education tasks where non-medical personnel must be introduced to medical concepts in a limited time.

Task Progress & Bibliography Information FY2012 
Task Progress: Major Accomplishments, Findings, and Milestones

We have interviewed numerous long duration crewmembers for the optimal human interface for the just-in-time training software for this program. We have conducted 20 baseline examinations with and without the Bracelet device on normal volunteers and optimizing a custom pressure monitoring device for calibration in conjunction with standard methodologies. We have developed a comprehensive methodology, in conjunction with SDTO activities on orbit, to allow non-expert operators to reproducibly conduct cardiac and vascular examinations with or without thigh occlusion devices. We have reliably characterized the profound cardiac, vascular, and optic nerve sheath changes with 6 degree down tilt testing, and the effects of the Bracelet device on intra-vascular volumetric changes.

Bibliography Type: Description: (Last Updated: 03/02/2022) 

Show Cumulative Bibliography Listing
 
Articles in Peer-reviewed Journals Hamilton DR, Alferova IV, Sargsyan AE, Fincke EM, Magnus SH, Lonchakov YV, Dulchavsky SA, Ebert D, Garcia K, Martin D, Matveev VP, Voronkov YI, Melton SL, Bogomolov VV, Duncan JM. "Right ventricular tissue Doppler assessment in space during circulating volume modification using the Braslet device." Acta Astronaut. 2011 May-Jun;68(9-10):1501-8. http://dx.doi.org/10.1016/j.actaastro.2009.11.015 , May-2011
Articles in Peer-reviewed Journals Hurst VW, Peterson S, Garcia K, Ebert D, Ham D, Amponsah D, Dulchavsky S. "Concept of operations evaluation for using remote-guidance ultrasound for exploration spaceflight." Aerosp Med Hum Perform. 2015 Dec;86(12):1034-8. http://dx.doi.org/10.3357/AMHP.3244.2015 , Dec-2015
Articles in Peer-reviewed Journals Sirek AS, Garcia K, Foy M, Ebert D, Sargsyan A, Wu JH, Dulchavsky SA. "Doppler ultrasound of the central retinal artery in microgravity." Aviat Space Environ Med. 2014 Jan;85(1):3-8. https://doi.org/10.3357/asem.3750.2014 ; PMID: 24479252 , Jan-2014
Project Title:  Bracelet Investigation Reduce
Fiscal Year: FY 2010 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 07/01/2008  
End Date: 06/30/2011  
Task Last Updated: 08/06/2010 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dulchavsky, Scott A. M.D., Ph.D. / Henry Ford Health System 
Address:  Surgery 
2799 W. Grand Boulevard, CFP-1 
Detroit , MI 48202-2608 
Email: sdulcha1@hfhs.org 
Phone: 313 916 9306  
Congressional District: 13 
Web:  
Organization Type: PUBLIC SERVICE 
Organization Name: Henry Ford Health System 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Sargsyan, Ashot  Wyle Laboratories 
Hamilton, Douglas  Wyle Laboratories 
Ebert, Douglas  Wyle Laboratories 
Project Information: Grant/Contract No. NCC 9-58-SMST01602 
Responsible Center: NSBRI 
Grant Monitor:  
Center Contact:   
Solicitation / Funding Source: 2007 Crew Health NNJ07ZSA002N 
Grant/Contract No.: NCC 9-58-SMST01602 
Project Type: GROUND 
Flight Program:  
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) Arrhythmia:Risk of Cardiac Rhythm Problems
(2) VIIP:Risk of Spaceflight-Induced Intracranial Hypertension/Vision Alterations (IRP Rev E)
Human Research Program Gaps: (1) CV07:How are fluids redistributed in flight?
Task Description: This proposal is a resubmission for NASA NNJ07ZSA002N and will provide information on crew health and performance risks, develop counter-measures, and develop technologies with strategies for monitoring and mitigating crew health. The objectives of this study are to validate just-in-time training methodologies for cardiovascular ultrasound imaging during long duration spaceflight and to quantify the effects of the Bracelet device on the cardiovascular system in ground based and fight experiments. The ultrasonic diagnostic investigations described in this proposal will provide a clinically relevant increased understanding of cardiovascular physiology as well as significant advances in space medical capabilities to facilitate exploration-class space missions.

The research investigations will use a tiered methodology:

I. Ground based investigations at the Johnson Space Center (Evaluation of the cardiovascular effects of the Bracelet device with ultrasound, Ultrasound optimization of Bracelet device application).

II. Simulated Microgravity investigations at the Johnson Space Center (Human factors optimization of stress cardiovascular ultrasound examination, Physiologic effects of simulated microgravity on cardiovascular performance, Effects of the Bracelet device on cardiac function in bed rest subjects).

III. Optimization of just-in-time training methodologies to allow non-expert operators to perform vascular and cardiac ultrasound evaluations at Henry Ford Hospital (Develop rapid hands on methodologies in vascular and cardiac ultrasound, Development and optimization of CD-ROM based training methods in ultrasonography, Compare the accuracy of expert versus just-in-time trained ultrasound operators performing vascular and cardiac ultrasound).

IV. Flight Experiments on the International Space Station (Evaluation of long duration spaceflight on cardiovascular function, Evaluation of the physiologic effects of the Bracelet device on cardiovascular function during long duration spaceflight).

Research Impact/Earth Benefits: The unique constraints imposed by the space environment require the development of novel strategies for crew member health evaluation and maintenance. The ultrasonic diagnostic modalities described in this proposal, involving the peripheral arterial and venous system, as well as focused echocardiography, would provide a significant, clinically relevant advance in space medical capabilities to facilitate exploration-class space missions. Terrestrial benefits of this study are also anticipated including enhanced understanding of the cardiovascular effects of venous occlusion in normal and pathologic states. Development of the high fidelity CD ROM-based training program in cardiovascular ultrasound for use by non-medical personnel will have direct educational implication for a broad audience including ultrasound technicians, students, and the lay population. These techniques are readily transferable to training in basic and advanced cardiopulmonary care and CPR training as well as other public health education tasks where non-medical personnel must be introduced to medical concepts in a limited time.

Task Progress & Bibliography Information FY2010 
Task Progress: We have developed a reproducible ground analysis model for the cardiovascular effects of the Bracelet Device and have tested 8 subjects. We are analyzing the data at present and will finish the ground testing portions of the experiment this month. We have been hampered with microgravity testing due to aircraft unavailability, cost, and reported poor parabola quality and will discuss next steps with NSBRI leadership. We are also hampered by a moratorium on bedrest at present due to medical concerns. We are developing just in time training aids to allow non-expert operators to obtain physiologic data on the Bracelet with remote expert guidance.

Bibliography Type: Description: (Last Updated: 03/02/2022) 

Show Cumulative Bibliography Listing
 
 None in FY 2010
Project Title:  Bracelet Investigation Reduce
Fiscal Year: FY 2009 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 07/01/2008  
End Date: 06/30/2011  
Task Last Updated: 08/12/2009 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dulchavsky, Scott A. M.D., Ph.D. / Henry Ford Health System 
Address:  Surgery 
2799 W. Grand Boulevard, CFP-1 
Detroit , MI 48202-2608 
Email: sdulcha1@hfhs.org 
Phone: 313 916 9306  
Congressional District: 13 
Web:  
Organization Type: PUBLIC SERVICE 
Organization Name: Henry Ford Health System 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Sargsyan, Ashot  Wyle Laboratories 
Hamilton, Douglas  Wyle Laboratories 
Ebert, Douglas  Wyle Laboratories 
Project Information: Grant/Contract No. NCC 9-58-SMST01602 
Responsible Center: NSBRI 
Grant Monitor:  
Center Contact:   
Solicitation / Funding Source: 2007 Crew Health NNJ07ZSA002N 
Grant/Contract No.: NCC 9-58-SMST01602 
Project Type: GROUND 
Flight Program:  
TechPort: No 
No. of Post Docs:
No. of PhD Candidates:
No. of Master's Candidates:
No. of Bachelor's Candidates:
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) Arrhythmia:Risk of Cardiac Rhythm Problems
(2) VIIP:Risk of Spaceflight-Induced Intracranial Hypertension/Vision Alterations (IRP Rev E)
Human Research Program Gaps: (1) CV07:How are fluids redistributed in flight?
Task Description: This proposal is a resubmission for NASA NNJ07ZSA002N and will provide information on crew health and performance risks, develop counter-measures, and develop technologies with strategies for monitoring and mitigating crew health. The objectives of this study are to validate just-in-time training methodologies for cardiovascular ultrasound imaging during long duration spaceflight and to quantify the effects of the Bracelet device on the cardiovascular system in ground based and fight experiments. The ultrasonic diagnostic investigations described in this proposal will provide a clinically relevant increased understanding of cardiovascular physiology as well as significant advances in space medical capabilities to facilitate exploration-class space missions.

The research investigations will use a tiered methodology: I. Ground based investigations at the Johnson Space Center (Evaluation of the cardiovascular effects of the Bracelet device with ultrasound, Ultrasound optimization of Bracelet device application). II. Simulated Microgravity investigations at the Johnson Space Center (Human factors optimization of stress cardiovascular ultrasound examination, Physiologic effects of simulated microgravity on cardiovascular performance, Effects of the Bracelet device on cardiac function in bed rest subjects) III. Optimization of just-in-time training methodologies to allow non-expert operators to perform vascular and cardiac ultrasound evaluations at Henry Ford Hospital (Develop rapid hands on methodologies in vascular and cardiac ultrasound, Development and optimization of CD-ROM based training methods in ultrasonography, Compare the accuracy of expert versus just-in-time trained ultrasound operators performing vascular and cardiac ultrasound) and IV. Flight Experiments on the International Space Station (Evaluation of long duration spaceflight on cardiovascular function, Evaluation of the physiologic effects of the Bracelet device on cardiovascular function during long duration spaceflight).

Research Impact/Earth Benefits: The educational methodologies developed for this proposal have significant Earth benefits to teach non-expert operators complex medical procedures. Furthermore, the tele-ultrasound procedures which are critical to this proposal are readily modified for planetary uses in rural, underserved, or military conflicts. Finally, the device being evaluated in this trial produces significant changes in the cardiovascular system which allows further refinement of our knowledge base in cardiac and vascular physiology.

Task Progress & Bibliography Information FY2009 
Task Progress: This proposal has developed an international team (US and Russian) to collaboratively evaluate the effectiveness and mechanism of action of the Bracelet device during microgravity exposure. Numerous meetings were held in Russia, and preliminary data have been obtained from normal volunteers to judge the effectiveness of the device. We have also analyzed data from the International Space Station obtained during DTO activities. We recently presented this data at the 17th annual Humans In Space Symposium in Moscow. We are currently finishing multi-media educational methods to teach non-experts to use ultrasound to evaluate the device on the space station.

Bibliography Type: Description: (Last Updated: 03/02/2022) 

Show Cumulative Bibliography Listing
 
Abstracts for Journals and Proceedings Duncan JM, Bogomolov VV, Alferova IV, Dulchavsky SA, Ebert DJW, Garcia K, Martin D, Matveev VP, Melton SL, Sargsyan DE, Hamilton DR. "Cardiac Assessment in microgravity using circulating volume modification and respiratory maneuvers." 17th Annual IAA Humans in Space Symposium, Moscow, Russia, June 7-11, 2009.

17th Annual IAA Humans in Space Symposium, Moscow, Russia, June 7-11, 2009. , Jun-2009

Project Title:  Bracelet Investigation Reduce
Fiscal Year: FY 2008 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 07/01/2008  
End Date: 06/30/2011  
Task Last Updated: 06/02/2008 
Download report in PDF pdf
Principal Investigator/Affiliation:   Dulchavsky, Scott A. M.D., Ph.D. / Henry Ford Health System 
Address:  Surgery 
2799 W. Grand Boulevard, CFP-1 
Detroit , MI 48202-2608 
Email: sdulcha1@hfhs.org 
Phone: 313 916 9306  
Congressional District: 13 
Web:  
Organization Type: PUBLIC SERVICE 
Organization Name: Henry Ford Health System 
Joint Agency:  
Comments:  
Co-Investigator(s)
Affiliation: 
Hamilton, Douglas  Wyle Laboratories 
Ebert, Douglas  Wyle Laboratories 
Sargsyan, Ashot Ernest  Wyle Laboratories 
Project Information: Grant/Contract No. NCC 9-58-SMST01602 
Responsible Center: NSBRI 
Grant Monitor:  
Center Contact:   
Solicitation / Funding Source: 2007 Crew Health NNJ07ZSA002N 
Grant/Contract No.: NCC 9-58-SMST01602 
Project Type: GROUND 
Flight Program:  
TechPort: No 
No. of Post Docs:  
No. of PhD Candidates:  
No. of Master's Candidates:  
No. of Bachelor's Candidates:  
No. of PhD Degrees:  
No. of Master's Degrees:  
No. of Bachelor's Degrees:  
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) Arrhythmia:Risk of Cardiac Rhythm Problems
(2) VIIP:Risk of Spaceflight-Induced Intracranial Hypertension/Vision Alterations (IRP Rev E)
Human Research Program Gaps: (1) CV07:How are fluids redistributed in flight?
Task Description: This project will provide information on crew health and performance risks, develop countermeasures, and develop technologies with strategies for monitoring and mitigating crew health. The objectives of this study are to validate just-in-time training methodologies for cardiovascular ultrasound imaging during long-duration spaceflight and to quantify the effects of the Bracelet device on the cardiovascular system in ground-based and flight experiments.

The ultrasonic diagnostic investigations in this project will provide a clinically-relevant, increased understanding of cardiovascular physiology as well as significant advances in space medical capabilities to facilitate exploration-class space missions.

The research investigations will use a tiered methodology:

1. Ground-based investigations at NASA Johnson Space Center Evaluation of the cardiovascular effects of the Bracelet device with ultrasound, and ultrasound optimization of the Bracelet device application.

2. Simulated microgravity investigations at NASA Johnson Space Center Human factors optimization of stress cardiovascular ultrasound examination, physiologic effects of simulated microgravity on cardiovascular performance, and effects of the Bracelet device on cardiac function in bed-rest subjects.

3. Optimization of just-in-time training methodologies to allow non-expert operators to perform vascular and cardiac ultrasound evaluations at Henry Ford Hospital Develop rapid, hands-on methodologies in vascular and cardiac ultrasound, development and optimization of CD-ROM-based training methods in ultrasonography, and comparison of the accuracy of expert versus just-in-time-trained ultrasound operators performing vascular and cardiac ultrasound.

4. Flight experiments on the International Space Station Evaluation of long-duration spaceflight on cardiovascular function, and evaluation of the physiologic effects of the Bracelet device on cardiovascular function during long-duration spaceflight.

Research Impact/Earth Benefits: 0

Task Progress & Bibliography Information FY2008 
Task Progress: New project for FY2008.

Bibliography Type: Description: (Last Updated: 03/02/2022) 

Show Cumulative Bibliography Listing
 
 None in FY 2008