TABLE 13.1 Summary of Highest-Priority Recommendations Made in Chapters 4 through 10

Recommendation Identifiera Recommendation Enabled by (EB) and/or Enabling (E) Space Exploration
Plant and Microbial Biology (Chapter 4)
P1 Establish a microbial observatory program on the ISS to conduct long-term, multigenerational studies of microbial population dynamics. EB
P2 Establish a robust spaceflight program of research analyzing plant and microbial growth and physiological responses to the multiple stimuli encountered in spaceflight environments. EB
P3 Develop a research program aimed at demonstrating the roles of microbial-plant systems in long-term life support systems. EB/E
Behavior and Mental Health (Chapter 5)
B1 Develop sensitive, meaningful, and valid measures of mission-relevant performance for both astronauts and mission control personnel. E
B2 Conduct integrated translational research in which long-duration missions are simulated specifically for the purpose of studying the interrelationships among individual functioning, cognitive performance, sleep, and group dynamics. E
B3 Determine the genetic, physiological, and psychological underpinnings of individual differences in resilience to stressors during extended space missions, with development of an individualized medicine approach to sustaining astronauts during such missions. E
B4 Conduct research to enhance cohesiveness, team performance, and effectiveness of multinational crews, especially under conditions of extreme isolation and autonomy. EB/E
Animal and Human Biology (Chapter 6)
AH1 The efficacy of bisphosphonates should be tested in an adequate population of astronauts on the ISS during a 6-month mission. EB/E
AH2 The preservation/reversibility of bone structure/strength should be evaluated when assessing countermeasures. EB/E
AH3 Bone loss studies of genetically altered mice exposed to weightlessness are strongly recommended. EB
AH4 New osteoporosis drugs under clinical development should be tested in animal models of weightlessness. EB
AH5 Conduct studies to identify underlying mechanisms regulating net skeletal muscle protein balance and protein turnover during states of unloading and recovery. EB/E
AH6 Conduct studies to develop and test new prototype exercise devices and to optimize physical activity paradigms/prescriptions targeting multisystem countermeasures. EB/E
AH7 Determine the daily levels and pattern of recruitment of flexor and extensor muscles of the neck, trunk, arms, and legs at 1 g and after being in a novel gravitational environment for up to 6 months. EB
AH8 Determine the basic mechanisms, adaptations, and clinical significance of changes in regional vascular/interstitial pressures (Starling forces) during long-duration space missions. EB/E
AH9 Investigate the effects of prolonged periods of microgravity and partial gravity (3/8 or 1/6 g) on the determinants of task-specific, enabling levels of work capacity. EB/E
AH10 Determine the integrative mechanisms of orthostatic intolerance after restoration of gravitational gradients (both 1 g and 3/8 g). EB/E

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