{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T17:13:10Z","timestamp":1780420390570,"version":"3.54.1"},"reference-count":33,"publisher":"Aerospace Medical Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["aerosp med hum perform"],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:p><jats:bold>INTRODUCTION:<\/jats:bold> With increasing engagement of commercial spaceflight participants in spaceflight activities, the evaluation of individuals with medical conditions not previously characterized in the spaceflight environment is of particular interest. Factors such as acceleration\n forces experienced during launch, reentry, and landing of spacecraft could pose an altered risk profile in some individuals due to known disease. Bleeding diatheses present a unique concern in the spaceflight environment given hypergravity exposure and, particularly, the potential for injury\n resulting from transient or impact acceleration.<jats:bold>CASE REPORT:<\/jats:bold> A 26-yr-old Caucasian man with severe hemophilia A and no detectable endogenous Factor VIII (FVIII) volunteered for participation in hypergravity exposures simulating spaceflight. His treatment regimen included 50 IU \u00b7\n kg<jats:sup>\u22121<\/jats:sup> FVIII-Fc fusion protein intravenous administration every 96 h, with supplemental FVIII administration as needed for injury or bleeding. The subject experienced two profiles at the National Aerospace Training and Research Center (NASTAR), with maximum exposure +4.0 G<jats:sub>z<\/jats:sub>,\n +4.5 G<jats:sub>x<\/jats:sub>, 6.1 G resultant, and maximum onset rate &lt;0.5 G<jats:sub>z<\/jats:sub> \u00b7 s<jats:sup>\u22121<\/jats:sup> and +1 G<jats:sub>x<\/jats:sub> \u00b7 s<jats:sup>\u22121<\/jats:sup>. The subject reported no abnormal events during the profiles other than brief mild vertigo. No petechial hemorrhage, ecchymosis,\n or other bleeding was noted during or after profiles. Supplemental FVIII was not required before, during, or after exposure.<jats:bold>DISCUSSION:<\/jats:bold> Inherited bleeding disorders present several potential concerns that must be evaluated prior to spaceflight participation. Cautious review and\n management of medical history, adherence and barriers to treatment, duration of spaceflight and longitudinal management concerns, and a thorough and detailed risk\/benefit assessment may provide a future pathway for inclusion of individuals with hematological disorders in commercial spaceflight.<jats:bold>Reeves\n IA, Blue RS, Au\u00f1on-Chancellor S, Harrison MF, Shah R, Powers WE. <jats:italic>Tolerance of centrifuge-simulated commercial spaceflight in a subject with hemophilia A<\/jats:italic>. Aerosp Med Hum Perform. 2023; 94(6):470\u2013474.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.6204.2023","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T04:36:00Z","timestamp":1684298160000},"page":"470-474","source":"Crossref","is-referenced-by-count":1,"title":["Tolerance of Centrifuge-Simulated Commercial Spaceflight in a Subject with Hemophilia A"],"prefix":"10.3357","volume":"94","author":[{"given":"Isaiah A.","family":"Reeves","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S.","family":"Blue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Au\u00f1on-Chancellor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael F.","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronak","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Powers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"issue":"3","key":"B1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1586\/17474086.2014.899896","article-title":"Factor VIII therapy for hemophilia A: current and future issues","volume":"7","year":"2014","journal-title":"Expert Rev Hematol"},{"issue":"6","key":"B2","first-page":"479","article-title":"Factor VIII replacement is still the standard of care in haemophilia A","volume":"17","year":"2019","journal-title":"Blood Transfus"},{"issue":"5","key":"B3","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1111\/jocs.14498","article-title":"Acceleration\u2010induced acute type A aortic dissection in the sky: 10\u2010year follow\u2010up","volume":"35","year":"2020","journal-title":"J Card Surg"},{"issue":"2","key":"B4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/2040620717746312","article-title":"Novel therapies and current clinical progress in hemophilia A","volume":"9","year":"2018","journal-title":"Ther Adv Hematol"},{"key":"B5","volume-title":"Fundamentals of Aerospace Medicine","year":"2020"},{"issue":"6","key":"B6","first-page":"535","article-title":"Diagnosis and care of patients with mild haemophilia: practical recommendations for clinical management","volume":"16","year":"2018","journal-title":"Blood Transfus"},{"issue":"7","key":"B7","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3357\/AMHP.4807.2017","article-title":"The effects of training on anxiety and task performance in simulated suborbital spaceflight","volume":"88","year":"2017","journal-title":"Aerosp Med Hum Perform"},{"issue":"7","key":"B8","doi-asserted-by":"crossref","first-page":"721","DOI":"10.3357\/ASEM.3956.2014","article-title":"Tolerance of centrifuge-simulated suborbital spaceflight by medical condition","volume":"85","year":"2014","journal-title":"Aviat Space Environ Med"},{"issue":"10","key":"B9","doi-asserted-by":"crossref","first-page":"929","DOI":"10.3357\/ASEM.3351.2012","article-title":"Commercial spaceflight participant G-force tolerance during centrifuge-simulated suborbital flight","volume":"83","year":"2012","journal-title":"Aviat Space Environ Med"},{"key":"B10","year":"2018"},{"key":"B11","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/j.1538-7836.2011.04349.x","article-title":"Immune tolerance induction in haemophilia: evidence and the way forward","volume":"9","year":"2011","journal-title":"J Thromb Haemost"},{"issue":"2","key":"B12","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/bjh.12028","article-title":"Immune tolerance in haemophilia: the long journey to the fork in the road","volume":"159","year":"2012","journal-title":"Br J Haematol"},{"key":"B13","first-page":"298","article-title":"Valsalva hemorrhagic retinopathy","volume":"70","year":"1972","journal-title":"Trans Am Ophthalmol Soc"},{"key":"B14","year":"2021."},{"issue":"2","key":"B15","first-page":"178","article-title":"The modern treatment of haemophilia: a narrative review","volume":"11","year":"2013","journal-title":"Blood Transfus"},{"key":"B16","volume-title":"Ernsting\u2019s Aviation and Space Medicine","year":"2016"},{"key":"B17","volume-title":"Manual of Civil Aviation Medicine. 3","year":"2012"},{"issue":"8","key":"B18","doi-asserted-by":"crossref","first-page":"540","DOI":"10.7326\/M19-1208","article-title":"Establishing the prevalence and prevalence at birth of hemophilia in males: a meta-analytic approach using national registries","volume":"171","year":"2019","journal-title":"Ann Intern Med"},{"issue":"8","key":"B19","doi-asserted-by":"crossref","first-page":"641","DOI":"10.7326\/0003-4819-114-8-641","article-title":"The changing prognosis of classic hemophilia (factor VIII \u201cdeficiency\u201d)","volume":"114","year":"1991","journal-title":"Ann Intern Med"},{"issue":"12","key":"B20","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.3357\/AMHP.4338.2015","article-title":"Scrotal hematoma precipitated by centrifuge training in a fighter pilot with an asymptomatic varicocele","volume":"86","year":"2015","journal-title":"Aerosp Med Hum Perform"},{"issue":"3","key":"B21","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1053\/j.jvca.2016.01.007","article-title":"Fundamentals of anesthesiology for spaceflight","volume":"30","year":"2016","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"5","key":"B22","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.blre.2009.06.001","article-title":"Bleeding in the heritable connective tissue disorders: mechanisms, diagnosis and treatment","volume":"23","year":"2009","journal-title":"Blood Rev"},{"issue":"7","key":"B23","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1182\/blood.V90.7.2515","article-title":"Desmopressin (DDAVP) in the treatment of bleeding disorders: the first 20 years","volume":"90","year":"1997","journal-title":"Blood"},{"key":"B24","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/j.1365-2516.2008.01708.x","article-title":"Back to the future: a recent history of haemophilia treatment","volume":"14","year":"2008","journal-title":"Haemophilia"},{"key":"B25","year":"2014"},{"issue":"5","key":"B26","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1097\/00000542-200005000-00006","article-title":"Anesthetic concerns of spaceflight","volume":"92","year":"2000","journal-title":"Anesthesiology"},{"issue":"2","key":"B27","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1586\/17474086.2015.1002465","article-title":"Individualizing prophylaxis in hemophilia: a review","volume":"8","year":"2015","journal-title":"Expert Rev Hematol"},{"key":"B28","doi-asserted-by":"crossref","first-page":"bcr2015211694","DOI":"10.1136\/bcr-2015-211694","article-title":"Haemophilia A in a major trauma patient","year":"2015","journal-title":"BMJ Case Rep"},{"issue":"2","key":"B29","first-page":"160","article-title":"Impact, diagnosis and treatment of von Willebrand disease","volume":"84","year":"2000","journal-title":"Thromb Haemost"},{"issue":"8","key":"B30","first-page":"748","article-title":"High G training and superficial phlebitis: a case report","volume":"61","year":"1990","journal-title":"Aviat Space Environ Med"},{"issue":"11","key":"B31","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.3357\/AMHP.4910.2017","article-title":"Dysrhythmias in laypersons during centrifuge-simulated suborbital spaceflight","volume":"88","year":"2017","journal-title":"Aerosp Med Hum Perform"},{"issue":"1","key":"B32","first-page":"12","article-title":"Ocular manifestations of Valsalva maneuver","volume":"23","year":"2012","journal-title":"CRO Journal"},{"issue":"3","key":"B33","first-page":"16","article-title":"Medical certification of a pilot with hemophilia A","volume":"51","year":"2013","journal-title":"FASMB"}],"container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/94\/6\/article-p470.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/94\/6\/article-p470.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/94\/6\/article-p470.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:33:42Z","timestamp":1728304422000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/94\/6\/article-p470.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,1]]},"references-count":33,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3357\/amhp.6204.2023","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"value":"2375-6314","type":"print"},{"value":"2375-6322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,1]]}}}