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the human body a complex and sometimes

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fragile machine as new plans are set

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new medical challenges will have to be

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previous space flights have demonstrated

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the physiological changes that may be

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expected after living in a microgravity

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areas of particular concern include

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loss of muscle and bone mass and changes

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in blood chemistry in addition to the

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physiological changes astronauts and

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scientists on space station will need to

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cope with common ailments such as two

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things as well as more serious medical

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conditions such as kidney stones crew

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members must also be prepared to face

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many of the hazards which are found in

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with longer missions larger crews and

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the complexities of a medical rescue the

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health of the crew will be an important

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factor to the success of the mission the

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space station health maintenance

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facility or h MF will provide necessary

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in-flight medical care including

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prevention diagnosis treatment and care

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during transport if the patient must be

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evacuated the hmf is currently under

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development by NASA at the Johnson Space

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Center in Houston Texas because of its

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specialized function the hmf is being

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designed primarily by a team of NASA

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physicians biomedical engineers and

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other allied health professionals in

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building the hmf current off-the-shelf

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equipment will be used as much as

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possible however existing technology

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must be adapted in order to operate in

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microgravity and conform to space

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the kc-135 provides a testing

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environment for equipment and procedures

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to be used in space using a parabolic

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flight path the kc-135 can simulate

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weightlessness for a few valuable

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seconds here a prototype of the patient

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restraint system is analyzed this piece

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of equipment must be both flexible and

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portable on space station it will be

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used as a stretcher a treatment area a

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dental chair and an x-ray table the

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health maintenance facility has been

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divided into flight subsystems as well

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as ground support these subsystems are

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similar to the medical services found in

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for example the hmf will be designed to

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provide emergency medical care for

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injuries medical life-support with

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respiratory support intravenous or IV

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fluid and nutritional support a variety

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of physicians instruments imaging for

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clinical laboratory to provide tests and

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pharmacy containing necessary

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medications and a computerized inventory

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control system central supply and a

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hyperbaric facility for treatment of

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decompression sickness although each of

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these capabilities will be needed on the

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space station it isn't feasible to

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launch a large hospital facility into

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orbit as a result the entire health

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maintenance facility with its preventive

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diagnostic and therapeutic capabilities

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must be designed to fit into a very

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in a hospital a large staff of highly

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trained professionals provides health

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care services the space station will not

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have those resources because of limited

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medical personnel the hmf equipment will

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in order to provide maximum flexibility

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the hmf will have a modular design each

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piece of equipment will be

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self-contained and will be held in

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this modular design will allow the

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components to be switched out easily for

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repairs or to be upgraded as new

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technology becomes available the patient

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restraint system which provides the

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treatment area will be located in front

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of the racks and will be stowed when not

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in use preventive health care is another

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major objective of the hmf exercise

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protocols will be designed to meet the

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individual needs of each crew member in

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addition to providing a cardiovascular

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workout these protocols will be used to

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help prevent the detrimental effects of

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weightlessness on bone and muscle

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exercise sessions will also generate

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physiological data for later analysis by

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NASA scientists here a computerized

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video system is being developed for use

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with the exercise equipment this system

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is designed to motivate the crew member

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another piece of equipment currently

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which converts to a rower this machine

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will provide a cardiovascular workout

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with the added feature of offering a

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choice of exercise activities unlike a

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hospital with its mounds of forms and

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stacks of paper the hmf will use the

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space station's computer resources to

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integrate all the information from each

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subsystem dr. James Logan manager of the

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Medical Sciences Space Station office at

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the Johnson Space Center explains this

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innovative approach one of the things

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that we're developing at Johnson Space

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Center is a concept known as the medical

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information bus or MIB the MIB would

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enable all the medical devices on the

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health maintenance facility to not only

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interact with each other but also

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interact with the hmf computer

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additional things that would be housed

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in the health maintenance facility

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computer would be things like diagnostic

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and treatment protocols or inventory

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management for the hmf another aspect

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would be the crew performance data

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especially as it related to the exercise

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devices if there was an illness on board

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the space station after the crew medical

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officer did a diagnostic physical exam

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he would enter the results of that

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physical exam on a keyboard which would

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put those results in an electronic

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medical record however all the

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laboratory data and the radiographic

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data and the electrophysiologic data

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such as an electrocardiogram would

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automatically be entered into an

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electronic medical record this is the

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Mission Control Center in Houston Texas

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this is the nerve center for the entire

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mission the flight director and all the

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flight controllers stay in this room

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throughout the duration of the mission

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this is also where the mission surgeon

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sits after the crew medical officer on

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the space station gathers all the

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medical data and the data is collated by

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the medical information bus that

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information is downlink to the earth and

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reconstructed at this console here in

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Mission Control when the information is

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reconstructed the mission surgeon has to

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make several key decision

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the first decision he or she would have

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to make is whether or not to activate a

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group of consultants which would be

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other physicians and surgeons located

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all across the country to have them

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actually look at the data with him or

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her the next decision that the doctor

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would have to make is whether or not the

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medical condition can be treated

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definitively at the hmf onboard the

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space station or whether a rescue needs

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to be even considered it becomes obvious

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then when you consider the mission and

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the cost of medical rescue that one of

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the prime goals of having a health

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maintenance facility on board the space

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station is to be able to treat as many

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medical conditions as possible in flight

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without having a rescue here on earth

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the development of a health maintenance

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facility may alter some current concepts

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for medical care the key to the hmf

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concept is the ability to combine

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existing equipment with computer

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technology this integrated package of

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health care resources can be used to

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assist in the diagnosis and management

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of medical problems which occur in

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remote environments such as isolated

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rural communities also the medical

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information bus can improve the quality

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of care in areas such as a hospital

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intensive care unit by integrating the

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information gathered from all the

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monitoring equipment the medical

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information bus will simplify the

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various equipment connections and

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eliminate most of the paperwork burden

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this will allow the care providers more

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on previous space flights there was

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nothing comparable to the hmf during

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those missions the need for in-flight

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health care was not as great as it will

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in order to successfully live and work

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on the space station crew members will

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have to maintain their health without

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the space station health maintenance

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facility the hmf will be an important

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step in understanding the intricacy of