Latest / Pediatrics Now: Cases Updates and Discussions for the Busy Pediatric Practitioner / Artemis II: From the Moon to Medicine — NASA’s AVATAR Experiment and Its Impact on Pediatric Care | Dr. Lisa Carnell

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Artemis II: From the Moon to Medicine — NASA’s AVATAR Experiment and Its Impact on Pediatric Care | Dr. Lisa Carnell · Pediatrics Now: Cases Updates and Discussions for the Busy Pediatric Practitioner

• 0:00
  And I know it's been such a busy week. A busy couple weeks. Oh my goodness.
• 0:06
  I can tell you, I literally just got home last night.
• 0:11
  I have been, it's been a whirlwind since days up to leading to the launch.
• 0:16
  You know, I've been, I was at Kennedy and then, you know, the most,
• 0:20
  I don't know if you've ever witnessed a space launch.
• 0:24
  Have you been to one? Not in person, but I watched this one and I was in tears. It's just astounding.
• 0:31
  Thank you for that. I was too.
• 0:34
  I was so blessed to have my family with me for this, you know,
• 0:38
  historic occasion. And then also having, you know, this really exciting science
• 0:43
  on board and, you know, seeing our astronauts lift off.
• 0:48
  I mean, it was, I see launches all the time.
• 0:51
  My division, we launch to the space station four times a year.
• 0:55
  In fact, I have a launch a week afterwards, right up to the space station.
• 0:59
  And, you know, I see them all the time. And this one was so different.
• 1:03
  The emotions were running high everywhere. We were, the excitement felt around the world.
• 1:10
  Just, it was spectacular. So I'm so glad that you had the opportunity to see
• 1:14
  it at home too and feel that same sensation that we all had just in person.
• 1:20
  You know, it was like, it's indescribable.
• 1:24
  That's a great way to put it. One of my favorite quotes by Mary Oliver is,
• 1:30
  pay attention, be astonished, tell about it. And.
• 1:36
  It was nothing short of astonishing. Joining me here today is Dr. Lisa Carnell.
• 1:41
  She's Director of NASA's Biological and Physical Sciences Division.
• 1:45
  Dr. Carnell, thank you so much for being here today on Pediatrics Now.
• 1:49
  Oh, thank you so much for having me.
• 1:52
  So I saw that for NASA, organ chips could provide vital data for future healthcare
• 1:59
  in pediatrics. Can you tell us about that?
• 2:02
  Yeah, you know, I feel like this mission that we sent forward is just so special
• 2:10
  to me because I did my graduate work.
• 2:13
  Actually, I was laughing. I tell folks, you know, all roads lead to,
• 2:17
  you know, this moment for me anyway.
• 2:21
  If I look back and connect the dots, because I studied, you know,
• 2:25
  stem cells and I made my own 3D, you know, model system when I was in graduate school.
• 2:32
  I can tell you, it's not as eloquent as what we have now.
• 2:36
  And at Duke, you went to Duke. Yeah.
• 2:39
  And, you know, I just, I had like such an incredible experience there, by the way.
• 2:45
  And, you know, it was just really welcoming to, you know, try it,
• 2:48
  try out different things.
• 2:50
  And I made my own model system there and was really passionate about how I could
• 2:55
  make a difference in space.
• 2:58
  One of my other true passions was how I translate that to medicine on Earth.
• 3:02
  I didn't ever want to go into anything that had like this single myopic focus.
• 3:07
  And so I've kind of had that lens in everything that I do for NASA.
• 3:11
  And so, you know, I pivoted as I came into NASA, back to NASA after I finished
• 3:19
  graduate school and was assigned to go work in space radiation,
• 3:22
  which radiation is critical in all of, you know,
• 3:26
  in the medical world, right? radiotherapy.
• 3:28
  I worked at the National Cancer Institute, some, you know, many other organizations at NIH.
• 3:33
  And, you know, I learned a great deal from them and how they evaluate and assess,
• 3:40
  radiation therapies, you know, whether it's to mitigate neutropenia,
• 3:44
  whether it's, you know, from some other clinical aspect, radiation damage,
• 3:48
  how do we protect from it?
• 3:50
  And so I led our medical countermeasures for space radiation.
• 3:54
  And I said, I really need some sort of a system that I can do some high throughput screening.
• 4:02
  But then at the same time, I also needed that biological data in the space radiation
• 4:07
  environment, which we just don't have because we haven't been doing biological
• 4:11
  missions out into deep space.
• 4:13
  And so, you know, these types of model systems, the 3D organ chip models,
• 4:19
  have been at the forefront of my mind for many years.
• 4:23
  I joined forces with many other government
• 4:26
  agencies through the National Institutes of Health, through FDA,
• 4:32
  BARDA, our program, the Human Research Program, and we collectively funded about
• 4:38
  $18 million worth of research about five years ago, six years ago.
• 4:44
  With the lens, I said, we all came together and I said, I really need these
• 4:49
  to last at least six months longer, but let's start with six months so I can
• 4:55
  send them to deep space and see what's going to happen on a long-duration mission.
• 4:59
  And they all said, well, I need this National Cancer Institute.
• 5:03
  I want to understand what's going to happen as I look longer term out for cancer therapies.
• 5:10
  Some folks were interested in toxicity of chemicals.
• 5:14
  And so together, we supported all of these researchers. You can find the information
• 5:19
  online. They're almost all done. And they've all been very successful in achieving this moment.
• 5:25
  So the six-month mark, that's going to really enable so much more research for us as well.
• 5:31
  Well, then, I'll let you—sorry, I'm just going on. Oh, please, please continue.
• 5:37
  No, I was just—I was going to say, you know, building on this,
• 5:41
  you know, I've—like I said, I always had that lens of, I need to send these to deep space.
• 5:46
  So I had this plan to put them on what was our previous version of Artemis 3
• 5:52
  going to the moon, and I had been working on that.
• 5:55
  And I got a new boss, and she said, I'm really fascinated with this research.
• 6:01
  Why are you not on Artemis 2? And I said, well, let me change that.
• 6:07
  So within two years, we redesigned the hardware, got these sewed and ready to fly on Artemis 2.
• 6:16
  And that was, yeah, it was truly scientifically an engineering feat all around.
• 6:24
  I think a lot of people don't realize, a lot of our doctor listeners,
• 6:28
  that along with those amazing astronauts were these tiny chips the size of a
• 6:33
  USB port where it can, and the chips can beat like a heart, breathe like a lung,
• 6:40
  or metabolize like a liver.
• 6:42
  Like, I was reading about the experiment. I mean, this really stops you.
• 6:47
  Thank you. Yes, and the experiment that we had flying alongside the crew members
• 6:53
  on Artemis II is called AVATAR.
• 6:55
  So, you know, it stands for a virtual astronaut tissue analog response.
• 7:01
  And this is the organ chip that we chose is a bone marrow chip model.
• 7:08
  And, you know, I've got a lot of questions. Why did you pick bone marrow?
• 7:12
  So going out into deep space, you know, the bone blood forming organs are literally
• 7:19
  like the most sensitive to the radiation environment.
• 7:22
  And so we knew we would see some impact on these types of organ chips.
• 7:28
  And we'll see it on the crew members.
• 7:30
  What's really neat is, you know, we were able to personalize them.
• 7:35
  So each of the astronauts donated their cells from their blood.
• 7:39
  We did not take bone marrow extracts from them, but they donated their cells.
• 7:45
  And we made personalized chips out of each of them so that we can compare across
• 7:51
  the board what happens in deep space, but also then really getting to that individual level.
• 7:57
  Now, this is a Pathfinder mission. It's a first of its kind.
• 8:00
  So it's probably not going to answer every question we have,
• 8:03
  but this is the start. This is how we get started.
• 8:07
  And, you know, what's really neat, the bone marrow model is,
• 8:10
  you know, really where hematopoiesis begins.
• 8:13
  And so where we're starting to get, you know, the B cell formation,
• 8:17
  and we see changes in the crew members already on the space station,
• 8:22
  you know, where we see suppressed immune function.
• 8:25
  And so this, we were thinking, could also help to really tie and dial back to
• 8:30
  what exactly, where are we seeing the changes altered in the formation of these
• 8:34
  different types of cells in the bone marrow?
• 8:37
  And is there something we can do about it to ensure that they maintain their
• 8:41
  immune function? if we're going to go live on the moon or out to Mars eventually.
• 8:47
  Because the astronauts' bodies, they're going through so much as they leave
• 8:50
  the atmosphere. We don't have as much protection from the radiation.
• 8:55
  It's affecting bones more rapidly.
• 8:58
  Yeah. So, yeah. So, you know, we've historically been doing most of our science
• 9:04
  on the International Space Station.
• 9:07
  If you're familiar with that, it's about 250 miles above Earth.
• 9:11
  So not too far, not 250,000 miles away. And we see impacts to the immune function
• 9:19
  very early on due to that space environment.
• 9:22
  It could be from microgravity. It could be combined. They do get a higher radiation exposure in space.
• 9:29
  We're really fortunate our planet is protected by the magnetosphere.
• 9:34
  So all of that penetrating radiation coming from the sun with the solar particle
• 9:39
  events or, you know, galactic cosmic radiation is ubiquitous in space.
• 9:45
  It's like, I would say, like taking a bath in radiation.
• 9:48
  And yeah, and then you've got the Van Allen belts, which are a lot of electrons
• 9:52
  and trapped radiation particles that they have to traverse once they go to deep space.
• 9:57
  But we're protected. So we find ourselves very fortunate.
• 10:01
  I smile like you hear a lot of people talking about the auroras,
• 10:06
  right? We love those, right?
• 10:08
  Well, we're right now in a period of what I call, you know, the solar cycle
• 10:15
  where we're at a solar maximum. And that means in those cycles usually last like 11 years.
• 10:20
  That means we're getting more high penetrating proton radiation coming down from the sun.
• 10:27
  And that's great in those beautiful auroras.
• 10:30
  So, you know, while we love them, it's all radiation-related.
• 10:33
  They're related. So very interesting.
• 10:37
  But yeah, we're lucky we're protected by the Van Allen belts around our planet.
• 10:44
  Once you get outside and we traverse those and they're heading out to the moon,
• 10:49
  Mars, or wherever, you no longer have that protective magnetosphere.
• 10:53
  So now you have to come up with ways to protect them, whether it's shielding,
• 10:58
  countermeasures, or something.
• 10:59
  Because, like I said, it's coming at them from everywhere.
• 11:04
  So it's a really one of our most incredible challenges.
• 11:10
  Wow. And this is going to help when astronauts are going farther out into space
• 11:16
  or staying longer in space, protect them, but also change the face of health
• 11:22
  care as we know it, it sounds like.
• 11:25
  Absolutely. And that's why, you know, I thought this was such an incredible opportunity.
• 11:30
  Opportunity you know i've been working with these
• 11:33
  other government agencies for years now since i was
• 11:35
  in space radiation and i said you know
• 11:38
  i'm i'm going to send these out into deep space i have
• 11:41
  four healthy humans and i'm comparing you know these bone marrow chip models
• 11:47
  to them directly they're being exposed to radiation you know in this environment
• 11:52
  and you know would you like to join me because they don't get that opportunity
• 11:57
  to see what the effect on a healthy human would be.
• 12:00
  It's not ethical to expose people to radiation and see what will happen.
• 12:05
  And so this, you know, is part of their job. So the astronauts,
• 12:09
  you know, are exposed, whether it's on station or beyond the Van Allen belts.
• 12:13
  And so this, they all jumped at the opportunity to really see that personalized
• 12:19
  impact and what that environment could do.
• 12:22
  So, and that speaks to the translational value of this technology and the science
• 12:28
  we did on Artemis II for advancing medical care here on Earth.
• 12:32
  And these chips are being used, it's my understanding, utilized for oncology
• 12:38
  care, but for a short period, you could tell for, is it 30 days?
• 12:43
  But this will really expand what knowledge can be gained from these chips.
• 12:49
  Yes. So that was the thing, you know, where we were looking at,
• 12:54
  you know, what, you know, the human body is full of many organs.
• 12:59
  And believe it or not, these are so powerful. they can literally make almost
• 13:03
  any organ, even female reproductive organs in the human body using these types
• 13:09
  of microphysiological systems. On the chip?
• 13:12
  Yeah, yeah. So, you know, they're called, people call them tissue chips,
• 13:18
  organ chips, microphysiological systems, you know, in some regards, organoids.
• 13:22
  They're all the same in that they're replicating the 3D human model organ system.
• 13:28
  They all have nuances, you know, some are microfluidic based,
• 13:32
  some are, you know, more organoid based where there are cells that kind of self-assemble
• 13:38
  and there's engineered organoids too.
• 13:40
  So this is really powerful for medicine.
• 13:44
  I'm super excited to see where this goes. And I think, you know,
• 13:49
  the PI that I'm working with out of the Waste Institute at Harvard,
• 13:53
  He did such a phenomenal job. I was so impressed. I'd been tracking him since
• 13:57
  he published in 2020, his first paper on this bone marrow chip model.
• 14:01
  He actually went, compared it to clinical data that had been published,
• 14:06
  did some, you know, hands-on work looking at how exposing these models to the
• 14:13
  radiation environment and then treating them with, like, GCSF,
• 14:17
  granulocytes to a colony stimulating factor,
• 14:20
  which is something you might give to somebody with neutropenia,
• 14:23
  you know, from radiotherapy or chemotherapy and see, but we also give that,
• 14:28
  that's what we prescribe for acute radiation syndrome.
• 14:31
  So what, you know, how well did this bone marrow chip model perform?
• 14:35
  It performed spectacular compared to the clinical outcomes that they saw.
• 14:39
  And so he's, and he's done a deeper dive into more of like pediatric related
• 14:45
  diseases. I know he published a paper, and I won't even pretend to be the expert in this.
• 14:51
  He did the work on it. But he modeled Schwachmann-Diamond syndrome,
• 14:56
  if I even pronounce that correctly.
• 14:59
  But I was so impressed with how he was able to show impaired hematopoiesis,
• 15:04
  altered neutrophil maturation.
• 15:09
  And then he was able to validate it with bone marrow aspirates.
• 15:11
  And I thought, this is powerful.
• 15:14
  How can we use this, you know, NASA's using it to advance personalized medicine
• 15:20
  for astronauts in space.
• 15:22
  How can we now use this and apply it for treating, you know,
• 15:26
  pediatric diseases, you know, early on, understanding at that individual,
• 15:32
  you know, child level, what's going to work for each one of them?
• 15:36
  How do we, you know, rather than, you know, medicine right now is sort of,
• 15:41
  you know, everybody gets their, you know, to take your two Tylenol,
• 15:46
  you know, it doesn't always work the same for everybody.
• 15:49
  We saw that a lot in COVID, right?
• 15:53
  Right. So, with the chips, you could see how the chip reacts to the Tylenol
• 16:01
  and then base the dose or try another medication because before that medication
• 16:06
  goes into the child's body?
• 16:08
  Yes. So, the whole goal would be, so, you know, if you're talking about one
• 16:12
  of these, like a disease model, you know, whether it's some type of leukemia, sickle cell disease.
• 16:20
  And I was looking these up, Fanconia anemia.
• 16:24
  You know, if you were to draw blood from the patient, and I know that's not
• 16:30
  always simple with children. My kids went through that.
• 16:34
  Right, mine too. Yeah, if you draw blood, you can create this bone marrow chip from a blood draw.
• 16:40
  So they don't have to undergo these invasive, you know, really painful, you know, extractions.
• 16:47
  And then, you know, as that bone marrow chip, these actually develop really
• 16:52
  quickly for the bone marrow model itself.
• 16:54
  You can create that bone marrow chip for them. And then, you know,
• 16:59
  they evaluate their disease because it's from them.
• 17:02
  So the cells and the way that they're performing are going to do that in the same model system.
• 17:08
  Then you can test different therapies. You could even possibly look at addressing
• 17:13
  it with CRISPR technology.
• 17:14
  You know, how do you treat, you know, your child or my child versus,
• 17:20
  you know, just a broader general population?
• 17:23
  And so I really think getting down to that, and that's where we need to go because
• 17:27
  not everybody responds the same.
• 17:29
  And I know we still suffer from really addressing a lot of the diseases to begin with.
• 17:35
  You know, how do we get a higher throughput screening of things,
• 17:39
  of different types of drugs or therapies that are going to work?
• 17:44
  Will this help regarding the harmful effects of necessary medical radiation,
• 17:51
  say, for medical tests and cancer treatments?
• 17:55
  We'll know better how to lessen those effects?
• 18:00
  That's a great question. And I really appreciate you asking that because that's
• 18:06
  one of the things I've been working with the National Cancer Institute on.
• 18:09
  And, you know, they're always, you know, whether you're giving,
• 18:13
  you know, whether it's proton therapy or, you know, x-rays or whatever type
• 18:18
  of, you know, exposure you're getting for radiotherapy, how do you protect the healthy cells?
• 18:23
  And how do you ensure that, you know, you can get the right level of treatment?
• 18:28
  And then also, what are some of the therapies that can, you know,
• 18:31
  ensure that you don't, you know, end up with neutropenia, which we do have some
• 18:36
  on the market, but does it work for everybody the same?
• 18:39
  And so, yeah, this technology has a power to address all of those things.
• 18:44
  What I also think is really interesting, and it's not the bone marrow specific model,
• 18:50
  but we have many of the organizations are literally, you know,
• 18:55
  getting tumor based models out there looking at cancer in different ways so
• 19:01
  that we can, you know, take a, say,
• 19:04
  a solid tumor model and actually,
• 19:07
  you know, deliver different types of treatments to that model so that we can
• 19:10
  understand what's going to perform the best or whether it's a cocktail.
• 19:13
  So the power of this is just starting to kind of unravel.
• 19:21
  It's incredible. And have you started looking at the chips yet?
• 19:24
  Do we, I know it's early on.
• 19:27
  Oh my gosh. Yeah. I said, I'm just beaming. It's like this whirlwind.
• 19:32
  We got the, you know, the crew landed on Friday and I was there at Splashdown in San Diego and,
• 19:39
  you know, we got them off and we waited patiently for the USS Martha to bring
• 19:44
  our avatar payload in, which I'll tell you was very exciting.
• 19:47
  The crew, all of the crew signed it, you know, so they, and they put some special
• 19:52
  notation, like Reed signed, you know, where he was in miles,
• 19:56
  like 219,000 some miles away.
• 19:59
  And, you know, so it was spectacular. And we got it to the Naval Health Research
• 20:03
  Center and opened it up and got those chips out and ready to be transported
• 20:08
  back to Boston for analysis. And I was just shaking, like, I can't wait what is in there.
• 20:13
  So, you know, they really got started on that Monday morning right away.
• 20:19
  And so I'm waiting. It's only been a few days.
• 20:21
  But, you know, for any type of data or number of results. So waiting with bated breath.
• 20:28
  It's just so exciting. Are there implications there for children,
• 20:32
  particularly with developing immune systems or chronic conditions that you want to talk about?
• 20:38
  Yeah, I mean, I think that there's so much possible with these organ chip models.
• 20:43
  I mean, I think, you know what's really exciting about this one in particular?
• 20:48
  There are many different types of suppliers out there.
• 20:52
  So right now we work with Emulate that made this chip model. You can buy them.
• 20:57
  Like, you can buy this, you know, polymer, you know, chip model and the whole
• 21:03
  system. And they'll explain to you how to actually create this.
• 21:07
  So you don't have to be the expert.
• 21:09
  You can get this expert advice so you can get more of this happening in your lab environment.
• 21:15
  But for helping, you know, some of these early stage issues with pediatrics
• 21:20
  and, you know, the inability for like, say, or impairment of red blood cell formation,
• 21:26
  you know, that this model system would be really beneficial to help with that.
• 21:31
  And I'm not sure what, I don't know the techniques that are used right now in
• 21:37
  evaluating that and understanding the disease.
• 21:39
  This will also let you not just understand it, you can do so many different
• 21:44
  types of analyses, single cell sequencing, you know, all different types of analyses.
• 21:49
  But this would also allow you to, again, like we've talked about,
• 21:53
  get back to that therapeutic potential.
• 21:55
  How do we fix that? How do we treat them so that they don't have to grow up
• 22:01
  and live with these really painful diseases?
• 22:04
  Amazing. And will we look back, do you think?
• 22:08
  And there'll be a time in the future we look back. I can't believe that it was
• 22:12
  just something was prescribed for all people, the same medication for this disease,
• 22:17
  and it wasn't personalized and targeted to that exact person's body.
• 22:22
  Oh, yes. I mean, even now, I think, don't we sometimes, you know,
• 22:27
  the question came up so much during COVID, too.
• 22:30
  You know, we see this across the disparity with, you know, men and women, women's health.
• 22:34
  You know, they've had like this kind of standard, you know, cookie cutter profile
• 22:40
  of how we address, you know, therapeutics, you know, in medicine back in the,
• 22:46
  you know, I don't even know how far back we go in the day.
• 22:49
  And we started to learn, well, men and women don't respond the same.
• 22:54
  Okay, now we take it a little bit further.
• 22:57
  Demographically, people respond differently. So this is, and so we think,
• 23:03
  didn't we think about this before?
• 23:05
  Well, maybe we did. Maybe we just didn't have the tools to do as much about it.
• 23:11
  You know, we've seen so often that, you know, animal models,
• 23:15
  that when we test therapeutics on them, they fail in clinical trials,
• 23:19
  right? because the animal just doesn't represent the human.
• 23:22
  In this case, not only does this model represent the human, it's human. It's made from you.
• 23:28
  So it's representing what your body will do.
• 23:32
  So, I mean, there's so much power in that. And so you're right. I think...
• 23:36
  I think it'll be a long time down the road that one day we're going to look
• 23:40
  back and say, wow, why didn't we think of this sooner?
• 23:45
  And will there be a need for less animal models, less animal testing?
• 23:50
  Yeah. And to be honest, that has been a worldwide push, not just in the U.S.
• 23:57
  The FDA already accepts this data in studies to move forward into clinical evaluation.
• 24:06
  So this has already started to demonstrate, you know, the power of these types of model systems.
• 24:12
  And this has been, you know, accepted worldwide.
• 24:16
  There is a huge push to move away from animal models.
• 24:20
  I think in some regards, there were some types of tests that you may need the
• 24:24
  animal models for, but it's really reducing that.
• 24:27
  And I think there's multiple benefits to that, you know, and like I said,
• 24:31
  the translational aspect, but, you know, this, and, you know,
• 24:34
  it's interesting because these are, the power of the science is there.
• 24:39
  I don't need to, you know, hammer that again, but, you know,
• 24:42
  these are so much simpler to make and, you know, you can test more of these in the lab.
• 24:47
  It's so much more work. I don't know if you've worked with the animal models,
• 24:50
  but, you know, it's so much more work and much more costly. Yeah.
• 24:56
  Dr. Cornell, what are you most excited about when it comes to Avatar?
• 25:03
  I am most excited about what this, the future of this science and technology,
• 25:10
  what it holds for NASA, for our future exploration missions.
• 25:14
  We have plans to send these out to, you know, the lunar environment and eventually
• 25:19
  onto Mars to see what happens so we can protect, you know, the health of astronauts
• 25:24
  on their way, you know, when they return home.
• 25:28
  We want to ensure that they maintain their health also while they're on their mission.
• 25:31
  And then I think, honestly, I wouldn't even separate them as one over the other
• 25:36
  is that the translational benefit to health right here on Earth is one of my top priorities as well.
• 25:42
  So that's, you know, the future of this, of Avatar and what it holds for,
• 25:49
  you know, NASA and for the general public is what I'm most excited about.
• 25:53
  And could it even give us information to help with sun protection, sunscreen that we use?
• 26:01
  Yeah, possibly. Well, there are skin models out there.
• 26:08
  Believe it or not, there are 3D skin models out there that you could do some
• 26:12
  of those testing and then you could couple that.
• 26:15
  So believe it or not, years back, the FDA and DARPA and NIH funded organizations
• 26:22
  to build multi-chip models. So they've put together 12 to 14 organs combined.
• 26:29
  So basically recreating a human with these different types of chips.
• 26:35
  You could choose what, you know, if you're going to use a sunscreen,
• 26:38
  I know there was a lot of hype out there about the nanoparticles in some of the sunscreens.
• 26:44
  So what if you could test that? And you could use, I could take your cells,
• 26:49
  Holly, and put them, make a skin chip model and possibly connect it to a liver
• 26:55
  or kidney chip to see how it's processed. And does it flow through the kidneys?
• 27:00
  Does it wash out? Does it get absorbed in the kidneys or in the liver itself?
• 27:05
  So really being able to understand even just sort of like the toxicity effects
• 27:10
  of the different types of sunscreens.
• 27:14
  But then, you know, how effective are they? So there's the benefits of this
• 27:19
  are just, you know, I can't even begin to go into everything that they're going to be enable us to do.
• 27:26
  It sounds like, as we all know, knowledge is power, and this is going to be incredibly powerful.
• 27:32
  Is there one takeaway that you want to mention to pediatricians,
• 27:37
  how this is going to help transform in the near future pediatric care?
• 27:44
  Yeah, I think, you know, I really appreciate you inviting me to come and talk
• 27:49
  with you and your community because it's not, you know, our normal community.
• 27:54
  And what I think, I would love to see the pediatric community embracing this
• 28:02
  science and technology and seeing how you can incorporate it into your everyday,
• 28:06
  because this isn't something that is to be left with the researchers and prestigious institutions.
• 28:15
  And ideally, I would love to see this incorporated into, you know,
• 28:20
  the physician's health care where, you know, you go in with an ailment and you,
• 28:25
  you know, the child is really sick,
• 28:28
  you know, possibly has a disease and you draw blood from them and create the
• 28:32
  organ chip model and really get down to how you can take care of them and really,
• 28:37
  you know, help them have a whole quality light, you know.
• 28:41
  So that's what I would love to have your community take away from this is really
• 28:47
  lean into embracing this and how they can start incorporating it.
• 28:53
  I love it. And for the parent listener, for our sister podcast,
• 28:57
  I've gotten questions from parents like, why do we need to leave Earth?
• 29:02
  I know that. What do you say to that? I want to say, why not?
• 29:07
  I love that. And, you know, honestly, Holly, I get that all the time.
• 29:11
  You know, I even get that from my family. And I work for NASA.
• 29:15
  You do? Um, yeah, but I would say that when people ask me, you know,
• 29:21
  why leap earth, you know, it's kind of like saying, well, why did Christopher
• 29:26
  Columbus sail the ocean?
• 29:28
  You know, we inherently are explorers, you know, that is in our DNA to explore the universe.
• 29:35
  And I have to say, if Artemis II didn't send that message of the excitement
• 29:40
  of actually going and leaving, you know, leaving Earth, going out around the
• 29:45
  moon, we didn't even land this time.
• 29:47
  And look at the excitement of being able to visually lay eyes on the far side
• 29:52
  of the moon and everybody following along with that.
• 29:55
  There's something special about exploring.
• 29:58
  And, you know, what I think is, you know, people will say, well,
• 30:01
  why do we spend money on that? We have so many problems here on Earth.
• 30:05
  And I say, I do understand that and I appreciate it.
• 30:09
  But I don't think people appreciate that the challenges that we take on in order
• 30:14
  to accomplish these exploration missions, whether it's Avatar or,
• 30:19
  you know, the technology for GPS signaling,
• 30:22
  calculators, all of it gets translated right back here on Earth.
• 30:25
  So, you know, so many things that we use every day would not have been possible
• 30:30
  without our exploration program. Right.
• 30:34
  We're forced to miniaturize everything. We had to, you know,
• 30:38
  for my avatar payload, literally, we send these cube labs to the ISS all the time.
• 30:45
  That stands for International Space Station.
• 30:47
  We send these all the time and just like literally plug them in.
• 30:51
  And so I thought, I called up Orion.
• 30:53
  I said, hey, you know, I want to send my organ chips.
• 30:56
  I'm just going to use this cube and plug it in. And they said,
• 30:59
  oh, no, you are not getting an outlet.
• 31:02
  So the only way I could do this is we had to redesign this miniaturized and
• 31:08
  create this whole life support system for these human organ chip models in this tiny package.
• 31:14
  All of that can now be translated here on earth to be used and it's just it's
• 31:20
  i think i think that's the struggle that sometimes people can't see those tangible
• 31:25
  benefits and maybe we need to do a better job of articulating it well i think
• 31:30
  you're doing a great job doing just that and.
• 31:34
  I saw that on the International Space Station, so there's greenhouses where
• 31:38
  tomatoes and weed are being grown.
• 31:41
  And it's just incredible learning how to how water behaves in space.
• 31:45
  How do you water a plant in microgravity?
• 31:48
  Oh, my gosh. And I love that you brought that up because that's my division, too. Oh, wow.
• 31:54
  We lead all of that work. And how are we going to grow food for humans to consume,
• 32:01
  you know, on and have, I don't know if you've seen The Martian. I loved it.
• 32:06
  I saw that. I tell Mary, loved it. Oh, it's incredible. Incredible.
• 32:12
  It makes me think of because these astronauts where they're willing to go through
• 32:16
  the effects of what happens in space to kind of sacrifice to go up in space.
• 32:22
  Anyway, it's a great movie.
• 32:24
  The absolute heroes, right? Yes. You know, but in that, we were literally focused
• 32:29
  and I've got my team down in like, I need, you know, I need a chamber for the
• 32:34
  moon, you know, and you got two years to come up with something for me.
• 32:38
  And, you know, that's a little overwhelming for them. But, you know,
• 32:41
  we've been practicing on the International Space Station.
• 32:44
  We've had people living in space for 25 years, you know.
• 32:48
  So people think, I actually did this panel this week at this 41st Annual Space Symposium.
• 32:56
  And somebody said, well, you know, what have we really demonstrated with the
• 33:01
  International Space Station?
• 33:03
  And I said, oh, my gosh, really?
• 33:06
  We did not know how to send humans
• 33:09
  to live and work in space for long durations, you know, 25 years ago.
• 33:15
  Now, fast forward, people take ISS for granted. They're like,
• 33:20
  oh, yeah, we're sending science up.
• 33:22
  Crew are going to go live there for six months, maybe a year.
• 33:25
  They live and work in space they do science they have hoods they do science
• 33:30
  in space and I think we it's underappreciated what it took to get us to that point and so I think.
• 33:40
  There is so much that we're accomplishing. And so when you're talking about
• 33:44
  the plants, I love that because the crew love it.
• 33:48
  They're always asking, can I eat that? And we're like, no, we're not really
• 33:51
  sure what's growing up there.
• 33:53
  I don't chime in there. That's the human research program or crew help,
• 33:57
  but they like make them wipe everything down where they can taste it.
• 34:02
  But there's, there's psychological benefit in being able to create your own living produce.
• 34:08
  And, you know, we have a lot more exciting things coming up,
• 34:11
  coming that way here soon.
• 34:13
  So stay tuned. And that will be happening on the moon?
• 34:16
  Yeah, we have, we actually have, we have a payload called LEAF,
• 34:21
  the lunar effects of agricultural flora that is launching on Artemis 4.
• 34:28
  So I had to recalibrate because two months ago our new administrator kind of
• 34:33
  reshaped our Artemis program.
• 34:35
  And so Artemis 4 will be happening in 2028 and that's where we land on the moon.
• 34:41
  So stay tuned and be watching for Avatar going to the moon and our leaf,
• 34:47
  our plant project is going to be on the lunar surface.
• 34:51
  Sounds incredible. Is there anything you want to mention, Dr.
• 34:54
  Carnell, before we go that we didn't touch on? This has been incredible.
• 34:59
  I'll tell you, Holly, I could go on.
• 35:03
  I mean, we're doing so many exciting things. But, you know, I think for,
• 35:09
  you know, all of us personally, when we can connect with the science,
• 35:13
  you know, science, you know, science is the why.
• 35:17
  When people are saying, why are we going? Why? Science is the why.
• 35:21
  I mean, to just go and land a human and say, hey, made it.
• 35:26
  Hi, everybody. You know, what are we doing?
• 35:29
  We're doing incredible science once we get there. And then we're going to learn
• 35:33
  so much off planet, off Earth, about how, you know, unique ways of doing things
• 35:39
  that, you know, will really help us learn more about our own planet.
• 35:44
  So, and then if I can just add one more thing about the plant area.
• 35:49
  You know, we work with the USDA often and Department of Energy related to plants.
• 35:57
  And part of that's because if we can learn to grow plants in these austere environments,
• 36:03
  then how can we help enable growing crops in like, say, austere environments
• 36:08
  right here on Earth? So we partner really tightly with them.
• 36:12
  They learn from us. We learn from them. So there's this synergy happening that
• 36:17
  I think is under-recognized.
• 36:21
  Wow. And I have three teenage children. So will our kids be going to space? Will it be fun?
• 36:30
  More routine? Absolutely. I think, you know, by the time your children might,
• 36:36
  I've got, I have two boys in college.
• 36:39
  By the time our children are our age, I think we will have full,
• 36:45
  sustainable human presence on the moon.
• 36:47
  And quite frankly, I believe we will have sent humans to Mars.
• 36:52
  So I don't think we'll have that full, sustainable presence at that time on
• 36:57
  Mars yet, but I think we'll be working towards it.
• 37:00
  But I think we will, they will definitely have opportunities to,
• 37:03
  to go to, go to the moon if they'd like.
• 37:07
  And there are some substances perhaps on the moon that could be beneficial too,
• 37:11
  that we're learning about. Is that anything you want to mention?
• 37:15
  Absolutely. You know, so lunar regolith is fascinating. Yeah.
• 37:21
  And there's so much. We have simulants on Earth.
• 37:23
  So, you know, in the Apollo program, they brought back lunar rocks.
• 37:28
  And, you know, we basically, we did every possible analysis to understand what
• 37:32
  the chemical compositions were. And then we recreated it, literally.
• 37:36
  So we have what we call simulants. But it still isn't an exact match because
• 37:41
  you can imagine the moon is out there and it's constantly being bombarded with
• 37:46
  radiation, meteorites, asteroids, you know, it's all over.
• 37:50
  So how do we, you know, how do we take that regolith and, you know,
• 37:55
  turn it into something? Can we extract oxygen?
• 37:58
  Can we, you know, use that to start to build structures? So I also have early
• 38:04
  stage work in what we call in-situ resource utilization.
• 38:08
  So I have a team working on a project where we would send a robotic lander to
• 38:14
  scoop and create, using a bioreactor,
• 38:17
  a type of flurry that we could then form into a shape to see if we do that, does it work?
• 38:23
  And could we make these larger, so like bricks, if you will,
• 38:27
  so we could start to build foundational structures on the moon.
• 38:30
  And there's just, I think, learning how to live on the moon or another planet
• 38:37
  and the technology that we're going to need to accomplish that is going to be
• 38:42
  such a win and a huge benefit right here on Earth.
• 38:45
  Amazing. And even how do you water a plant?
• 38:49
  Oh, yeah. So, which I appreciate that you recognize that because my team works on fluidics, too.
• 38:55
  And so fluids, you guys probably, if you've ever seen it, and if you haven't,
• 38:59
  you should go watch because it's fun even for me.
• 39:02
  The astronauts with water in space, they get like a big bubble and they run
• 39:07
  around and catch it. And the kids love watching that.
• 39:10
  You know, the way fluids behave in space is entirely different than on the ground.
• 39:15
  Because of the microgravity environment. Everything floats. And that has a lot
• 39:20
  of challenges. So we've had to learn how do you maneuver water?
• 39:25
  Or like an IV. You know, you give an IV in the clinical setting.
• 39:30
  You know, you just, everybody does it. You've got standard of care.
• 39:33
  You just put the needle in, put the IV in.
• 39:36
  Putting an IV in in space is a whole different ballgame. And creating the ability
• 39:41
  for that to pump and flow is different than what you would have on ground.
• 39:47
  So we've been developing all these technologies.
• 39:49
  We have like literally plant water management systems that are designed just to deliver water.
• 39:55
  You can't just go around with your, you know, little watering can because it
• 40:00
  would just all float around.
• 40:01
  So it is, we've had to overcome every, you can't even imagine all the details
• 40:08
  that you have to think about. because it's so different, but it kind of makes it fun, too. Wow.
• 40:15
  Well, just throwing this out there, could I maybe be the first podcast host in space?
• 40:21
  If you need someone, just let me know. Oh, my gosh. Love that.
• 40:24
  I love that idea.
• 40:28
  I'll pass that one over to Aries, our PAO person who deals in that,
• 40:32
  but that would be super cool. Sounds great. I love it.
• 40:36
  Dr. Cornell, thank you so much for helping us understand how this work in space
• 40:41
  may shape health care here on Earth and for giving us all something to be astonished
• 40:45
  by. This is just incredible.
• 40:48
  Thank you so much, Holly. This has been a lot of fun, and I really appreciate
• 40:52
  and value what you all do in your community.
• 40:55
  Thank you. Thank you, and thank you for being on Pediatrics Now.
• 41:00
  And for our listeners and viewers, don't forget to click on the link in this
• 41:03
  podcast for free credit that may include CME, MOC, or ethics credit,
• 41:08
  depending on our topic, or podcast.
• 41:10
  I'm Holly Wayment, and I'll see you next week.