Long-duration Spaceflight Research Articles

Zoster patients on earth and astronauts in space share similar immunologic profiles

BackgroundOn long-duration spaceflight, most astronauts experience persistent immune dysregulation and the reactivation of latent herpesviruses, including varicella zoster virus (VZV). To understand the clinical risk of these perturbations to astronauts, we paralleled the immunology and virology work-up of astronauts to otherwise healthy terrestrial persons with acute herpes zoster. MethodsBlood samples from 42 zoster patients – confirmed positive by PCR for VZV DNA in saliva (range from 100 to >285 million copies/mL) were analyzed for peripheral leukocyte distribution, T cell function, and plasma cytokine profiles via multi-parametric flow cytometry and multiplex bead-based immune-array assays. Patient findings were compared to normal value ranges specific for each assay that were defined in-house previously from healthy adult test subjects. ResultsCompared to the healthy adult ranges, the zoster patients possess (1) a higher proportion of constitutively activated T-cells, (2) a T-cell population skewed towards a more experienced maturation state, (3) depressed general T-cell function, and (4) a higher concentration of 20 of 22 measured plasma cytokines. DiscussionThe pattern of immune dysregulation in zoster patients is similar to that of astronauts during spaceflight who shed VZV DNA in their saliva. Because future deep space exploration missions will be of an unprecedented duration, prolonged immune depression and chronic viral reactivation threaten to manifest overt disease in exploration class astronauts.

Inflight leg cuff test does not identify the risk for orthostatic hypotension after long-duration spaceflight

Landing day symptoms from orthostatic hypotension after prolonged spaceflight can be debilitating, but severity of these symptoms can be unpredictable and highly individual. We tested the hypothesis that an impaired baroreflex response to an inflight leg cuff test could predict orthostatic intolerance on return to Earth. Eight male astronauts (44 ± 7 years of age (mean ± SD); mean mission length: 167 ± 12 days) participated in a standardized supine-to-sit-to-stand test (5 min–30s–3 min) pre- and postflight, and a 3 min thigh cuff occlusion test pre- and inflight with continuous monitoring of heart rate and arterial blood pressure. The arterial baroreflex was not changed inflight as shown by similar reductions in mean arterial pressure (MAP) response to leg cuff deflation (preflight −19 ± 2 mmHg vs. inflight −18 ± 5 mmHg). With the sit/stand test, the nadir of MAP was lower postflight (−17 ± 9 mmHg) than preflight (−11 ± 6 mmHg, p < 0.05). A greater increase in heart rate (25 ± 7; 16 ± 3 bpm) and decrease in stroke volume (−24 ± 11; −6 ± 4 mL) occurred with sit/stand postflight than leg cuffs inflight (p < 0.001). Inflight testing was influenced by elevated cardiac output resulting in a smaller drop in total peripheral resistance. Two of eight subjects exhibited orthostatic hypotension during the postflight stand test; their responses were not predicted by the inflight leg cuff deflation test. These results suggest that the baroreflex response examined by inflight leg cuff deflation was not a reliable indicator of postflight stand responses.

Changes in human skeletal muscle architecture and function induced by extended spaceflight

The aim of this study was to quantitatively describe the relationships between joint angles and muscle architecture (lengths (Lf) and angles (Θf) of fascicles) of human triceps surae [medial (MG) and lateral (LG) gastrocnemius and soleus (SOL) muscles] invivo for three men-cosmonaut after long-duration spaceflight. Sagittal sonographs of MG, LG, SOL were taken at ankle was positioned at 15° (dorsiflexion), 0° (neutral position), +15°, and +30° (plantarflexion), with the knee at 90° at rest and after a long-duration spaceflight. At each position, longitudinal ultrasonic images of the MG and LG and SOL were obtained while the cosmonauts was relaxed from which fascicle lengths and angles with respect to the aponeuroses were determined. After space flight plantarflexor force declined significantly (26%; p < 0.001). The internal architecture of the GM, and LG, and SOL muscle was significantly altered. In the passive condition, Lf changed from 45, 53, and 39 mm (knee, 0°, ankle, −15°) to 26, 33, and 28 mm (knee, 90° ankle, 30°) for MG, LG, and SOL, respectively. Different lengths and angles of fascicles, and their changes by contraction, might be related to differences in force-producing capabilities of the muscles and elastic characteristics of tendons and aponeuroses. The three heads of the triceps surae muscle substantially differ in architecture, which probably reflects their functional roles. Differences in fiber length and pennation angle that were observed among the muscles and could be associated with differences in force production and in elastic properties of musculo-tendinous complex and aponeuroses.

Assessment of ventricular repolarization instability in terms of T-wave alternans induced by head-down bed-rest immobilization

Objective: To assess the effects of different durations of simulated microgravity exposure on ventricular repolarization (VR) in terms of T-wave alternans (TWA) as well as to test whether an increase in VR heterogeneity could be detected once normal gravity was restored. Approach: A total of 63 healthy volunteers were recruited in several head-down bed-rest (HDBR) experiments in the context of the European Space Agency bed-rest strategy. TWA is evaluated during the night period using ambulatory ECG recordings, before, during and after long- (60 d), mid- (21 d) and short- (5 d) duration HDBR by the long-term averaging technique. Main results: 5–21 d of exposure to simulated microgravity by means of the HDBR model do not lead to a significant increase of cardiac electrical instability in healthy myocardial substrates up to the point of eliciting TWA on the surface ECG. However, TWA indices increased after long-term HDBR exposure, once normal gravity was re-established, indicative of incipient electrical instability on VR at the conclusion of 60 d of HDBR. Significance: The results of this work underline the importance of focusing future research on immediate effects after long-term microgravity exposure, both simulated by HDBR or from space mission scenarios, once partial gravity conditions are re-established. A deeper insight in the understanding of human body reactions in these scenarios results crucial in the design of future long-duration spaceflight missions, to mitigate any potential risk that can limit astronaut’s performance.

Human Neural Stem Cells Flown into Space Proliferate and Generate Young Neurons.

Here we demonstrate that human neural stem cells (NSCs) proliferate while in space and they express specific NSC markers after being in space. NSCs displayed both higher oxygen consumption and glycolysis than ground controls. These cells also kept their ability to become young neurons. Electrophysiological recordings of space NSC-derived neurons showed immature cell membrane properties characterized by small capacitance and very high input resistance. Current injections elicited only an incipient action potential. No spontaneous synaptic events could be detected, suggesting their immature status even though most recorded cells displayed complex morphology and numerous cell processes. Ascertaining the origin of the NSCs′ increased energy requirement is of the essence in order to design effective measures to minimize health risks associated with long-duration human spaceflight missions.

Neck Muscle Changes Following Long-Duration Spaceflight.

The effects of long-duration spaceflight on crewmember neck musculature have not been adequately studied. The purpose of this study was to evaluate the changes in the neck musculature on pre-flight and post-flight magnetic resonance imaging (MRI) examinations of six crewmembers on 4- to 6-month missions equipped with the advanced resistive exercise device (aRED). The MRI images were resliced to remove variations in spinal curvature, the cross-sectional area (CSA), and muscle fat infiltration (MFI) of neck musculature at the C1-C2, C4-C5, C7-T1, and T1-T2 intervertebral disc levels were measured bilaterally. Percent changes in the neck muscle CSA and fatty infiltration following spaceflight were calculated, and mixed models were used to assess significance of these changes. Crewmembers on missions equipped with the aRED experienced an average 25.1% increase in CSA for the trapezius muscle at C6-C7, an average 11.5% increase in CSA for the semispinalis capitis muscle at C4-C5, an average 9.0% increase in CSA for the sternocleidomastoid muscle at C4-C5, and an average 23.1% increase in CSA for the rhomboid minor at T1-T2. There were no significant changes in the CSA of the levator scapulae, splenius capitis, rectus capitis posterior major, scalenus anterior, scalenus posterior, scalenus medius, longissimus capitis, or obliquus capitis inferior muscles at the locations measured. None of the muscles analyzed experienced statistically significant changes in fatty infiltration with spaceflight. Our study indicates that long-duration spaceflight conditions are associated with preservation of CSA in most neck muscles and significant increases in the CSAs of the trapezius, semispinalis capitis, sternocleidomastoid, and rhomboid minor muscles. This may indicate that cervical muscles are not subjected to the same degradative effects microgravity imparts on the majority of muscles.

Use of Quantitative Computed Tomography to Assess for Clinically-relevant Skeletal Effects of Prolonged Spaceflight on Astronaut Hips

Introduction: In 2010, experts in osteoporosis and bone densitometry were convened by the Space Life Sciences Directorate at NASA Johnson Space Center to identify a skeletal outcome in astronauts after spaceflight that would require a clinical response to address fracture risk. After reviewing astronaut data, experts expressed concern over discordant patterns in loss and recovery of bone mineral density (BMD) after spaceflight as monitored by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT). The pilot study described herein demonstrates the use of QCT to evaluate absence of recovery in hip trabecular BMD by QCT as an indicator of a clinically actionable response. Methodology: QCT and DXA scans of both hips were performed on 10 astronauts: once preflight and twice postflight about 1 wk and 1 yr after return. If trabecular BMD had not returned to baseline (i.e., within QCT measurement error) in 1 or both hips 1 yr after flight, then another QCT hip scan was obtained at 2 yr after flight. Results: Areal BMD by DXA recovered in 9 of 10 astronauts at 1 yr postflight while incomplete recovery of trabecular BMD by QCT was evident in 5 of 10 astronauts and persisted in 4 of the 5 astronauts 2 yr postflight. Conclusion: As an adjunct to DXA, QCT is needed to detect changes to hip trabecular BMD after spaceflight and to confirm complete recovery. Incomplete recovery at 2 yr should trigger the need for further evaluation and possible intervention to mitigate premature fragility and fractures in astronauts following long-duration spaceflight.

Alterations of Functional Brain Connectivity After Long-Duration Spaceflight as Revealed by fMRI.

The present study reports alterations of task-based functional brain connectivity in a group of 11 cosmonauts after a long-duration spaceflight, compared to a healthy control group not involved in the space program. To elicit the postural and locomotor sensorimotor mechanisms that are usually most significantly impaired when space travelers return to Earth, a plantar stimulation paradigm was used in a block design fMRI study. The motor control system activated by the plantar stimulation involved the pre-central and post-central gyri, SMA, SII/operculum, and, to a lesser degree, the insular cortex and cerebellum. While no post-flight alterations were observed in terms of activation, the network-based statistics approach revealed task-specific functional connectivity modifications within a broader set of regions involving the activation sites along with other parts of the sensorimotor neural network and the visual, proprioceptive, and vestibular systems. The most notable findings included a post-flight increase in the stimulation-specific connectivity of the right posterior supramarginal gyrus with the rest of the brain; a strengthening of connections between the left and right insulae; decreased connectivity of the vestibular nuclei, right inferior parietal cortex (BA40) and cerebellum with areas associated with motor, visual, vestibular, and proprioception functions; and decreased coupling of the cerebellum with the visual cortex and the right inferior parietal cortex. The severity of space motion sickness symptoms was found to correlate with a post- to pre-flight difference in connectivity between the right supramarginal gyrus and the left anterior insula. Due to the complex nature and rapid dynamics of adaptation to gravity alterations, the post-flight findings might be attributed to both the long-term microgravity exposure and to the readaptation to Earth’s gravity that took place between the landing and post-flight MRI session. Nevertheless, the results have implications for the multisensory reweighting and gravitational motor system theories, generating hypotheses to be tested in future research.

Negative Effects of Long-duration Spaceflight on Paraspinal Muscle Morphology

Prospective case series. Determine the extent of paraspinal muscle cross-sectional area (CSA) and attenuation change after long-duration spaceflight and recovery on Earth. Determine association between in-flight exercise and muscle atrophy. Long-duration spaceflight leads to marked muscle atrophy. However, another negative consequence of disuse is intramuscular fatty infiltration. Notably, few studies have investigated the effects of spaceflight on intramuscular fatty infiltration, or how muscle atrophy is associated with in-flight exercise. We analyzed computed tomography scans of the lumbar spine (L1/L2) from 17 long-duration astronauts and cosmonauts to determine paraspinal muscle CSA and attenuation. Computed tomography scans were collected preflight, postflight, 1-year postflight, and, in a subset, 2 to 4 years postflight. We measured CSA (mm) and attenuation (Hounsfield Units) of the erector spinae (ES), multifidus (MF), psoas (PS), and quadratus lumborum (QL) muscles. We used paired t tests to compare muscle morphology at each postflight time point to preflight values and Pearson correlation coefficients to determine the association between muscle changes and in-flight exercise. ES, MF, and QL CSA and attenuation were significantly decreased postflight compared with preflight (-4.6% to -8.4% and -5.9% to -8.8%, respectively, p < 0.05 for all). CSA of these muscles equaled or exceeded preflight values upon Earth recovery, however QL and PS attenuation remained below preflight values at 2 to 4 years postflight. More resistance exercise was associated with less decline in ES and MF CSA, but greater decline in PS CSA. Increased cycle ergometer exercise was associated with less decline of QL CSA. There were no associations between in-flight exercise and muscle attenuation. Both CSA and attenuation of paraspinal muscles decline after long-duration spaceflight, but while CSA returns to preflight values within 1 year of recovery, PS and QL muscle attenuation remain reduced even 2 to 4 years postflight. Spaceflight-induced changes in paraspinal muscle morphology may contribute to back pain commonly reported in astronauts. 4.

Effects and Solutions on the Human Body After Long-Duration Space Flights

During the Cold War, President John F. Kennedy made it a mission for the National Aeronautics and Space Administration (NASA) to accomplish a lunar landing and return to Earth. The final lunar landing and the last time humans left Low Earth Orbit (LEO) was in December, 1972. However, 47 years have passed and the fascination with traveling into deep space remains alive and flourishing. A major problem with future human missions to Mars is the effects of microgravity and Mars’ 0.38g environment. Unfortunately, space medicine is limited and little is known about the effects of microgravity on the human body after one year in space. Is it possible for astronauts to survive long spaceflight missions to Mars? To help address this question, my research focuses on the effects of microgravity on astronauts in order to find solutions for long-duration space flights to Mars. Bone and muscle loss are factors that could lead to severe, unknown consequences on an astronaut’s health. My methods included doing an analytical interpretation of historical and contemporary research on long-distance spaceflight. In the future, longer missions are going to require more permanent solutions for humans to be an interplanetary species. The current solutions being used in the International Space Station (ISS) are only to treat individual symptoms separately. Only theoretical permanent solutions were found, such as artificial gravity; therefore, further research is needed. Centripetal acceleration has shown great promise to eliminate microgravity effects but more research is needed to understand the health consequences and the limitations of rotation that humans can sustain.

Lumbopelvic Muscle Changes Following Long-Duration Spaceflight.

Long-duration spaceflight has been shown to negatively affect the lumbopelvic muscles of crewmembers. Through analysis of computed tomography scans of crewmembers on 4- to 6-month missions equipped with the interim resistive exercise device, the structural deterioration of the psoas, quadratus lumborum, and paraspinal muscles was assessed. Computed tomography scans of 16 crewmembers were collected before and after long-duration spaceflight. The volume and attenuation of lumbar musculature at the L2 vertebral level were measured. Percent changes in the lumbopelvic muscle volume and attenuation (indicative of myosteatosis, or intermuscular fat infiltration) following spaceflight were calculated. Due to historical studies demonstrating only decreases in the muscles assessed, a one-sample t test was performed to determine if these decreases persist in more recent flight conditions. Crewmembers on interim resistive exercise device-equipped missions experienced an average 9.5% (2.0% SE) decrease in volume and 6.0% (1.5% SE) decrease in attenuation in the quadratus lumborum muscles and an average 5.3% (1.0% SE) decrease in volume and 5.3% (1.6% SE) decrease in attenuation in the paraspinal muscles. Crewmembers experienced no significant changes in psoas muscle volume or attenuation. No significant changes in intermuscular adipose tissue volume or attenuation were found in any muscles. Long-duration spaceflight was associated with preservation of psoas muscle volume and attenuation and significant decreases in quadratus lumborum and paraspinal muscle volume and attenuation.

The escape of retrobulbar cerebrospinal fluid in the astronaut's eye: mission impossible?

Ophthalmic abnormalities including unilateral and bilateral optic disc edema, optic nerve sheath distention, globe flattening, choroidal folds, and hyperopic shifts have been observed in astronauts during and after long-duration spaceflight. An increased understanding of factors contributing to this syndrome, termed spaceflight-associated neuro-ocular syndrome, is currently a top priority for the ESA and NASA, especially since this medical obstacle could impact the visual health of astronauts as well as the success of future missions, including continued trips to the International Space Station, a return to the moon, or a future human mission to Mars. Currently, the exact mechanisms causing this neuro-ocular syndrome are not fully understood. In the present paper, we propose a hypothetical framework by which optic disc edema in astronauts may result, at least partly, from the forcing of perioptic cerebrospinal fluid into the optic nerve and optic disc along perivascular spaces surrounding the central retinal vessels, related to long-standing microgravity fluid shifts and variations in optic nerve sheath anatomy and compliance. Although this hypothesis remains speculative at the present time, future research in this area of investigation could not only provide exciting new insights into the mechanisms underlying microgravity-induced optic disc swelling but also offer opportunities to develop countermeasure strategies.

Brain ventricular volume changes induced by long-duration spaceflight

Long-duration spaceflight induces detrimental changes in human physiology. Its residual effects and mechanisms remain unclear. We prospectively investigated the changes in cerebrospinal fluid (CSF) volume of the brain ventricular regions in space crew by means of a region of interest analysis on structural brain scans. Cosmonaut MRI data were investigated preflight (n = 11), postflight (n = 11), and at long-term follow-up 7 mo after landing (n = 7). Post hoc analyses revealed a significant difference between preflight and postflight values for all supratentorial ventricular structures, i.e., lateral ventricle (mean % change ± SE = 13.3 ± 1.9), third ventricle (mean % change ± SE = 10.4 ± 1.1), and the total ventricular volume (mean % change ± SE = 11.6 ± 1.5) (all P < 0.0001), with higher volumes at postflight. At follow-up, these structures did not quite reach baseline levels, with still residual increases in volume for the lateral ventricle (mean % change ± SE = 7.7 ± 1.6; P = 0.0009), the third ventricle (mean % change ± SE = 4.7 ± 1.3; P = 0.0063), and the total ventricular volume (mean % change ± SE = 6.4 ± 1.3; P = 0.0008). This spatiotemporal pattern of CSF compartment enlargement and recovery points to a reduced CSF resorption in microgravity as the underlying cause. Our results warrant more detailed and longer longitudinal follow-up. The clinical impact of our findings on the long-term cosmonauts' health and their relation to ocular changes reported in space travelers requires further prospective studies.

Projection-based visualization technology and its design implications in space habitats

The variety of stressors inherent to space missions and other extreme environments can cause crewmembers to experience complex psychological difficulties. Such conditions will likely become more severe during long-duration space flights, exposing crewmembers to situations of extreme sensory deprivation and loneliness. Means to integrate novelty and reduce monotony in space habitat environments can alleviate the negative psychological impacts of long-term space missions. Although various physical and psychological countermeasures have been successfully implemented in orbital spaceflight, deep space travel poses new challenges that will require existing strategies to be adapted and redesigned, and new solutions to be developed. In this paper, we describe how mixed reality technologies can be used to create and deliver stimuli to the crew by eliciting desired emotional responses and enabling novel design opportunities.

Stress Induced Immune Dysregulation: A Continuum Spanning Antarctica Winterover, Spaceflight, and Terrestrial Patients

Abstract Spaceflight, a unique environment characterized by stress, microgravity, isolation, circadian misalignment, and radiation exposure, impacts immune health. This analysis compares various aspects of immune dysregulation in astronauts during long-duration orbital spaceflight to ground-analog populations, including hypoxic and normoxic Antarctic winterover. Astronaut data were also compared to a clinical immunodeficiency population, shingles patients, to help interpret clinical risks during deep space missions. A comprehensive evaluation was performed across all platforms which included plasma and mitogen stimulated cytokine profiles, T cell function, and peripheral leukocyte distribution. A cross platform analysis was then performed to define in-flight immune alterations, determine analog appropriateness, and interpret clinical risk. Astronauts manifest a distinct pattern of immune alterations, including unaltered leukocyte distribution, reduced T/NK cell function, and increases in plasma cytokines leading to the reactivation of latent herpesviruses. The pattern is similar to that observed in shingles patients, but reduced in magnitude. Immune alterations during interior Antarctic winterover were dissimilar from spaceflight, likely due to hypobaric hypoxia. Normoxic winterover, to date only cytokine data exist, appears more homologous to spaceflight. Stress induced reductions in immunity can lead to clinical disease. This phenomenon may represent a continuum, where alterations in astronauts may represent more subtle variations which precede the development of disease. Antarctica data, at a magnitude between flight and disease, suggest that stress and circadian issues may be a primary contributor.

Susceptibility of Host Immunity to Infectious Diseases in the Spacecraft Environment

Introduction:The principles of Disaster and Emergency Medicine are applicable beyond the confines of planet Earth. With the accelerating rate of climate change, natural disasters, and overpopulation, as well as the innate human appetite for knowledge and technological advancement, there has recently been an increased interest in the prospect of long-duration spaceflight with a view to colonize extra-terrestrial bodies, such as Mars. However, there is a need to understand the risk of adverse medical events in the hostile environment of space. For example, previous incidences of infectious disease and immune dysregulation during a short-term mission have threatened to jeopardize the crew dynamic and the mission objectives. The risk of infectious diseases to the astronaut is one of the many knowledge gaps that must be addressed before long-duration flight is considered.Aim:To review how spaceflight impacts an astronaut’s in-flight susceptibility to infectious diseases.Methods:Research was guided by the Microbiology section of the NASA Human Research Roadmap Program. Search terms in the University of Adelaide Library Search database collection included: “infectious diseases + spaceflight,” “astronaut + immunity,” “analog,” and “inflammatory marker.”Results:Studies that have been conducted in-flight and on Earth demonstrate that both the astronaut and the microbe are affected by spaceflight. Stress, microgravity, and the isolated nature of the spacecraft have been found to compromise the immunity of the astronaut, as shown by reduced T cell counts and increased viral shedding of dormant viruses. Microbes have demonstrated rapid adaptation mechanisms, including genetic mutation and increased virulence.Discussion:This paper identifies a significant need for further research into host immunity during spaceflight to mitigate infectious disease risk. It is recommended that in-situ studies and terrestrial space analogs are most effective and that current knowledge on the principles of wilderness and expedition medicine be applied where possible.

Improving Success of Orotracheal Intubation by Novice Operators in Microgravity with Video-Laryngoscopy

Background: The risk of severe medical and surgical events during long-duration spaceflight is significant. Orotracheal intubation, which may be required for a range of medical and surgical conditions, is a technically challenging procedure, especially in novice hands. We hypothesized that the procedure may be facilitated by the use of a video-laryngoscope (VL), and compared intubation success rates of experts and novices under normogravity or simulated microgravity in parabolic flights. Methods: Six subjects (3 experts and 3 novices) performed 180 orotracheal intubations on a mannequin, with half during simulated microgravity and half on the ground (normogravity condition). Half of the attempts used direct laryngoscopy (DL) and half VL. The primary outcome was intubation success rate. We also recorded intubation time and the confidence score into the success of tube placement. Findings: Using DL, the intubation success rate was higher in experts than novices regardless of gravity condition. The success rate for intubation with VL was significantly higher for experts than novices in normogravity (80% versus 28%, p<0·001), but not in microgravity (95% versus 80%, p=0·14). When novices used VL in microgravity, intubation success rates (80% versus 40%, p<0·006) were higher and intubation time shorter than when using DL. Better confidence scores were achieved with VL compared with DL. Interpretation: VL was associated with higher intubation success rate and speed and higher confidence for correct tube placement by novice operators in microgravity, and as such may represent the best technique for advanced airway management during long duration spaceflight. Funding: This work was supported by the French National Space Agency (CNES). Declaration of Interest: The authors declare that they have no competing interest. The medical equipment was graciously made available by their respective manufacturers. Ethical Approval: This study was authorized by the CNES ethical committee. All participants were volunteers and provided written informed consent for the research

Prediction of Planetary Mission Task Performance for Long-Duration Spaceflight.

This study aimed to determine values and ranges for key aerobic fitness variables that can individually map the level of success for planetary mission tasks performance for long-duration spaceflight, with the goal to develop a predictor-testing model that can be performed with in-flight equipment. We studied a group of 45 men and women who completed a series of mission-critical tasks: a surface traverse task and a hill climb task. Participants performed each mission task at a low and moderate intensity designed to elicit specific metabolic responses similar to what is expected for ambulation in lunar and Martian gravities, respectively. Aerobic fitness was characterized via cycling and rowing V˙O2peak, ventilatory threshold (VT), and critical power. Logistic regression and receiver operating characteristic curve analysis were used to determine the cutoff thresholds for each aerobic fitness parameter that accurately predicted task performance. The participants of this study were characterized by a range of cycling V˙O2peak from 15.5 to 54.1 mL·kg·min. A V˙O2peak optimal cutoff values of X and Y mL·kg·min were identified for the low- and moderate-intensity surface traverse tasks, respectively. For the low- and moderate-intensity hill climb test, the optimal V˙O2peak cutoff values were X and Y mL·kg·min, respectively. VT and critical power also showed high sensitivity and specificity for identifying individuals who could not complete the mission tasks. In summary, we identified aerobic fitness thresholds below which task performance was impaired for both low- and moderate-intensity mission-critical tasks. In particular, cycling V˙O2peak, VT, and rowing CP could each be used to predict task failure.

A New Vision for Therapeutic Hypothermia in the Era of Targeted Temperature Management: A Speculative Synthesis.

Three decades of animal studies have reproducibly shown that hypothermia is profoundly cerebroprotective during or after a central nervous system (CNS) insult. The success of hypothermia in preclinical acute brain injury has not only fostered continued interest in research on the classic secondary injury mechanisms that are prevented or blunted by hypothermia but has also sparked a surge of new interest in elucidating beneficial signaling molecules that are increased by cooling. Ironically, while research into cold-induced neuroprotection is enjoying newfound interest in chronic neurodegenerative disease, conversely, the scope of the utility of therapeutic hypothermia (TH) across the field of acute brain injury is somewhat controversial and remains to be fully defined. This has led to the era of Targeted Temperature Management, which emphasizes a wider range of temperatures (33–36°C) showing benefit in acute brain injury. In this comprehensive review, we focus on our current understandings of the novel neuroprotective mechanisms activated by TH, and discuss the critical importance of developmental age germane to its clinical efficacy. We review emerging data on four cold stress hormones and three cold shock proteins that have generated new interest in hypothermia in the field of CNS injury, to create a framework for new frontiers in TH research. We make the case that further elucidation of novel cold responsive pathways might lead to major breakthroughs in the treatment of acute brain injury, chronic neurological diseases, and have broad potential implications for medicines of the distant future, including scenarios such as the prevention of adverse effects of long-duration spaceflight, among others. Finally, we introduce several new phrases that readily summarize the essence of the major concepts outlined by this review—namely, Ultramild Hypothermia, the “Responsivity of Cold Stress Pathways,” and “Hypothermia in a Syringe.”

Long-duration spaceflight adversely affects post-landing operator proficiency

Performance of astronaut pilots during space shuttle landing was degraded after a few weeks of microgravity exposure, and longer-term exposure has the potential to impact operator proficiency during critical landing and post-landing operations for exploration-class missions. Full-motion simulations of operationally-relevant tasks were utilized to assess the impact of long-duration spaceflight on operator proficiency in a group of 8 astronauts assigned to the International Space Station, as well as a battery of cognitive/sensorimotor tests to determine the underlying cause of any post-flight performance decrements. A ground control group (N = 12) and a sleep restriction cohort (N = 9) were also tested to control for non-spaceflight factors such as lack of practice between pre- and post-flight testing and fatigue. On the day of return after 6 months aboard the space station, astronauts exhibited significant deficits in manual dexterity, dual-tasking and motion perception, and a striking degradation in the ability to operate a vehicle. These deficits were not primarily due to fatigue; performance on the same tasks was unaffected after a 30-h period of sleep restriction. Astronauts experienced a general post-flight malaise in motor function and motion perception, and a lack of cognitive reserve apparent only when faced with dual tasks, which had recovered to baseline by four days after landing.