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At least 343 records · Page 19

Introduction to Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT)

A key component in the development of NASA Human Research Programs (HRP) next generation risk model, the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) intends to deliver a means to quantify how HRP products impact astronaut medical and health risks. MEDPRAT is extensible to the majority of exploration missions. Similar to other risk models, the tool utilizes the available space and terrestrial medical data. MEDPRAT is designed to be extended with additional human health research information, medical equipment, space and terrestrial standards and practices to assess space flight medical risk in a manner consistent with other risk measures used in spacecraft and mission design. This tool provides risk-based medical system design information necessary to evaluate new technologies, procedures, research insights and mission plans.

physiological response↗

Physiology of Fluid and Electrolyte Responses During Inactivity: Water Immersion and Bed Rest

This manuscript emphasizes the physiology of fluid-electrolyte-hormonal responses during the prolonged inactivity of bed rest and water immersion. An understanding of the total mechanism of adaptation (deconditioning) should provide more insight into the conditioning process. Findings that need to be confirmed during bed rest and immersion are: (1) the volume and tissues of origin of fluid shifted to the thorax and head; (2) interstitial fluid pressure changes in muscle and subcutaneous tissue, particularly during immersion; and (3) the composition of the incoming presumably interstitial fluid that contributes to the early hypervolemia. Better resolution of the time course and source of the diuretic fluid is needed. Important data will be forthcoming when hypotheses are tested involving the probable action of the emerging diuretic and natriuretic hormones, between themselves and among vasopressin and aldosterone, on diuresis and blood pressure control.

Greenleaf, John E.↗

Effect of 3-Day Bed Rest on the Basal Sympathetic Activity and Responsiveness of this System to Physiological Stimuli In Athletes and Sedentary Subjects

The aims of this study were: (1) to examine the effect of three days of bed rest (BR) on basal plasma epinephrine [E] and norepinephrine [NE] and the catecholamine responses to various physiological stimuli, and (2) to find out whether previous physical activity modifies effects of BR. In the first series, 29 young men (11 sedentary students, 8 endurance and 10 strength trained athletes) were submitted to oral glucose tolerance test in supine position and to active orthostatic test before and after 3 days of BR. Plasma [E] and [NE] were measured after overnight fast (basal condition), at 60, 120 and 180 min after glucose ingestion (70 a), and at the 8th min of unsupported standing. In the second series, other 22 subjects (12 sedentary students, 10 endurance and 10 strength trained athletes) were submitted to 2 min cold pressor test (CPT) and exercise. Plasma E and NE were determined in the supine position after overnight fast and at 60th and 120th s of hand cooling. Then, after breakfast followed by 2-3 hour sitting, the subjects performed cycle ergometer exercise with workload increasing until volitional exhaustion. Plasma [E] and [NE] were determined at the end of each load. Plasma catecholamines were determined made radioenzymatically. After BR, basal plasma [NE] was decreased in endurance and strength athletes (p<0.01) but not in sedentary subjects. In neither group BR affected the basal [E]. Responses of both catecholamines to glucose load were diminished after BR in all three groups (p<0.05) but the effect was most pronounced in the endurance athletes. All subjects tolerated well 8-min standing although their heart rate response was increased after BR. Plasma catecholamine responses standing were not significantly affected by BR in either group but the plasma [NE] and [E] during standing were lowered after BR in endurance athletes (p<0.01). BR did not affect blood pressure and catecholamine responses to CPT. The pre- and post-exercise plasma catecholamines were similar before and after BR although the subjects achieved lower maximal loads after BR. In endurance athletes the threshold for plasma NA rise occurred at lower work intensity after than before BR (p<0.05).

Smorawinski, Jerzy↗

Instrumentation for Non-Invasive Assessment of Cardiovascular Regulation

It is critically important to be able to assess alterations in cardiovascular regulation during and after space flight. We propose to develop an instrument for the non-invasive assessment of such alterations that can be used on the ground and potentially during space flight. This instrumentation would be used by the Cardiovascular Alterations Team at multiple sites for the study of the effects of space flight on the cardiovascular system and the evaluation of countermeasures. In particular, the Cardiovascular Alterations Team will use this instrumentation in conjunction with ground-based human bed-rest studies and during application of acute stresses e.g., tilt, lower body negative pressure, and exercise. In future studies, the Cardiovascular Alterations Team anticipates using this instrumentation to study astronauts before and after space flight and ultimately, during space flight. The instrumentation may also be used by the Bone Demineralization/Calcium Metabolism Team, the Neurovestibular Team and the Human Performance Factors, Sleep and Chronobiology Team to measure changes in autonomic nervous function. The instrumentation will be based on a powerful new technology - cardiovascular system identification (CSI) - which has been developed in our laboratory. CSI provides a non-invasive approach for the study of alterations in cardiovascular regulation. This approach involves the analysis of second-to-second fluctuations in physiologic signals such as heart rate and non-invasively measured arterial blood pressure in order to characterize quantitatively the physiologic mechanisms responsible for the couplings between these signals. Through the characterization of multiple physiologic mechanisms, CSI provides a closed-loop model of the cardiovascular regulatory state in an individual subject.

Cohen, Richard J.↗

Polycystins 1 and 2 mediate mechanosensation in the primary cilium of kidney cells

Several proteins implicated in the pathogenesis of polycystic kidney disease (PKD) localize to cilia. Furthermore, cilia are malformed in mice with PKD with mutations in TgN737Rpw (encoding polaris). It is not known, however, whether ciliary dysfunction occurs or is relevant to cyst formation in PKD. Here, we show that polycystin-1 (PC1) and polycystin-2 (PC2), proteins respectively encoded by Pkd1 and Pkd2, mouse orthologs of genes mutated in human autosomal dominant PKD, co-distribute in the primary cilia of kidney epithelium. Cells isolated from transgenic mice that lack functional PC1 formed cilia but did not increase Ca(2+) influx in response to physiological fluid flow. Blocking antibodies directed against PC2 similarly abolished the flow response in wild-type cells as did inhibitors of the ryanodine receptor, whereas inhibitors of G-proteins, phospholipase C and InsP(3) receptors had no effect. These data suggest that PC1 and PC2 contribute to fluid-flow sensation by the primary cilium in renal epithelium and that they both function in the same mechanotransduction pathway. Loss or dysfunction of PC1 or PC2 may therefore lead to PKD owing to the inability of cells to sense mechanical cues that normally regulate tissue morphogenesis.

Non-NASA Center↗

Communications biophysics

Sweep frequency technique used in auditory nerve fiber responses to two-tone stimuli

PHYSIOLOGICAL RESPONSE↗

Integrated Model of the Eye/Optic Nerve Head Biomechanical Environment

Visual Impairment and Intracranial Pressure (VIIP) syndrome is a concern for long-duration space flight. Previously, it has been suggested that ocular changes observed in VIIP syndrome are related to the cephalad fluid shift that results in altered fluid pressures [1]. We are investigating the impact of changes in intracranial pressure (ICP) using a combination of numerical models, which simulate the effects of various environment conditions, including finite element (FE) models of the posterior eye. The specific interest is to understand how altered pressures due to gravitational changes affect the biomechanical environment of tissues of the posterior eye and optic nerve sheath. METHODS: Additional description of the numerical modeling is provided in the IWS abstract by Nelson et al. In brief, to simulate the effects of a cephalad fluid shift on the cardiovascular and ocular systems, we utilized a lumped-parameter compartment model of these systems. The outputs of this lumped-parameter model then inform boundary conditions (pressures) for a finite element model of the optic nerve head (Figure 1). As an example, we show here a simulation of postural change from supine to 15 degree head-down tilt (HDT), with primary outcomes being the predicted change in strains at the optic nerve head (ONH) region, specifically in the lamina cribrosa (LC), retrolaminar optic nerve, and prelaminar neural tissue (PLNT). The strain field can be decomposed into three orthogonal components, denoted as the first, second and third principal strains. We compare the peak tensile (first principal) and compressive (third principal) strains, since elevated strain alters cell phenotype and induces tissue remodeling. RESULTS AND CONCLUSIONS: Our lumped-parameter model predicted an IOP increase of c. 7 mmHg after 21 minutes of 15 degree HDT, which agreed with previous reports of IOP in HDT [1]. The corresponding FEM simulations predicted a relative increase in the magnitudes of the peak tensile and compressive strains in the lamina cribrosa of 42 and 43, respectively (Fig. 2). The corresponding changes in the optic nerve strains were 17 and 39, while in the PLNT they were 47 and 43. These magnitudes of relative elevations in peak strains may induce a phenotypic response in resident mechano-responsive resident cells [2]. This approach may be expanded to investigate other environmental changes (e.g. parabolic flight). Through our VIIP SCHOLAR project, we will validate and improve these integrated models by measuring patient-specific changes in optic nerve sheath geometry in patients with idiopathic intracranial hypertension before and after lumbar puncture and CSF removal.

biomechanics↗

Performance, physiological, and oculometer evaluation of VTOL landing displays

A methodological approach to measuring workload was investigated for evaluation of new concepts in VTOL aircraft displays. Physiological, visual response, and conventional flight performance measures were recorded for landing approaches performed in the NASA Visual Motion Simulator (VMS). Three displays (two computer graphic and a conventional flight director), three crosswind amplitudes, and two motion base conditions (fixed vs. moving base) were tested in a factorial design. Multivariate discriminant functions were formed from flight performance and/or visual response variables. The flight performance variable discriminant showed maximum differentation between crosswind conditions. The visual response measure discriminant maximized differences between fixed vs. motion base conditions and experimental displays. Physiological variables were used to attempt to predict the discriminant function values for each subject/condition trial. The weights of the physiological variables in these equations showed agreement with previous studies. High muscle tension, light but irregular breathing patterns, and higher heart rate with low amplitude all produced higher scores on this scale and thus represent higher workload levels.

North, R. A.↗

Sweating the Small Stuff: A Sensor for Real-Time Neuro-Immune Axis Monitoring

Although manageable with certain precautions, circadian rhythm misalignment and sleep disturbances pose a potential threat to astronaut health. It is well-known that sleep is essential for proper immunological and neurological functioning, while impairments in these functions result in risks for spaceflight success. Neuropeptides and hormones are involved in regulating the circadian clock and are used as biomarkers for circadian alignment. However, in-flight monitoring of these biomarkers is limited due to the lack of real-time sensor systems and sample collection/processing confines. Therefore, real-time measurements of biomarkers in-flight are necessary for mission success and crew health. For this, a robust biomarker involved in the neuro-immune axis of circadian rhythm cycling, physiological stress responses, and inflammation would be well-received as a viable biomarker for assessing physiological health for crew during long-duration missions, as these are currently NASA Human Research Program defined risks. Therefore, this paper describes the development of a wearables we at biosensor to measure the biological clock neuropeptide, orexin/hypocretin. Additionally, potential for implementation of a user-friendly sensor of orexin/hypocretin to be telemetrically reported in real-time, is proposed. In brief, the proposed system has the possibility to be used as a biomarker monitor to support preventive and personalized medicine.

Amber M Paul↗

Implementation of Model-Based Design of Experiments: Application of Computational Modeling to Support HRP Studies

This study illustrates the potential gains obtained by leveraging computational modeling to improve experimental efficiency in NASA research and counter measures studies through implementation of Model-Based Design of Experiments (MBDOE). MBDOE is a method to utilize analogous computational models to improve understanding of complex, multifactor, experimental responses and to determine experimental conditions and optimize information in the fewest number of experimental tests.

physiological response↗

Probabilistic Modeling Of Ocular Biomechanics In VIIP: Risk Stratification

Visual Impairment and Intracranial Pressure (VIIP) syndrome is a major health concern for long-duration space missions. Currently, it is thought that a cephalad fluid shift in microgravity causes elevated intracranial pressure (ICP) that is transmitted along the optic nerve sheath (ONS). We hypothesize that this in turn leads to alteration and remodeling of connective tissue in the posterior eye which impacts vision. Finite element (FE) analysis is a powerful tool for examining the effects of mechanical loads in complex geometries. Our goal is to build a FE analysis framework to understand the response of the lamina cribrosa and optic nerve head to elevations in ICP in VIIP. To simulate the effects of different pressures on tissues in the posterior eye, we developed a geometric model of the posterior eye and optic nerve sheath and used a Latin hypercubepartial rank correlation coef-ficient (LHSPRCC) approach to assess the influence of uncertainty in our input parameters (i.e. pressures and material properties) on the peak strains within the retina, lamina cribrosa and optic nerve. The LHSPRCC approach was repeated for three relevant ICP ranges, corresponding to upright and supine posture on earth, and microgravity [1]. At each ICP condition we used intraocular pressure (IOP) and mean arterial pressure (MAP) measurements of in-flight astronauts provided by Lifetime Surveillance of Astronaut Health Program, NASA Johnson Space Center. The lamina cribrosa, optic nerve, retinal vessel and retina were modeled as linear-elastic materials, while other tissues were modeled as a Mooney-Rivlin solid (representing ground substance, stiffness parameter c1) with embedded collagen fibers (stiffness parameters c3, c4 and c5). Geometry creationmesh generation was done in Gmsh [2], while FEBio was used for all FE simulations [3]. The LHSPRCC approach resulted in correlation coefficients in the range of 1. To assess the relative influence of the uncertainty in an input parameter on the peak strains, we ranked and then normalized these coefficients, considering that normalized values 0.5 implied a substantial influence on the range of the peak strains in the optic nerve head (ONH). IOP and ICP were found to have a major influence on the peak strains in the ONH, as did optic nerve and LC stiffness. Interestingly, the stiffness of the sclera far from the scleral canal did not have a large influence on peak strains in ONH tissues; however, the collagen fiber stiffness in the peripapillary sclera and annular ring both influenced the peak strains within the ONH. We have created a physiologically relevant model that incorporated collagen fibers to study the effects of elevated ICP. Elevated ICP resulted in strains in the optic nerve that are not predicted to occur on earth: the upright or supine conditions. We found that IOP, ICP, lamina cribrosa stiffness and optic nerve stiffness had the highest association with these extreme strains in the ONH. These extreme strains may activate mechanosensitive cells that induce tissue remodeling and are a risk factor for the development of VIIP.

biomechanics↗

Optic Nerve Sheath Mechanics in VIIP Syndrome

Visual Impairment Intracranial Pressure (VIIP) syndrome is a major concern in current space medicine research. While the exact pathology of VIIP is not yet known, it is hypothesized that the microgravity-induced cephalad fluid shift increases intracranial pressure (ICP) and drives remodeling of the optic nerve sheath. To investigate this possibility, we are culturing optic nerve sheath dura mater samples under different pressures and investigating changes in tissue composition. To interpret results from this work, it is essential to first understand the biomechanical response of the optic nerve sheath dura mater to loading. Here, we investigated the effects of mechanical loading on the porcine optic nerve sheath.Porcine optic nerves (number: 6) were obtained immediately after death from a local abattoir. The optic nerve sheath (dura mater) was isolated from the optic nerve proper, leaving a hollow cylinder of connective tissue that was used for biomechanical characterization. We developed a custom mechanical testing system that allowed for unconfined lengthening, twisting, and circumferential distension of the dura mater during inflation and under fixed axial loading. To determine the effects of variations in ICP, the sample was inflated (0-60 millimeters Hg) and circumferential distension was simultaneously recorded. These tests were performed under variable axial loads (0.6 grams - 5.6 grams at increments of 1 gram) by attaching different weights to one end of the dura mater. Results and Conclusions: The samples demonstrated nonlinear behavior, similar to other soft connective tissue (Figure 1). Large increases in diameter were observed at lower transmural pressures (approximately 0 to 5 millimeters Hg), whereas only small diameter changes were observed at higher pressures. Particularly interesting was the existence of a cross-over point at a pressure of approximately 11 millimeters Hg. At this pressure, the same diameter is obtained for all axial loads applied to the tissue; i.e., as the axial load is varied, the diameter of the dura mater remains constant. This cross-over in the pressure-diameter curves occurred in all optic nerve sheaths that were tested, and may correspond with in vivo ICP levels for pigs. These data suggest that diameter of the dura mater of the optic nerve remains nearly constant in vivo despite being stretched axially. This may be a homeostatic mechanism aimed at maintaining target stresses/strains on the cells in the dura mater, and deviations from these stresses may play an important role in optic nerve sheath remodeling. Future studies will involve subjecting the dura mater to varying pressures and axial tensions for extended periods of time, while monitoring changes in the biomechanical properties. The data can then be used to study the effects of changes in ICP on the remodeling of the dura mater.

biomechanics↗