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MPCV Exercise Operational Volume Analysis

In order to minimize the loss of bone and muscle mass during spaceflight, the Multi-purpose Crew Vehicle (MPCV) will include an exercise device and enough free space within the cabin for astronauts to use the device effectively. The NASA Digital Astronaut Project (DAP) has been tasked with using computational modeling to aid in determining whether or not the available operational volume is sufficient for in-flight exercise.Motion capture data was acquired using a 12-camera Smart DX system (BTS Bioengineering, Brooklyn, NY), while exercisers performed 9 resistive exercises without volume restrictions in a 1g environment. Data were collected from two male subjects, one being in the 99th percentile of height and the other in the 50th percentile of height, using between 25 and 60 motion capture markers. Motion capture data was also recorded as a third subject, also near the 50th percentile in height, performed aerobic rowing during a parabolic flight. A motion capture system and algorithms developed previously and presented at last years HRP-IWS were utilized to collect and process the data from the parabolic flight [1]. These motions were applied to a scaled version of a biomechanical model within the biomechanical modeling software OpenSim [2], and the volume sweeps of the motions were visually assessed against an imported CAD model of the operational volume. Further numerical analysis was performed using Matlab (Mathworks, Natick, MA) and the OpenSim API. This analysis determined the location of every marker in space over the duration of the exercise motion, and the distance of each marker to the nearest surface of the volume. Containment of the exercise motions within the operational volume was determined on a per-exercise and per-subject basis. The orientation of the exerciser and the angle of the footplate were two important factors upon which containment was dependent. Regions where the exercise motion exceeds the bounds of the operational volume have been identified by determining which markers from the motion capture exceed the operational volume and by how much. A credibility assessment of this analysis was performed in accordance with NASA-STD-7009 prior to delivery to the MPCV program.

mathematical models↗

Closed Loop Control Compact Exercise Device for Use on MPCV

Long duration space travel to Mars or to an asteroid will expose astronauts to extended periods of reduced gravity. To combat spaceflight physiological deconditioning, astronauts will use resistive and aerobic exercise regimens for the duration of the space flight to minimize the loss of bone density, muscle mass and aerobic capacity that occurs during exposure to a reduced gravity environment. Unlike the International Space Station (ISS), the mass and volume available for an exercise device in the next generation of spacecraft is limited. Therefore, compact exercise device prototypes are being developed for human in the loop evaluations. The NASA Human Research Program (HRP) is managing Advanced Exercise Concepts (AEC) requirements development and candidate technology maturation for all exploration mission profiles from Multi-Purpose Crew Vehicle (MPCV) exploration missions (e.g., EM-2, up to 21 day) to Mars Transit (up to 1000 day) missions. Numerous technologies have been considered and evaluated against HRP-approved functional requirements and include flywheel, pneumatic and closed-loop microprocessor-controlled motor driven power plants. Motor driven technologies offer excellent torque density and load accuracy characteristics as well as the ability to create custom mechanical impedance (the dynamic relationship between force and velocity) and custom load versus position exercise algorithms. Further, closed-loop motor-driven technologies offer the ability to monitor exercise dose parameters and adapt to the needs of the crewmember for real time optimization of exercise prescriptions. A simple proportional-integral-derivative (PID) controller is demonstrated in a prototype motor driven exercise device with comparison to resistive static and dynamic load set points and aerobic work rate targets. The resistive load term in the algorithm includes a constant force component (Fcmg) as well as inertial component (Fima) and a discussion of system tuning is presented in terms of addressing key functional requirements and human interfaces. The device aerobic modality is modelled as a rowing exercise using ground data sets obtained from Concept 2 rowers as well as competitive rowing1. A discussion of software and electronic implementations are presented which demonstrate unique approaches to meeting the constrained mass, volume and power requirements of the MPCV. . In addition to utilizing traditional PID control, controllers utilizing state feedback with gains solved using a Linear Quadratic Regulator will be developed. Controllability and observability will be utilized to investigate the need for state measurement in the design. As the control system directly interacts with human test subjects, robust methods such as H-infinity are also being investigated.1. Kleshnev V. Biomechanics. In: Rowing, Handbook of Sports Medicine and Science. ed. by Secher N., Voliantis S. IOC Medical Commission, Blackwell Pub. pp. 22-34, 2007

microgravity↗

Increasing the Statistical Rigor of Cross-Species Differential Expression Analysis

Microgravity inflicts substantial, but undercharacterized, pressure on organisms that induces metabolic responses such as increased microbial virulence and antibiotic resistance, altered organ weights in developing rats, and loss of bone tissue in astronauts. Numerous studies have analyzed the effects of microgravity on specific organisms, tissues, or test conditions, but these projects are necessarily limited by the small sample size of space research. Increasing the sample size of spaceflight studies is non-trivial; however, pooling data from numerous studies can greatly increase the statistical rigor of comparative analyses. The GeneLab houses datasets from 73 spaceflight studies that performed transcription profiling assays. These data encompass a diverse array of organisms ranging from Escherichia coli to Mus musculus to Homo sapiens and comprise studies analyzing ionizing radiation, mammalian pregnancy, etc. Collectively, the GeneLab database contains a large quantity of transcription assays and RNA sequence data analyzing Differential Gene Expression (DGE) between microand normogravity. Xspecies, a cross-species analysis method for DGE developed by Kristiansson, et al. in 2012, identifies homologous genes between species that are universally up- or downregulated in response to test conditions. Previous work by an intern at GeneLab applied Xspecies to 19 datasets containing seven different species and identified 14 homologous groups differentially expressed under spaceflight conditions including several heat shock proteins and cytoskeletal components. Unfortunately, these results may be biased by the disproportionate number of studies on Arabidopsis thaliana (5) and Mus musculus (6) and the results are not normalized by evolutionary distances. Here, we present modifications to the Xspecies algorithm that permits incorporation of multi-omic data and normalizes data for effect size, directionality, and evolutionary distances. We then apply this algorithm to all currently available GeneLab studies

Xspecies↗

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Pre-, In-, and Post-Spaceflight

NASA’s vision for future exploration missions depends on the ability to protect astronauts’ health and safety for performance of Extravehicular Activity (EVA), and to allow astronauts to safely egress from vehicles in a variety of landing scenarios (e.g. water landing upon return to Earth and undefined planetary/lunar landings). Prolonged exposure to spaceflight results in diminished tolerance to prolonged physical activity, decreased cardiac and sensorimotor function, and loss of bone mineral density, muscle mass, and muscle strength. For over 50 years exercise has been the primary countermeasure against these physiologic decrements during spaceflight, and while the resulting protection is adequate for ISS missions (i.e., Soyuz landing, microgravity EVAs), there is little information regarding time-course changes in muscle and aerobic performance. As spaceflight progresses towards longer exploration missions and vehicles with less robust exercise capabilities compared to ISS, countermeasures will need to be combined and optimized to protect crew health and performance across all organ systems over the course of exploration missions up to 3 years in duration. This will require a more detailed understanding of the dynamic effects of spaceflight on human performance. Thus, the focus of this study is quantifying decrements in physical performance over different mission durations, and to provide detailed information on the physiological rational for “why” and “when” observed changes in performance occur. The research proposed will temporally profile changes in astronauts’ cardiorespiratory fitness, muscle mass, strength, and endurance over spaceflight missions of 2 months, 6 months, and up to 1 year in duration. Additionally, an extrapolation model will provide predictions for changes associated with exploration missions 2-3 years in duration. To accomplish these objectives astronauts will be asked to participate in pre, in, post-flight measurement of muscle performance, muscle size, cardiorespiratory fitness and submaximal performance capabilities, as well as non-invasive assessment of cerebral and muscle oxygenation and perfusion (Table 1). Additionally, ambulatory and in-flight exercise, nutrition, and sleep will be monitored using a variety of commercial technologies and in-flight assessment tools. Significance: Our detailed testing protocol will provide valuable information for describing how and when spaceflight-induced muscle and aerobic based adaptations occur over the course of spaceflight missions up to and beyond 1 year. This information will be vital in the assessment as to whether humans can be physically ready for deep space exploration such as Mars missions with current technology, or if additional mitigation strategies are necessary.

Downs, M. E.↗

The problem of partial gravity on the Moon and Mars

Astronauts who spend many weeks or months in space in zero g suffer serious health problems including muscle atrophy, cardiovascular deconditioning, bone calcium loss, impaired vision, and immune system change. The debilitating effects of weightlessness were first demonstrated on the early Skylab, Salyut, and Mir missions, but it was too optimistically hoped that in-flight exercise and resistance training could prevent these problems. Similar problems are anticipated in the partial gravity of the Moon and Mars. Partial gravity exposure below 0.4 g seems too low to maintain musculoskeletal and cardiopulmonary conditioning in the long term. Some studies show a strong correlation between heart rate, oxygen consumption, net metabolic rate and simulated gravity from 0 to 1 g. Exposure to Moon and Mars gravities probably will cause less severe physiological deconditioning than experienced in 0 g, but the benefit of partial gravity seems likely to be roughly proportional to the 1/6 or 1/3 gravity experienced. As in 0 g, exercise countermeasures seem necessary but insufficient to preserve all physiological systems to a 1 g standard.

Harry W Jones↗

The Partial Gravity of the Moon and Mars Appears Insufficient to Maintain Human Health

Astronauts who spend many weeks or months in space in microgravity suffer serious health problems including muscle atrophy, cardiovascular deconditioning, bone calcium loss, impaired vision, and immune system changes. The debilitating effects of weightlessness were first demonstrated on the early Skylab, Salyut, and Mir missions, but it was then hoped that countermeasures including in-flight exercise and resistance training could reduce most of these problems. Similar effects are anticipated in the partial gravity of the Moon and Mars. Direct evidence of the long-term effects of partial gravity on humans is not yet available, but indirect evidence suggests that partial gravity exposure below 0.4 g will be insufficient to maintain musculoskeletal and cardiopulmonary conditioning over the long term. Some studies show a strong correlation between heart rate, oxygen consumption, net metabolic rate, and simulated gravity from 0 to 1 g. Exposure to moon and Mars gravities will probably cause less severe physiological deconditioning than microgravity, but the benefit of partial gravity seems likely to be roughly proportional to the level of gravity experienced. As in microgravity, exercise countermeasures seem useful but insufficient to preserve all physiological systems as they would be in Earth gravity.

Harry W. Jones↗

Prediction of Calcium Oxalate Stone Risk with Interventions

Introduction Mitigations intended to reduce bone mineral loss in-flight also influence the level of renal stone risk to astronauts. Extending a recent study completed by our group [1], we investigate the likely influence of combined fluid intake and Ca excretion mitigation strategies. Methods A computational biochemistry model representing CaOx crystal precipitation, growth, and agglomeration [2] is combined with a probabilistic analysis to predict the in-flight CaOx renal stone incidence risk ratio (IRR) relative to pre-flight values using 1517 astronaut 24-hour urine chemistries. The output of this simulation is used to assess the combined impact of controlling fluid intake and Ca excretion on maintaining IRR < 1.2 for > 95% of the population, a threshold determined from initial analysis of the model output compared to referent populations [1]. Results and Conclusions Figure 1 illustrates the simulated in-flight astronaut population (n=40000) with CaOx IRR > 1.2. The red lines indicate the known clinical risk boundary of each factor, and the white box is considered the area of high combined clinical risk. The simulation and identified risk threshold conform well to the expected clinical risk boundaries. The results, assuming insensible water losses equal or exceed 0.7 L/day, imply mitigations achieve risks similar to pre-flight levels when either Ca < 150 mg/day or fluid volume intake > 3.2 L/day individually, or combined Ca < 200 and fluid volume intake > 2.5 L/day. We continue to investigate similar compounded effects and look to apprise engineering trades by informing relative risk changes during mission design. References [1] D. A. Goodenow-Messman, S. A. Gokoglu, M. Kassemi, and J. Myers, Jerry G., “Characterization of Astronaut CaOx Renal Stone Incidence Rates to Quantify In-flight and Post-flight Relative Risk,” npj Microgravity, in review, 2021. [2] M. Kassemi and D. Thompson, “Prediction of renal crystalline size distributions in space using a PBE analytic model. 1. Effect of microgravity-induced biochemical alterations,” Am. J. Physiol. Physiol., vol. 311, no. 3, pp. F520–F530, Sep. 2016, doi: 10.1152/ajprenal.00401.2015.

Debra A Goodenow↗

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Before, During and After Spaceflight

Background: NASA’s planned space exploration missions will require astronauts to safely perform extravehicular activity (EVA) and to safely egress vehicles in a variety of landing scenarios. Prolonged exposure to spaceflight can diminish tolerance for physical activity, decrease cardiovascular and sensorimotor function, and cause loss of bone mineral density, and reduced muscle mass and strength. Although exercise can mitigate these spaceflight-induced physiological decrements, little is known regarding the time-course of changes in muscle and aerobic performance during spaceflight. Furthermore, these exercise countermeasures are not fully protective. For example, maximal aerobic capacity (VO2pk), lower body muscle cross-sectional area, and strength decrease by about 10% to 15% after short- (~ 14 days) and long-duration (~ 6 months) missions on the International Space Station (ISS). Future space missions that are longer in duration and further from Earth will employ exploration vehicles that will have exercise hardware with less robust and more constrained exercise capabilities than of those available on the ISS. Thus, countermeasures will need to be optimized to protect crew health and performance on exploration-class missions that will last up to 3 years. This will require a more detailed understanding of the dynamic effects of spaceflight on human health and performance, and the ability of exercise to protect against this deconditioning, and the interaction of exercise with interrelated factors like nutrition, sleep, and environmental conditions. Methods: We will use standardized research and medical testing protocols previously validated in 1-G and 0-G to quantify the time course and the inter-individual variability of changes in physical performance, including cardiorespiratory fitness, and muscle strength, and endurance, before, during and after spaceflight missions lasting 2 months, 6 months, and 1 year. Additionally, we will use an extrapolation model to predict changes associated with 2–3-year exploration missions. Additionally, we will monitor in-flight exercise, nutrition, and sleep using in-flight assessment tools. Significance: Our testing protocols will provide valuable information for determining time course of change and the interindividual variability of spaceflight-induced deconditioning of aerobic capacity and muscle strength and endurance over the course of spaceflight missions up to and beyond 1 year. This information will be vital to assess whether humans can be physically ready for deep space exploration, such as on a mission to Mars, using current technology, or if additional mitigation strategies are necessary.

countermeasures↗

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Before, During, and After Spaceflight

Background: NASA’s planned space exploration missions will require astronauts to safely perform extravehicular activity (EVA) and to safely egress vehicles in a variety of landing scenarios. Prolonged exposure to spaceflight can diminish tolerance for physical activity, decrease cardiovascular and sensorimotor function, cause loss of bone mineral density, as well as reduced muscle mass and strength. Although exercise can mitigate these spaceflight-induced physiological decrements, little is known regarding the time-course of changes in muscle and aerobic performance during spaceflight. Furthermore, these exercise countermeasures are not fully protective. For example, maximal aerobic capacity (VO2pk), lower body muscle cross-sectional area, and strength decrease by about 10% to 15% after short- (≈14 days) and long-duration (≈6 months) missions on the International Space Station (ISS). Future space missions longer in duration and further from Earth will employ exploration vehicles that will have exercise hardware with less robust and more constrained exercise capabilities than of those available on the ISS. Thus, countermeasures will need to be optimized to protect crew health and performance on exploration-class missions lasting up to 3 years. This requires a more detailed understanding of the dynamic effects of spaceflight on human health and performance, the ability of exercise to protect against this deconditioning, and the interaction of exercise with interrelated factors like nutrition, sleep, and environmental conditions. Methods: We will use standardized research and medical testing protocols previously validated in 1g and microgravity to quantify the time course and the inter-individual variability of changes in physical performance, including cardiorespiratory fitness and muscle strength and endurance, before, during, and after spaceflight missions lasting 2 months, 6 months, and 1 year. Additionally, we will use an extrapolation model to predict changes associated with multi-year exploration missions. Additionally, we will monitor in-flight exercise, nutrition, and sleep using in-flight assessment tools. Significance: Our testing protocols will provide valuable information for determining time course of change and the interindividual variability of spaceflight-induced deconditioning of aerobic capacity and muscle strength and endurance over the course of spaceflight missions up to and beyond 1 year. This information will be vital to assess whether humans can be physically ready for deep space exploration, such as on a mission to Mars, using current technology, or if additional mitigation strategies are necessary.

N Strock↗

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Before, During, and After Spaceflight

NASA’s planned space exploration missions will require astronauts to safely perform extravehicular activity (EVA) and to safely egress vehicles in a variety of landing scenarios. Prolonged exposure to spaceflight decreases cardiovascular and sensorimotor function, causes loss of bone mineral density, reduces muscle mass and strength, and ultimately diminishes tolerance for physical activity. Although exercise can help mitigate these spaceflight-induced physiological decrements, little is known regarding the time-course of changes in muscle and aerobic performance during spaceflight. Furthermore, these exercise countermeasures are not fully protective. For example, maximal aerobic capacity (VO2pk), lower body muscle cross-sectional area, and strength all decrease by about 10% to 15% after long-duration missions on the International Space Station (ISS). Future long-duration space missions beyond Low Earth Orbit will employ exploration vehicles with less robust exercise hardware and more constrained exercise capabilities (e.g., less operational volume, less active exercise time) than provided on the ISS. Thus, countermeasures will need to be optimized to protect crew health and performance on exploration-class missions lasting up to 3 years. This requires a more detailed understanding of the dynamic effects of spaceflight on human health and performance, the ability of exercise to protect against this deconditioning, and the interaction of exercise with interrelated factors like nutrition, sleep, and environmental conditions.

N.C. Strock↗

Long Term Human Presence in Space Requires Artificial Gravity and Radiation Shielding

Astronauts who spend many months in microgravity suffer serious health problems including muscle atrophy, cardiovascular deconditioning, bone calcium loss, impaired vision, and immune system changes. Exercise countermeasures have been insufficient to maintain normal human performance. Similar problems can be expected in the partial gravity of the Moon and Mars. Achieving the long-term presence of healthy humans in space requires providing artificial Earth level gravity. This can be done on the Moon and Mars by using horizontally rotating habitats with angled floors, but it is easier in space habitats. Astronauts travelling beyond the protection of the Earth’s magnetic field can suffer harm from cosmic background radiation and occasional strong solar flares. Supporting healthy long-term human lives will require radiation shielding on the Moon and Mars as well as in space. Human space settlement will probably begin with artificial rotating space habitats in Low Earth Orbit (LEO) where they will be shielded from radiation. The earlier anticipated human communities in pressurized domes on the Moon or Mars appear unrealistic because of the now known problems of partial gravity and radiation.

Astronauts↗

Long Term Human Presence in Space Requires Artificial Gravity and Radiation Shielding

Astronauts who spend many months in microgravity suffer serious health problems including muscle atrophy, cardiovascular deconditioning, bone calcium loss, impaired vision, and immune system changes. Exercise countermeasures have been insufficient to maintain normal human performance. Similar problems can be expected in the partial gravity of the Moon and Mars. Achieving the long-term presence of healthy humans in space requires providing artificial Earth level gravity. This can be done on the Moon and Mars by using horizontally rotating habitats with angled floors, but it is easier in space habitats. Astronauts travelling beyond the protection of the Earth’s magnetic field can suffer harm from cosmic background radiation and occasional strong solar flares. Supporting healthy long-term human lives will require radiation shielding on the Moon and Mars as well as in space. Human space settlement will probably begin with artificial rotating space habitats in Low Earth Orbit (LEO) where they will be shielded from radiation. The earlier anticipated human communities in pressurized domes on the Moon or Mars appear unrealistic because of the now known problems of partial gravity and radiation.

Astronauts↗

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Before, During, and After Spaceflight

NASA’s planned space exploration missions will require astronauts to safely perform extravehicular activity (EVA) and to safely egress vehicles in a variety of landing scenarios. Prolonged exposure to spaceflight decreases cardiovascular and sensorimotor function, causes loss of bone mineral density, reduces muscle mass and strength, and ultimately diminishes tolerance for physical activity. Although exercise can help mitigate these spaceflight-induced physiological decrements, little is known regarding the time-course of changes in muscle and aerobic performance during spaceflight. Furthermore, these exercise countermeasures are not fully protective. For example, maximal aerobic capacity (VO2pk), lower body muscle cross-sectional area, and strength all decrease by about 10% to 15% after long-duration missions on the International Space Station (ISS). Future long-duration space missions beyond Low Earth Orbit will employ exploration vehicles with less robust exercise hardware and more constrained exercise capabilities (e.g., less operational volume, less active exercise time) than provided on the ISS. Thus, countermeasures will need to be optimized to protect crew health and performance on exploration-class missions lasting up to 3 years. This requires a more detailed understanding of the dynamic effects of spaceflight on human health and performance, the ability of exercise to protect against this deconditioning, and the interaction of exercise with interrelated factors like nutrition, sleep, and environmental conditions.

N. Strock↗

The Role of GH/IGF-I Axis in Muscle Homeostasis During Weightlessness

Exposure to reduced gravity during space travel profoundly alters the loads placed on bone and muscle. Astronauts suffer significant losses of muscle and bone strength during weightlessness. Exercise as a countermeasure is only partially effective in remedying severe muscle atrophy and bone demineralization. Similar wasting of muscles and bones affects people on Earth during prolonged bed rest or immobilization due to injury. In the absence of weight bearing activity, atrophy occurs primarily in the muscles that act in low power, routine movements and in maintaining posture. Hormonal disfunction could contribute in part to the loss of muscle and bone during spaceflight. Reduced levels of human Growth Hormone (hGH) were found in astronauts during space flight, as well as reduced GH secretory activity was observed from the anterior pituitary in 7-day space flight rats. Growth hormone has been shown to be required for maintenance of muscle mass and bone mineralization, in part by mediating the biosynthesis IGF-I, a small polypeptide growth factor. IGF biosynthesis and secretion plays an important role in potentiating muscle cell differentiation and has been shown to drive the expression of myogenin, a myogenic specific basic helix-loop-helix factor. IGF-I has also been shown to have an important role in potentiating muscle regeneration, repair and adult muscle hypertrophy.

Schwartz, Robert J.↗

Magnetic Resonance Imaging (MRI) to Assess Changes to Trabecular Microarchitecture (Trb µArch) of the Hip

BACKGROUND . Calculated loss rates in trabecular (Trb) volumetric bone mineral density (vBMD), in astronauts after return from 6-month long-duration (LD) spaceflight, are rapid relative to menopause-induced loss rates and could contribute to the observed lack of recovery. Perforations in the Trb bony struts, skeletal fragility and fractures [5] have been associated with the rapid rate of bone loss in women due to menopause. The more rapid loss rate observed in astronauts could be inducing similar, irreversible losses of trabecular connectivity as seen in cadaver studies of female skeletons. These changes are not detectable by DXA technology and would not be discovered in astronauts during scheduled, triennial DXA testing for primary osteoporosis. High-resolution-peripheral quantitative computed tomography (HR-pQCT) of the lower leg have detected losses in Trb vBMD (vBMD) and changes in Trb microarchitecture (µArch) in astronauts immediately following routine 6-month spaceflights and continuing in some individuals for 1 or more years postflight with no signs of recovery. Resolution of these microarchitectural changes by whole body QCT, especially in the deeply embedded hip bone, is prohibitive due to excessive and unsafe radiation exposures. While HR-pQCT has sufficient resolution to study Trb µArch at safe and lower radiation exposure testing is restricted only to the lower leg and wrist. Hence, a technology to detect detrimental changes to Trb µArch in astronauts, especially of the hip, is needed to inform type and timing of countermeasures to irreversible deficits (preflight, inflight and postflight). METHODS . This HRP-funded study (2023-2027) will verify the sensitivity of a protocol for MRI scanning (on a 3T Siemens Vida) to detect changes to hip Trb µArch in persons following spinal cord injury (SCI); skeletal immobilization below the spinal lesion will serve as an analog for non-weight-bearing during spaceflight. The study period has been extended by 1 yr due to delayed Richmond IRB approval in Y1. A 3T MRI protocol will characterize serial changes in hip Trb µArch in SCI patients from time of admission at the Richmond VA Medical Center to their scheduled annual exam 12-months later. SCI patients with age, sex, and physical characteristics like ISS astronauts will be consented. The ability of 3T MRI hip scan to discriminate loss of trabecular connectivity subjects with SCI will be compared to age- and sex-matched ambulatory controls. A comparison between HR-pQCT and MRI measurements at the ankle (distal tibia) of study subjects will also be performed. A modified DXA scan analysis (3D-Shaper) will also be verified as a potential method for monitoring concurrent changes in hip Trb bone over 12-month. SIGNIFICANCE . Deliverables: a surveillance method for assessing for irreversible losses of connectivity and how skeletal changes after LD spaceflight(s) would modify the terrestrial risk of primary osteoporosis.

Spinal Cord Injury↗

Magnetic Resonance Imaging (MRI) to Assess Changes to Trabecular Microarchitecture (Trb µArch) of the Hip

BACKGROUND . Calculated loss rates in trabecular (Trb) volumetric bone mineral density (vBMD), in astronauts after return from 6-month long-duration (LD) spaceflight, are rapid relative to menopause-induced loss rates and could contribute to the observed lack of recovery. Perforations in the Trb bony struts, skeletal fragility and fractures [5] have been associated with the rapid rate of bone loss in women due to menopause. The more rapid loss rate observed in astronauts could be inducing similar, irreversible losses of trabecular connectivity as seen in cadaver studies of female skeletons. These changes are not detectable by DXA technology and would not be discovered in astronauts during scheduled, triennial DXA testing for primary osteoporosis. High-resolution-peripheral quantitative computed tomography (HR-pQCT) of the lower leg have detected losses in Trb vBMD (vBMD) and changes in Trb microarchitecture (µArch) in astronauts immediately following routine 6-month spaceflights and continuing in some individuals for 1 or more years postflight with no signs of recovery. Resolution of these microarchitectural changes by whole body QCT, especially in the deeply embedded hip bone, is prohibitive due to excessive and unsafe radiation exposures. While HR-pQCT has sufficient resolution to study Trb µArch at safe and lower radiation exposure testing is restricted only to the lower leg and wrist. Hence, a technology to detect detrimental changes to Trb µArch in astronauts, especially of the hip, is needed to inform type and timing of countermeasures to irreversible deficits (preflight, inflight and postflight). METHODS . This HRP-funded study (2023-2027) will verify the sensitivity of a protocol for MRI scanning (on a 3T Siemens Vida) to detect changes to hip Trb µArch in persons following spinal cord injury (SCI); skeletal immobilization below the spinal lesion will serve as an analog for non-weight-bearing during spaceflight. The study period has been extended by 1 yr due to delayed Richmond IRB approval in Y1. A 3T MRI protocol will characterize serial changes in hip Trb µArch in SCI patients from time of admission at the Richmond VA Medical Center to their scheduled annual exam 12-months later. SCI patients with age, sex, and physical characteristics like ISS astronauts will be consented. The ability of 3T MRI hip scan to discriminate loss of trabecular connectivity subjects with SCI will be compared to age- and sex-matched ambulatory controls. A comparison between HR-pQCT and MRI measurements at the ankle (distal tibia) of study subjects will also be performed. A modified DXA scan analysis (3D-Shaper) will also be verified as a potential method for monitoring concurrent changes in hip Trb bone over 12-month. SIGNIFICANCE . Deliverables: a surveillance method for assessing for irreversible losses of connectivity and how skeletal changes after LD spaceflight(s) would modify the terrestrial risk of primary osteoporosis.

Risk Surveillance↗

Evidence that Resorption of Bone by Rat Peritoneal Macrophages Occurs in an Acidic Environment

Skeletal loss in space, like any form of osteoporosis, reflects a relative imbalance of the activities of cells resorbing (degrading) or forming bone. Consequently, prevention of weightlessness induced bone loss may theoretically be accomplished by (1) stimulating bone formation or (2) inhibiting bone resorption. This approach, however, requires fundamental understanding of the mechanisms by which cells form or degrade bone, information not yet at hand. An issue central to bone resorption is the pH at which resorption takes place. The pH dependent spectral shift of a fluorescent dye (fluorescein isothiocyanate) conjugated to bone matrix was used to determine the pH at the resorptive cell bone matrix interface. Devitalized rat bone was used as the substrate, and rat peritoneal macrophages were used as the bone resorbing cells. The results suggest that bone resorption is the result of generation of an acidic microenvironment at the cell matrix junction.

Blair, H. C.↗

Evidence Report: Risk Factor of Inadequate Nutrition

The importance of nutrition in exploration has been documented repeatedly throughout history, where, for example, in the period between Columbus' voyage in 1492 and the invention of the steam engine, scurvy resulted in more sailor deaths than all other causes of death combined. Because nutrients are required for the structure and function of every cell and every system in the body, defining the nutrient requirements for spaceflight and ensuring provision and intake of those nutrients are primary issues for crew health and mission success. Unique aspects of nutrition during space travel include the overarching physiological adaptation to weightlessness, psychological adaptation to extreme and remote environments, and the ability of nutrition and nutrients to serve as countermeasures to ameliorate the negative effects of spaceflight on the human body. Key areas of clinical concern for long-duration spaceflight include loss of body mass (general inadequate food intake), bone and muscle loss, cardiovascular and immune system decrements, increased radiation exposure and oxidative stress, vision and ophthalmic changes, behavior and performance, nutrient supply during extravehicular activity, and general depletion of body nutrient stores because of inadequate food supply, inadequate food intake, increased metabolism, and/or irreversible loss of nutrients. These topics are reviewed herein, based on the current gap structure.

Smith, Scott M.↗