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At least 127 records · Page 7

Induced venous pooling and cardiorespiratory responses to exercise after bed rest

Venous pooling induced by a specially constructed garment is investigated as a possible means for reversing the reduction in maximal oxygen uptake regularly observed following bed rest. Experiments involved a 15-day period of bed rest during which four healthy male subjects, while remaining recumbent in bed, received daily 210-min venous pooling treatments from a reverse gradient garment supplying counterpressure to the torso. Results of exercise testing indicate that while maximal oxygen uptake endurance time and plasma volume were reduced and maximal heart rate increased after bed rest in the control group, those parameters remained essentially unchanged for the group undergoing venous pooling treatment. Results demonstrate the importance of fluid shifts and venous pooling within the cardiovascular system in addition to physical activity to the maintenance of cardiovascular conditioning.

Convertino, V. A.↗

Using Natural Stable Calcium Isotopes to Rapidly Assess Changes in Bone Mineral Balance Using a Bed Rest Model to Induce Bone Loss

Metabolic bone diseases like osteoporosis result from the disruption of normal bone mineral balance (BMB) resulting in bone loss. During spaceflight astronauts lose substantial bone. Bed rest provides an analog to simulate some of the effects of spaceflight; including bone and calcium loss and provides the opportunity to evaluate new methods to monitor BMB in healthy individuals undergoing environmentally induced-bone loss. Previous research showed that natural variations in the Ca isotope ratio occur because bone formation depletes soft tissue of light Ca isotopes while bone resorption releases that isotopically light Ca back into soft tissue (Skulan et al, 2007). Using a bed rest model, we demonstrate that the Ca isotope ratio of urine shifts in a direction consistent with bone loss after just 7 days of bed rest, long before detectable changes in bone mineral density (BMD) occur. The Ca isotope variations tracks changes observed in urinary N-teleopeptide, a bone resorption biomarker. Bone specific alkaline phosphatase, a bone formation biomarker, is unchanged. The established relationship between Ca isotopes and BMB can be used to quantitatively translate the changes in the Ca isotope ratio to changes in BMD using a simple mathematical model. This model predicts that subjects lost 0.25 0.07% ( SD) of their bone mass from day 7 to day 30 of bed rest. Given the rapid signal observed using Ca isotope measurements and the potential to quantitatively assess bone loss; this technique is well suited to study the short-term dynamics of bone metabolism.

Morgan, J. L. L.↗

Submaximal exercise VO2 and Qc during 30-day 6 degrees head-down bed rest with isotonic and isokinetic exercise training

BACKGROUND: Maintaining intermediary metabolism is necessary for the health and well-being of astronauts on long-duration spaceflights. While peak oxygen uptake (VO2) is consistently decreased during prolonged bed rest, submaximal VO2 is either unchanged or decreased. METHODS: Submaximal exercise metabolism (61 +/- 3% peak VO2) was measured during ambulation (AMB day-2) and on bed rest days 4, 11, and 25 in 19 healthy men (32-42 yr) allocated into no exercise (NOE, N = 5) control, and isotonic exercise (ITE, N = 7) and isokinetic exercise (IKE, N = 7) training groups. Exercise training was conducted supine for two 30-min periods per day for 6 d per week: ITE training was intermittent at 60-90% peak VO2; IKE training was 10 sets of 5 repetitions of peak knee flexion-extension force at a velocity of 100 degrees s-1. Cardiac output was measured with the indirect Fick CO2 method, and plasma volume with Evans blue dye dilution. RESULTS: Supine submaximal exercise VO2 decreased significantly (*p < 0.05) by 10.3%* with ITE and by 7.3%* with IKE; similar to the submaximal cardiac output decrease of 14.5%* (ITE) and 20.3%* (IKE), but different from change in peak VO2 (+1.4% with ITE and -10.2%* with IKE) and decrease in plasma volume of -3.7% (ITE) and -18.0%* (IKE). Reduction of submaximal VO2 during bed rest correlated 0.79 (p < 0.01) with submaximal Qc, but was not related to change in peak VO2 or plasma volume. CONCLUSION: Reduction in submaximal oxygen uptake during prolonged bed rest is related to decrease in exercise but not resting cardiac output; perturbations in active skeletal muscle metabolism may be involved.

NASA Discipline Regulatory Physiology↗

Neuro-Motor Responses to Daily Centrifugation in Bed-Rested Subjects

It is well known from numerous space flight studies that exposure to micro-g produces both morphological and neural adaptations in the major postural muscles. However, the characteristics and mechanism of these changes, particularly when it may involve the central nervous system are not defined. Furthermore, it is not known what role unloading of the muscular system may have on central changes in sensorimotor function or if centrifugation along the +Gz direction (long body axis) can mitigate both the peripheral changes in muscle function and modification of the central changes in sensorimotor adaptation to the near weightless environment of space flight. The purpose of this specific effort was, therefore, to investigate the efficacy of artificial gravity (AG) as a method for maintaining sensorimotor function in micro-g. Eight male subjects were exposed to daily 1 hr centrifugation during a 21 day 6 degree head-down bed rest study. Seven controls were placed on the centrifuge without rotation. The radius and angular velocity of the centrifuge were adjusted such that each subject experienced a centripetal acceleration of 2.5g at the feet, and approximately 1.0g at the heart. Both the tendon (MSR) and functional stretch reflexes (FSR) were collected using an 80 lb. ft. servomotor controlled via position feedback to provide a dorsiflexion step input to elicit the MSR, and the same step input with a built in 3 sec hold to evoke the FSR. EMG data were obtained from the triceps surae. Supplementary torque, velocity and position data were collected with the EMG responses. All data were digitized and sampled at 4 kHz. Only the MSR data has been analyzed at this time, and preliminary results suggest that those subjects exposed to active centrifugation (treatment group) show only minor changes in MSR peak latency times, either as a function of time spent in bed rest or exposure to centrifugation, while the control subjects show delays in the MSR peak latencies that are typical of bed rested subjects. There also appears to be a trend in the treatment group where centrifugation results in peak latencies that are shorter than the control group. This trend is supported by the observation that peak reflex amplitudes are larger (up to 40% in magnitude)than those of the control subjects. Furthermore, centrifugation tends, by day 21 of bed rest, to normalize the peak amplitudes to the amplitudes observed prior to bed rest or centrifugation. From a preliminary point of view, centrifugation appears to have a positive effect on the sensorimotor system, and specifically on those muscles that provide anti-gravity and postural support.

Reschke, Millard F.↗

Effect of dietary sodium on fluid/electrolyte regulation during bed rest

BACKGROUND: A negative fluid balance during bed rest (BR) is accompanied by decreased plasma volume (PV) which contributes to cardiovascular deconditioning. HYPOTHESIS: We hypothesized that increasing dietary sodium while controlling fluid intake would increase plasma osmolality (POSM), stimulate fluid conserving hormones, and reduce fluid/electrolyte (F/E) losses during BR; conversely, decreasing dietary sodium would decrease POSM, suppress fluid conserving hormones, and increase F/E losses. METHODS: We controlled fluid intake (30 ml x kg(-1) x d(-1)) in 17 men who consumed either a 4.0 +/- 0.06 g x d(-1) (174 mmol x d(-1)) (CONT; n = 6), 1.0 +/- 0.02 g x d(-1) (43 mmol x d(-1)) (LS; n = 6), or 10.0 +/- 0.04 g x d(-1) (430 mmol x d(-1)) (HS; n = 5) sodium diet before, during, and after 21 d of 6 degrees head-down BR. PV, total body water, urine volume and osmolality, POSM, and F/E controlling hormone concentrations were measured. RESULTS: In HS subjects, plasma renin activity (-92%), plasma/urinary aldosterone (-59%; -64%), and PV (-15.0%; 6.0 ml x kg(-1); p < 0.05) decreased while plasma atrial natriuretic peptide (+34%) and urine antidiuretic hormone (+24%) increased during BR (p < 0.05) compared with CONT. In LS, plasma renin activity (+166%), plasma aldosterone (+167%), plasma antidiuretic hormone (+19%), and urinary aldosterone (+335%) increased with no change in PV compared with CONT (p < 0.05). Total body water did not change in any of the subjects. CONCLUSIONS: Contrary to our hypothesis, increasing dietary sodium while controlling fluid intake during BR resulted in a greater loss of PV compared with the CONT subjects. Reducing dietary sodium while controlling fluid intake did not alter the PV response during BR compared with CONT subjects.

Clinical Trial↗

The hemodynamic effects of repeated bed rest exposure

The effects of three 2-week periods of bed rest (with and without isometric/aerobic exercise, and separated by 3-week ambulatory recovery periods) on hemodynamic responses to stepwise application of LBNP (-20 to -40 mm Hg) are investigated experimentally in seven physically active male subjects aged 19-21 years. The data are presented in extensive tables and graphs and characterized in detail. It is found that bed rest produces significant changes in the responses of heart rate and end-diastolic volume index which (1) are greater than can be accounted for by lowered plasma volume, (2) persist during the recovery periods, and (3) do not respond to the exercises employed to prevent deconditioning.

Sandler, Harold↗

Contributions of MSNA and stroke volume to orthostatic intolerance following bed rest

We examined whether the altered orthostatic tolerance following 14 days of head-down tilt bed rest (HDBR) was related to inadequate sympathetic outflow or to excessive reductions in cardiac output during a 10- to 15-min head-up tilt (HUT) test. Heart rate, blood pressure (BP, Finapres), muscle sympathetic nerve activity (MSNA, microneurography), and stroke volume blood velocity (SVV, Doppler ultrasound) were assessed during supine 30 degrees (5 min) and 60 degrees (5-10 min) HUT positions in 15 individuals who successfully completed the pre-HDBR test without evidence of orthostatic intolerance. Subjects were classified as being orthostatically tolerant (OT, n = 9) or intolerant (OI, n = 6) following the post-HDBR test. MSNA, BP, and SVV during supine and HUT postures were not altered in the OT group. Hypotension during 60 degrees HUT in the post-bed rest test for the OI group (P < 0.05) was associated with a blunted increase in MSNA (P < 0.05). SVV was reduced following HDBR in the OI group (main effect of HDBR, P < 0.02). The data support the hypothesis that bed rest-induced orthostatic intolerance is related to an inadequate increase in sympathetic discharge that cannot compensate for a greater postural reduction in stroke volume.

NASA Discipline Musculoskeletal↗

Prevention of disuse osteoporosis: Effect of sodium fluoride during five weeks of bed rest

An attempt was made to modify factors which promote disuse osteoporosis and thereby prevent it from occurring. Since fluoride is currently used to enhance bone formation in the treatment of low turnover osteoporosis, it was hypothesized that if the fluoride ion was available over a long period of time that it would slow the demonstrated loss of calcium by inhibiting bone resorption and enhancing bone formation. This study was used to determine whether oral medication with sodium F will modify or prevent 5 weeks of bed rest induced disuse osteoporosis, to determine the longitudinal effects of 5 weeks of bed rest on PTH, CT and calcitriol, to measure muscle volume changes and metabolic activity by magnetic resonance imaging and magnetic resonance spectroscopy during prolonged bed rest, to measure changes in peak muscle strength and fatigability, and to measure bone turnover in bone biopsies. Subjects were studied during 1 week of equilibration, 4 weeks of control ambulation, 5 weeks of bed rest, and 1 week of reambulation.

Schneider, Victor S.↗

WISE-2005: Adrenergic Responses Before and After 60 Days of 6 Degree Head-Down Bed-Rest in Women

Sixteen women who participated in the WISE-2005 headdown bed rest (HDBR) were studied before and on day 56 of bed rest to test the hypothesis that chronic changes in circulating norepinephrine (NOR) would change the response to adrenergic receptor agonists. Five minute infusions of 2 doses of isoproterenol (ISO), and 2 doses of NOR were administered while heart rate (HR), mean arterial pressure (MAP) and total peripheral resistance (TPR) were measured. Before HDBR, the higher dose of ISO increased HR by 13 beats/min (P<O.OOl) and decreased TPR by -50% (P<O.OOl) with no changes in MAP, the higher dose of NOR increased MAP by 8 mmHg (P<O.OOl) and increased TPR -20% (P=0.007) with no change in HR. On HDBR day 56, subjects who took part in daily exercise+lower body negative pressure (EX+LBNP) countermeasures had no change in HR response to ISO while the control group (CON) had greater increases in HR. MAP tended to be lower post-HDBR in CON but not in EX+LBNP, while TPR was higher in both groups. In response to NOR, MAP increased with elevated TPR with no change in HR. Post-HDBR TPR increased more in the EX+LBNP group. These studies indicate that HDBR alters the HR response to IS0 but that EX+LBNP countermeasure prevented this change. The greater TPR response to NOR in the post-HDBR for the EX+LBNP group might reflect enhanced peripheral vasoconstrictor response that could reduce the risk of orthostatic intolerance after this countermeasure.

Edgell, H.↗

Comparison of cardiovascular function during the early hours of bed rest and space flight

This paper reviews the cardiovascular responses of six healthy male subjects to 6 hours in a 5 degrees head-down bed rest model of weightlessness, and compares these responses to those obtained when subjects were positioned in head-up tilts of 10 degrees, 20 degrees, and 42 degrees, simulating 1/6, 1/3, and 2/3 G, respectively. Thoracic fluid index, cardiac output, stroke volume, and peak flow were measured using impedance cardiography. Cardiac dimensions and volumes were determined from two-dimensional guided M-mode echocardiograms in the left lateral decubitus position at 0, 2, 4, and 6 hours. Cardiovascular response to a stand test were compared before and after bed rest. The impedance values were related to tilt angle for the first 2 hours of tilt; however, after 3 hours, at all four angles, values began to converge, indicating that cardiovascular homeostatic mechanisms seek a common adapted state, regardless of effective gravity level (tilt angle) up to 2/3 G. Echocardiography revealed that left ventricular end-diastolic and end-systolic volume, stroke volume, ejection fraction, heart rate, and cardiac output had returned to control values by hour 6 for all tilt angles. The lack of a significant immediate change in left ventricular end-diastolic volume, despite decrements in stroke volume (P < .05) and heart rate (not significant), indicates that multiple factors may play a role in the adaptation to simulated hypogravity. The echocardiography data indicated that no angle of tilt, whether head-down or head-up for 4 to 6 hours, mimicked exactly the changes in cardiovascular function recorded after 4 to 6 hours of space flight. Changes in left ventricular end-diastolic volume during space flight and tilt may be similar, but follow a different time course. Nevertheless, head-down tilt at 5 degrees for 6 hours mimics some (stroke volume, systolic and diastolic blood pressure, mean arterial blood pressure, and total resistance), but not all, of the changes occurring in an equivalent time of space flight. The magnitude of the change in the mean heart rate response to standing was greater after six hours of tilt at -5 degrees or 10 degrees. Thus, results from the stand test after 6 hours of bed rest at -5 degrees and 10 degrees, but not at 20 degrees or 42 degrees, are similar to those obtained after space flight.

Space Flight↗

Effect of heat acclimation on sitting orthostatic tolerance in the heat after 48 and 96 hour bed rest in men

The purpose of this pilot study was to investigate sitting orthostatic tolerance and determine potentially adverse signs and symptoms that would incapacitate subjects in a hot environment (Gemini reentry cabin temperature profile) after 48 hr and 96 hr of horizontal bed rest (BR), which simulated microgravity deconditioning. Six college men (23-29 yr) were allocated into two groups: heat acclimated (three subjects: No. 1- control, No. 2- 48 hr BR, and No. 3- 96 hr BR) and nonheat acclimated (three subjects: No. 4- control, No. 5- 48 hr BR, and No. 6- 96 hr BR). After BR they sat in an ambient temperature of 57 C (135 F) for 30 min which then was decreased to 49 C (120 F) for up to 480 min. Tolerance time in the heat with seated orthostatic stress was 480 min (subject No. 1) and 180 min (subject No. 4) in the two ambulatory men, but was reduced to 22-150 min in the four bed-rested men irrespective of their heat acclimation status. Although heat acclimation appeared to enhance tolerance and attenuate accompanying physiological responses, as well as ameliorate the frequency and intensity of adverse signs and symptoms at termination of exposure, tolerance was reduced in the bed-rest deconditioned subjects regardless of their acclimation level. Thus, these few collective findings do not indicate an unequivocal positive effect of acute heat acclimation on sitting orthostatic tolerance in acute bed-rest deconditioned subjects.

Greenleaf, J. E.↗

Electrical impedance measurements in the arm and the leg during a thirty day bed rest study

The need to detect, follow, and understand the effects of gravity on body fluid distribution is a constant stimulus to the quest for new techniques in this area of research. One of these techniques is electrical bioimpedance spectroscopy (BIS). Although not new, this is a technique whose applications to biomedical research are fairly recent. What is new is the development of instrumentation that has made practical the use of impedance spectroscopy in the biomedical setting, particularly in studies involving human subjects. The purpose of this paper is to report impedance spectroscopy observations made on a subject who was submitted to bed rest for a period of thirty days. These observations were made as part of a study on muscle atrophy during a thirty day head down bed rest. Since bed rest studies are very costly in human and financial terms, and technically difficult to realize, we felt that even though the present study deals only with a single case it was worthy of reporting because it illustrates kinds of questions impedance spectroscopy may help to answer in microgravity research.

Cardus, David↗

Analysis of Arterial Mechanics During Head-Down-Tilt Bed Rest

Carotid, brachial, and tibial arteries reacted differently to HDTBR. Previous studies have not analyzed the mechanical properties of the human brachial or anterior tibial arteries. After slight variations during bed-rest, arterial mechanical properties and IMT returned to pre-bed rest values, with the exception of tibial stiffness and PSE, which continued to be reduced post-bed rest while the DC remained elevated. The tibial artery remodeling was probably due to decreased pressure and volume. Resulting implications for longer duration spaceflight are unclear. Arterial health may be affected by microgravity, as shown by increased thoracic aorta stiffness in other ground based simulations (Aubert).

Elliott, Morgan B.↗

Prolonged bed rest decreases skeletal muscle and whole body protein synthesis

We sought to determine the extent to which the loss of lean body mass and nitrogen during inactivity was due to alterations in skeletal muscle protein metabolism. Six male subjects were studied during 7 days of diet stabilization and after 14 days of stimulated microgravity (-6 degrees bed rest). Nitrogen balance became more negative (P < 0.03) during the 2nd wk of bed rest. Leg and whole body lean mass decreased after bed rest (P < 0.05). Serum cortisol, insulin, insulin-like growth factor I, and testosterone values did not change. Arteriovenous model calculations based on the infusion of L-[ring-13C6]-phenylalanine in five subjects revealed a 50% decrease in muscle protein synthesis (PS; P < 0.03). Fractional PS by tracer incorporation into muscle protein also decreased by 46% (P < 0.05). The decrease in PS was related to a corresponding decrease in the sum of intracellular amino acid appearance from protein breakdown and inward transport. Whole body protein synthesis determined by [15N]alanine ingestion on six subjects also revealed a 14% decrease (P < 0.01). Neither model-derived nor whole body values for protein breakdown change significantly. These results indicate that the loss of body protein with inactivity is predominantly due to a decrease in muscle PS and that this decrease is reflected in both whole body and skeletal muscle measures.

Non-NASA Center↗

The effects of bed rest on crew performance during simulated shuttle reentry. Volume 1: Study overview and physiological results

A centrifuge study was carried out to measure physiological stress and control task performance during simulated space shuttle orbiter reentry. Jet pilots were tested with, and without, anti-g-suit protection. The pilots were exposed to simulated space shuttle reentry acceleration profiles before, and after, ten days of complete bed rest, which produced physiological deconditioning similar to that resulting from prolonged exposure to orbital zero g. Pilot performance in selected control tasks was determined during simulated reentry, and before and after each simulation. Physiological stress during reentry was determined by monitoring heart rate, blood pressure, and respiration rate. Study results indicate: (1) heart rate increased during the simulated reentry when no g protection was given, and remained at or below pre-bed rest values when g-suits were used; (2) pilots preferred the use of g-suits to muscular contraction for control of vision tunneling and grayout during reentry; (3) prolonged bed rest did not alter blood pressure or respiration rate during reentry, but the peak reentry acceleration level did; and (4) pilot performance was not affected by prolonged bed rest or simulated reentry.

Chambers, A.↗

Fluid and electrolyte shifts in women during +Gz acceleration after 15 days' bed rest

Experiments were conducted on twelve women aged 23-34 yr - a bed rest (BR) group of eight subjects and an ambulatory (AMB) group of four subjects - to determine the effect of bed rest on shifts in plasma volume, electrolytes, and erythrocyte volume during +Gz acceleration on a centrifuge. The BR group underwent the +Gz acceleration during a two-week ambulatory control period, after 15 days of a 17-day BR period, and on the third day of ambulatory recovery. The AMB group underwent the same experimental procedures, but continued their normal daily routine during the BR period without additional prescribed physical exercise. Major conclusions are that (1) the higher the mean control tolerance, the greater the tolerance decline after BR; (2) relative confinement and reduced activity contribute as much to reduction in tolerance as does the horizontal body position during BR; (3) BR deconditioning has no effect on the erythrocyte volume during +3.0 Gz; and (4) about one-half the loss in tolerance after BR can be attributed to plasma volume and electrolyte shifts.

Greenleaf, J. E.↗

Artificial Gravity as a Multi-System Countermeasure to Bed Rest Deconditioning: Pilot Study Overview

Efficient, effective, multi-system countermeasures will likely be required to protect the health, safety, and performance of crews aboard planned exploration-class space flight missions to Mars and beyond. To that end, NASA, DLR, and IMBP initiated a multi-center international project to begin systematically exploring the utility of artificial gravity (AG) as a multi-system countermeasure in ground based venues using test subjects deconditioned by bed rest. The goal of this project is to explore the efficacy of short-radius, intermittent AG as a countermeasure to bone, muscle, cardiovascular, and sensory-motor adaptations to hypogravity. This session reports the results from a pilot study commissioned to validate a standardized protocol to be used by all centers involved in the project. Subject selection criteria, medical monitoring requirements, medical care procedures, experiment control procedures, and standardized dependent measures were established jointly. Testing was performed on 15 rigorously screened male volunteers subjected to 21 days of 6deg HDT bed rest. (All provided written consent to volunteer after the nature of the study and its hazards were clearly explained to them.) Eight were treated with daily 1hr AG exposures (2.5g at the feet decreasing to 1.0g at the heart) aboard a short radius (3m) centrifuge, while the other seven served as controls. Multiple tests of multiple dependent measures were made in each of the primary physiological systems of interest during a 10 day acclimatization period prior to HDT bed rest and again during an 8 day recovery period after the bed rest period was complete. Analyses of these data (presented in other papers in this session) suggest the AG prescription had salutary effects on aspects of the bone, muscle, and cardiovascular systems, with no untoward effects on the vestibular system, the immune system, or cognitive function. Furthermore, treatment subjects were able to tolerate 153/160 centrifuge sessions over the 21 day deconditioning protocol, suggesting that tolerance was unaffected by deconditioning. These positive results set the stage for full implementation of the planned multi-center international AG project. Future work will be devoted to developing optimization techniques for AG prescriptions (likely supplemented by exercise) to provide maximum physiological protection across all systems subject to space flight deconditioning in both men and women with minimum time and/or side effects. While a continuous AG solution (rotating vehicle) would likely be more efficient, this study suggests that intermittent AG could be an effective multi-system countermeasure.

Paloski, William H.↗

Exploring Endothelial Function Risk Factors and Optic Disc Edema Changes During Strict 6º Head-Down Tilt Bed Rest

Approximately 20% of astronauts on International Space Station missions experience ophthalmic pathologies including optic disc edema, part of what is characterized as Spaceflight Associated Neuro-ocular Syndrome (SANS). While the cause of SANS is unknown, there are likely multiple contributing factors, including genetics, that may affect the response to spaceflight in affected individuals. B-vitamin status and the presence of specific one-carbon pathway single nucleotide polymorphism (SNP) alleles predicted the incidence of SANS pathologies in astronauts and in bed rest subjects. There are several hypotheses for how genetic variants could lead to SANS, specifically related to endothelial function. The biochemical pathway to which these genes are associated is intimately involved in maintaining endothelial function via nitric oxide synthase (eNOS) coupling and nitric oxide (NO) production. Furthermore, eNOS uncoupling can impair the functional status of the endothelial glycocalyx, which lines the entirety of the vascular lumen and affects endothelial function. Vascular distension, stasis and altered shear forces, which are associated with headward fluid shifts, may also contribute to glycocalyx dysfunction and shedding, resulting in endothelial dysfunction and increased vascular permeability and tissue edema, potentially contributing to optic nerve and optic disc edema in affected individuals. Given the findings relating genetics and the risk of optic disc edema in astronauts during flight and subjects during bed rest, further investigation is warranted. In this study, we will assess the same genetic variants in another bed rest study: AGBRESA. Some of the AGBRESA subjects developed optic disc edema, but their genetics have not been studied. Furthermore, we will test available urine samples from prior bed rest studies (VaPER and AGBRESA) for markers of glycocalyx degradation to expand our understanding of factors contributing to SANS.

S R Zwart↗