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Mapping by VESGEN of Blood Vessels in the Retinas of Astronauts Pre- and Post-Flight to the ISS

Research by NASA [1] established that significant risks for visual and ocular impairments associated with increased intracranial pressure (VIIP) are incurred by microgravity spaceflight, especially long-duration missions. It is well established in physiology and pathology that a fundamental role of the microvasculature is to mediate fluid transfers and remodel actively in response to environmental, immune and other stresses. We therefore hypothesize that remodeling of retinal blood vessels necessarily occurs during accommodation of microgravity-induced fluid shifts prior to subsequent development of visual and ocular impairments. Potential contributions of retinal vascular remodeling to VIIP etiology are therefore being investigated by NASA's innovative VESsel GENeration Analysis (VESGEN) software for two studies: (1) U.S. crew members before and after ISS missions, and (2) head-down tilt in human subjects before and after 70 days of bed rest. We anticipate that results of the two studies will be complete by the Investigators Workshop (January 22, 2017). METHODS: For the 2013 NASA NRA award, we are concluding the analysis of 30 degree infrared (IR) Heidelberg Spectralis images of retinal blood vessels by VESGEN (patents pending), a mature, automated software developed as a translational and basic vascular research discovery tool, particularly for retinal vascular disease. Subjects of our retrospective study include eight ISS crew members monitored for routine occupational surveillance pre- and post-flight, who provided their study consents to NASAs Lifetime Surveillance of Astronaut Health (LSAH) in coordination with approval of the VESGEN retrospective study protocol by NASAs Institutional Review Board (IRB). The ophthalmic retinal images (average image resolution, approximately 5.6 microns per pixel) are blinded as to pre and post ISS status until the second portion of our study, when VESGEN results will be correlated with other ophthalmic and medical findings for the crew members. Due to image resolution challenges, a novel Matlab tool was developed for aligning pre and post images, and comparing (querying) the two images for differences in the morphology of small vessels. RESULTS: During the past year, LSAH approved the release of all astronaut retinal images to our study for VESGEN analysis. Substantial progress on the initial blinded portion of the study is in place. We anticipate that VESGEN analysis of the 32 Spectralis IR retinal images will be complete for presentation at the 2017 IWS meeting. CONCLUSIONS: Modified retinal vascular patterning may offer early-stage predictions of ocular changes resulting in decreased visual acuity for the VIIP syndrome. Novel insights provided by VESGEN into progressively pathological and blinding vascular remodeling in the human retina currently help to guide other NIH- and NASA-supported therapeutic studies of retinal disease and modeling of the VIIP risk. Results of our vascular investigation of the retinas of astronauts pre- and post-flight may help advance the understanding of both healthy and pathological adaptations to fluid shifts in microgravity associated with the VIIP syndrome. Preliminary results indicate that imaging of higher resolution, such as the new OCT angiography (OCT-A) technology, will be required to determine conclusively the role of the smaller retinal and choroidal vessels in VIIP etiology.

VESGEN↗

Spaceflight Associated Neuro-Ocular Syndrome: A Brief for Astronaut Candidates

INTRODUCTION: Spaceflight Associated Neuro-ocular Syndrome (SANS) was first described in 2011 as a clinical process involving degradation of visual acuity and structural changes of the eye when exposed to microgravity. This syndrome poses a risk to astronaut vision, safety, and mission performance, especially during extended-duration missions. The modern astronaut cohort is a diverse group of men and women including scientists, engineers, teachers, pilots, business professionals, and artists. Given their diverse backgrounds, it is imperative all crews are educated on SANS risks and potential countermeasures. This education must be comprehensive and easily understood, regardless of academic background or specific expertise. TOPIC: A PowerPoint was created to serve as a presentation and stand-alone educational aid for all astronaut candidates (ASCANS). This medium was chosen as it can be updated dynamically as new information emerges. The brief was split into sections to facilitate organized delivery of complex content in easy-to-understand components. Sections included descriptive statistics, signs and symptoms, outcomes, myths and ongoing research, countermeasures, ongoing surveillance, and unknown and future directions. More research is necessary in order to understand this syndrome, and without continued ASCAN participation in research, acquisition of data will not be possible. These efforts will become increasingly critical with deep space and exploration missions. APPLICATION: We recommend regular use of this brief for all ASCANS, and potentially veteran crewmembers, given the high risks and potentially poor outcomes associated with SANS. For ASCANS, recommendations include that this brief be provided at the start of their training, with a bi-annual refresher course for all astronauts. This ensures they are current on SANS information, given the dynamic nature of this syndrome. Additionally, this brief will be made available to all as a self-study aid, utilized as a refresher immediately prior to launch. It is anticipated that this brief will promote the health, safety, and wellbeing of professional and private crews alike, during and after long-duration spaceflight. RESOURCES: Brunstetter, T., Tarver, B., & Tsung, A. (2022, October). Spaceflight Associated Neuro-ocular Syndrome (Sans) and its Risk to Nasa Astronauts. JSC Aerospace Medicine Clerkship. Houston, TX; Lyndon B. Johnson Space Center. Laurie, S. S., Macias, B. R., Pardon, L. P., Brunstetter, T., Tarver, W. J., Gibson, C. R., Greenwald, S. H., Jasien, K. V., Mason, S., & Tsung, A. (2022). (rep.). Evidence Report: Risk of Spaceflight Associated Neuro-ocular Syndrome (SANS). Houston, TX: National Aeronautics and Space Administration. Mader, T. H., Gibson, C. R., Pass, A. F., Kramer, L. A., Lee, A. G., Fogarty, J., ... & Polk, J. D. (2011). Optic disc edema, globe flattening, choroidal folds, and hyperopic shifts observed in astronauts after long-duration space flight. Ophthalmology, 118(10), 2058-2069. LEARNING OBJECTIVES: • The audience will be able to describe current Spaceflight Associated Neuro-ocular Syndrome (SANS) findings, significance, and countermeasures. • The audience will understand the importance of astronauts’ familiarity with SANS prior to flying and the large risks associated with this syndrome. CME QUESTIONS (3 QUESTIONS, MULTIPLE CHOICE A-D): 1. What is the approximate prevalence rate of SANS in astronauts? A. 22% B. 50% C. 66% D. 80% Answer: C. 2. Which of the ocular findings are NOT associated with SANS? A. Optic disc edema B. Retinal detachment C. Globe flattening D. Chorioretinal folds Answer: B. 3. Which of the following diagnostic technologies are NOT available in-flight? A. Ocular ultrasound B. Retinal photography C. MRI Orbit D. Optical Coherence Tomography (OCT) Answer: C.

Sara Stroble Mason↗

Evaluation of Human Spaceflight-Related Tissue Weight Relief Using Whole Body Finite Element Model Simulations

Tissue Weight Relief (TWR) is a physiological condition observed in human spaceflight. It not only impacts the injury biomechanics of soft tissue but also the physiological responses of the cardiovascular system both due to fluid redistribution and the effect of tissue-related transmural pressure on the large venous blood vessels. Understanding the effects of tissue weight relief is especially important because of the role it may play in understanding the cause of Space Associated Neuro-Ocular Syndrome (SANS). SANS can be characterized by a number of ocular changes which reduce visual acuity and SANS related symptoms occur in up to 51% of astronauts. A prevailing theory for the causation of SANS is that of headward (cephalad) fluid shift and a prolonged increase of Intracranial Pressure (ICP) similar to intracranial hypertension, which is not fully supported by the experimental data or astronaut symptom reporting. However, it is still believed that SANS is caused by a pressure change in the eye and the surrounding tissues. It has been proposed that TWR plays a substantial role in affecting internal pressures and fluid shifts in microgravity. In this effort, two whole-body Finite Element (FE) models – Elemance and THUMS – are used to ascertain the microgravity-associated TWR of the musculature surrounding the lower body veins. Elemance and THUMS are physics-based computational models that have been validated and verified for several automotive and domestic applications, and as such, can simulate the relief of soft tissue weight due to changes in the gravitation vector. Specifically, the current effort modeled the transition of the gravitational vector from 1G to 0G, applied across the whole-body model in a supine position. For each 1G to 0G transition simulation, the lower body vein’s transmural pressure-time profile was extracted and averaged around the anterior portion of the thigh muscle. The ascertained transmural pressure changes from 1G to 0G transition are given in Figure 1 for the Elemance and the THUMS FE models. The transmural pressure changes of 10 mmHg and 21 mmHg are in the same order of magnitude as Lu’s value of 44 mmHg. It is to be noted that Lu implemented a 0D to 1D lumped parameter model and the Elemance and THUMS are 3D higher order computational models. This proof-of-concept approach demonstrates that TWR pressure can be adequately estimated with in silico techniques however, further in silico investigations need to be conducted to address the unique contributions to the transmural pressure from each of the computational models.

Finite element modeling↗

Light as a Reactive Countermeasure to Sleep Inertia: Translating Laboratory Findings to the Field

Sleep inertia describes the brief period of impaired alertness, mood, and cognitive performance experienced after waking. Under laboratory settings, light exposure upon waking during a habitual sleep period has been shown to improve sleep inertia symptoms. We investigated whether a field-deployable light-emitting device would help to mitigate sleep inertia in a real-world setting. Thirty-six participants (18 female; 26.6 years ± 6.1) completed an at-home, within-subject, randomized crossover study. Participants followed their habitual sleep-wake schedule for five nights before an adaptation and experimental night. Forty-five minutes after bedtime on the experimental night, participants received a phone call and were instructed to wear light-emitting glasses with the light either on (light condition) or off (control). A 5-minute psychomotor vigilance task (PVT), the Karolinska Sleepiness Scale (KSS), visual analog scales of mood (VASmood), and a 3-minute descending subtraction task (DST) were performed starting at +2, +12, +22, and +32 minutes after the call. Participants then went back to sleep and were called 45 minutes after lights out for the opposite condition. A series of mixed-effects models were performed with fixed effects of test bout, condition, test bout × condition, and a random effect of participant. Covariates included pre-sleep baseline scores, randomization order, sex, and sleep history. Participants rated themselves as more alert and energetic in the light condition compared to the control condition (VASalert-sleepy p = .01; VASlethargic-energetic p = .001). There was no effect of condition for DST outcomes, but there was a significant improvement in DST total responses in the light condition in a subset of participants waking from N3 (p = .03). There was a significant effect of condition for PVT outcomes, with faster responses (p < .001) and fewer lapses (p < .001) in the control condition. Our results under naturalistic at-home settings suggest that, similar to the in-laboratory study findings, the light intervention improved subjective alertness and mood, while working memory improved after waking from N3. Future studies of light interventions should include measures of visual acuity and comfort to assess the full feasibility and efficacy of interventions in real-world environments.

sleep inertia↗

Light as a Reactive Countermeasure to Sleep Inertia: Translating Laboratory Findings to the Field

Sleep inertia describes the brief period of impaired alertness, mood, and cognitive performance experienced after waking. Under laboratory settings, light exposure upon waking during a habitual sleep period has been shown to improve sleep inertia symptoms. We investigated whether a field-deployable light-emitting device would help to mitigate sleep inertia in a real-world setting.\ Thirty-six participants (18 female; 26.6 years ± 6.1) completed an at-home, within-subject, randomized crossover study. Participants followed their habitual sleep-wake schedule for five nights before an adaptation and experimental night. Forty-five minutes after bedtime on the experimental night, participants received a phone call and were instructed to wear light-emitting glasses with the light either on (light condition) or off (control). A 5-minute psychomotor vigilance task (PVT), the Karolinska Sleepiness Scale (KSS), visual analog scales of mood (VASmood), and a 3-minute descending subtraction task (DST) were performed starting at +2, +12, +22, and +32 minutes after the call. Participants then went back to sleep and were called 45 minutes after lights out for the opposite condition. A series of mixed-effects models were performed with fixed effects of test bout, condition, test bout × condition, and a random effect of participant. Covariates included pre-sleep baseline scores, randomization order, sex, and sleep history. Participants rated themselves as more alert and energetic in the light condition compared to the control condition (VASalert-sleepy p = .01; VASlethargic-energetic p = .001). There was no effect of condition for DST outcomes, but there was a significant improvement in DST total responses in the light condition in a subset of participants waking from N3 (p = .03). There was a significant effect of condition for PVT outcomes, with faster responses (p < .001) and fewer lapses (p < .001) in the control condition. Our results under naturalistic at-home settings suggest that, similar to the in-laboratory study findings, the light intervention improved subjective alertness and mood, while working memory improved after waking from N3. Future studies of light interventions should include measures of visual acuity and comfort to assess the full feasibility and efficacy of interventions in real-world environments.

sleep inertia↗

Light as a Reactive Countermeasure to Sleep Inertia: Translating Laboratory Findings to the Field

Sleep inertia describes the brief period of impaired alertness, mood, and cognitive performance experienced after waking. Under laboratory settings, light exposure upon waking during a habitual sleep period has been shown to improve sleep inertia symptoms. We investigated whether a field-deployable light-emitting device would help to mitigate sleep inertia in a real-world setting. Thirty-six participants (18 female; 26.6 years ± 6.1) completed an at-home, within-subject, randomized crossover study. Participants followed their habitual sleep-wake schedule for five nights before an adaptation and experimental night. Forty-five minutes after bedtime on the experimental night, participants received a phone call and were instructed to wear light-emitting glasses with the light either on (light condition) or off (control). A 5-minute psychomotor vigilance task (PVT), the Karolinska Sleepiness Scale (KSS), visual analog scales of mood (VASmood), and a 3-minute descending subtraction task (DST) were performed starting at +2, +12, +22, and +32 minutes after the call. Participants then went back to sleep and were called 45 minutes after lights out for the opposite condition. A series of mixed-effects models were performed with fixed effects of test bout, condition, test bout × condition, and a random effect of participant. Covariates included pre-sleep baseline scores, randomization order, sex, and sleep history. Participants rated themselves as more alert and energetic in the light condition compared to the control condition (VASalert-sleepy p = .01; VASlethargic-energetic p = .001). There was no effect of condition for DST outcomes, but there was a significant improvement in DST total responses in the light condition in a subset of participants waking from N3 (p = .03). There was a significant effect of condition for PVT outcomes, with faster responses (p < .001) and fewer lapses (p < .001) in the control condition. Our results under naturalistic at-home settings suggest that, similar to the in-laboratory study findings, the light intervention improved subjective alertness and mood, while working memory improved after waking from N3. Future studies of light interventions should include measures of visual acuity and comfort to assess the full feasibility and efficacy of interventions in real-world environments.

sleep inertia↗

Testing Models for Perceptual Discrimination Using Repeatable Noise

Adding noise to stimuli to be discriminated allows estimation of observer classification functions based on the correlation between observer responses and relevant features of the noisy stimuli. Examples will be presented of stimulus features that are found in auditory tone detection and visual Vernier acuity. Using the standard signal detection model (Thurstone scaling), we derive formulas to estimate the proportion of the observer's decision variable variance that is controlled by the added noise. One is based on the probability of agreement of the observer with him/herself on trials with the same noise sample. Another is based on the relative performance of the observer and the model. When these do not agree, the model can be rejected. A second derivation gives the probability of agreement of observer and model when the observer follows the model except for internal noise. Agreement significantly less than this amount allows rejection of the model.

Ahumada, Albert J., Jr.↗

Masking by Gratings Predicted by an Image Sequence Discriminating Model: Testing Models for Perceptual Discrimination Using Repeatable Noise

Adding noise to stimuli to be discriminated allows estimation of observer classification functions based on the correlation between observer responses and relevant features of the noisy stimuli. Examples will be presented of stimulus features that are found in auditory tone detection and visual vernier acuity. using the standard signal detection model (Thurstone scaling), we derive formulas to estimate the proportion of the observers decision variable variance that is controlled by the added noise. one is based on the probability of agreement of the observer with him/herself on trials with the same noise sample. Another is based on the relative performance of the observer and the model. When these do not agree, the model can be rejected. A second derivation gives the probability of agreement of observer and model when the observer follows the model except for internal noise. Agreement significantly less than this amount allows rejection of the model.

Ahumada, Albert J., Jr.↗

Effect of microgravity on several visual functions during STS shuttle missions

Changes in the acuity of astronaut vision during flight are discussed. Parameters such as critical flicker vision, stereopsis to 10 seconds of arc, visual acuity in small steps to 20/7.7, cyclophoria, lateral and vertical phoria and retinal rivalry were tested using a visual function tester. Twenty-three Space Transportation System (STS) astronauts participated in the experiments. Their vision was assessed twice before launch and after landing, and three to four times while on-orbit and landing. No significant differences during space flight were observed for any of the visual parameters tested. In some cases, slight changes in acuity and stereopsis were observed with a subsequent return to normal vision after flight.

Oneal, Melvin R.↗

Visual Systems for Remotely Controlled Vehicles

The Variable Acuity Remote Viewing System is discussed. It was conceived as a technique for resolving the field of view/resolution/ bandwidth tradeoffs that exist in remote viewing systems. This system is based on the fact that integration of the human eye acuity function shows only about 130,000 pixels are required to fully support the human vision. This quantity is well within the capabilities of conventional video systems. The technique utilizes a non-linear optical system in both the sensing and display equipment. The non-linearity is achieved by a special lens which translates a uniform pixel array on its image plane into the object field as a variable angular array. This lens will record the same angular detail the eye would see when viewing the same scene and compress this detail into a uniform matrix of equal sized picture elements on its image plane. This image can be scanned with a broadcast quality tv having a 525 line raster scan. Conventional transmission equipment can then also be used to send the image information to a remote location. When received, the image is projected by a light valve projector onto a hemispherical screen by an identical non-linear lens.

Rezek, T.↗

Digital halftoning methods for selectively partitioning error into achromatic and chromatic channels

A method is described for reducing the visibility of artifacts arising in the display of quantized color images on CRT displays. The method is based on the differential spatial sensitivity of the human visual system to chromatic and achromatic modulations. Because the visual system has the highest spatial and temporal acuity for the luminance component of an image, a technique which will reduce luminance artifacts at the expense of introducing high-frequency chromatic errors is sought. A method based on controlling the correlations between the quantization errors in the individual phosphor images is explored. The luminance component is greatest when the phosphor errors are positively correlated, and is minimized when the phosphor errors are negatively correlated. The greatest effect of the correlation is obtained when the intensity quantization step sizes of the individual phosphors have equal luminances. For the ordered dither algorithm, a version of the method can be implemented by simply inverting the matrix of thresholds for one of the color components.

Mulligan, Jeffrey B.↗

Space adaptation syndrome experiments (8-IML-1)

A set of seven experiments will study adaptation of the human nervous system to weightlessness. Particular emphasis will be placed on the vestibular and proprioceptive systems. The experiments are as follows: the sled/H-reflex; rotation/vestibulo-ocular reflex; the visual stimulator experiment; proprioception (relaxed) experiment; proprioception (active) experiment; proprioception (illusion) experiment; and tactile acuity.

Watt, D.↗

Vision Test in Seconds

Acuity Systems, Inc. developed an electro-optical instrument under a grant from NASA to measure the visual performance of pilots. Transferred from Ames Research Center, this instrument now allows you to have your eyes tested in seconds by relatively unskilled operators. The device automatically measures refractive error of eye and prints out proper prescription for glasses. The unit also detects cataracts and glaucoma.

Source record↗

Dose-Dependent Sensorimotor Impairment in Human Ocular Tracking After Acute Low-Dose Alcohol Administration

Changes in oculomotor behaviours are often used as metrics of sensorimotor disruption due to ethanol (EtOH); however, previous studies have focused on deficits at blood-alcohol concentrations (BACs) above about 0.04%.We investigated the dose dependence of the impairment in oculomotor and ocular behaviours caused by EtOH administration across a range of ultra-low BACs (≤0.035%).We took repeated measures of oculomotor and ocular performance from sixteen participants, both pre- and post-EtOH administration. To assess the neurological impacts across a wide range of brain areas and pathways, our protocol measured 21 largely independent performance metrics extracted from a range of behavioural responses ranging from ocular tracking of radial step-ramp stimuli, to eccentric gaze holding, to pupillary responses evoked by light flashes. Our results show significant impairment of pursuit and visual motion processing at 0.015% BAC, reflecting degraded neural processing within extrastriate cortical pathways. However, catch-up saccades largely compensate for the tracking displacement shortfall caused by low pursuit gain, although there still is significant residual retinal slip and thus degraded dynamic acuity. Furthermore, although saccades are more frequent, their dynamics are more sluggish (i.e. show lower peak velocities) starting at BAC levels as low as 0.035%. Small effects in eccentric gaze holding and no effect in pupillary response dynamics were observed at levels below 0.07%, showing the higher sensitivity of the pursuit response to very low levels of blood alcohol, under the conditions of our study.

visual motion processing↗

Orientational anisotropy in infant vision

Infants prefer to look at horizontal and vertical gratings rather than at oblique gratings only when they are at or near threshold spatial frequencies, as would be expected if acuity for oblique edges is lower than that for horizontal and vertical edges. That such a bias exists as early as 6 weeks of age suggests that the orientational asymmetry of the visual system depends on endogeneous maturation rather than exposure to a carpentered world.

Cohen Leehey, S.↗

A study of payload specialist station monitor size constraints

Constraints on the CRT display size for the shuttle orbiter cabin are studied. The viewing requirements placed on these monitors were assumed to involve display of imaged scenes providing visual feedback during payload operations and display of alphanumeric characters. Data on target recognition/resolution, target recognition, and range rate detection by human observers were utilized to determine viewing requirements for imaged scenes. Field-of-view and acuity requirements for a variety of payload operations were obtained along with the necessary detection capability in terms of range-to-target size ratios. The monitor size necessary to meet the acuity requirements was established. An empirical test was conducted to determine required recognition sizes for displayed alphanumeric characters. The results of the test were used to determine the number of characters which could be simultaneously displayed based on the recognition size requirements using the proposed monitor size. A CRT display of 20 x 20 cm is recommended. A portion of the display area is used for displaying imaged scenes and the remaining display area is used for alphanumeric characters pertaining to the displayed scene. The entire display is used for the character alone mode.

Kirkpatrick, M., III↗