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PubMed2005

[Characteristic of medical support and health care for Shenzhou-5 and Shenzhou-6 astronauts at main landing site].

OBJECTIVE: To investigate the characteristics of medical support and health care for the Shenzhou-5 and Shenzhou-6 astronauts at the main landing site, with special emphasis on the technical requirements for two astronauts during flight, in order to provide reference data for medical support in the battle field and disasters. METHODS: The data associated with accidental injuries of astronauts during the space flight collected from foreign nations and domestically were reviewed retrospectively. Based on the experience in medical support for Shenzhou-5 and Shenzhou-6 astronauts and the special environments of field operations, a scheme for first-aid and emergent treatment were drafted for a system of organization, prophylactic measurements, equipment and their effective implementation pending the test in the real situation. RESULTS: Two sets of high-quality intensive care unit (ICU) equipment were set up in helicopters, and an ambulance was equipped with the instruments and facilities that could be used in the first-aid and surgical operation in case accident and injuries should happen. The three sets of highly mobile ICU mentioned above could cover a vast area of both grassland and desert at the landing site to ensure that the astronauts could be rescued should accident occur, reaction to emergency would be most rapid and technique and equipment would be best. This scheme of first-aid for emergency which might occur in astronauts would seem to be a scientific, reasonable and practical system and would also meet the need in battle field. CONCLUSION: The first-aid scheme for astronauts at the main landing site, and its equipment, first aid strategies as well as it execution might provide an advanced system for medical aid and emergency treatment in the battlefield, disasters, and other special occasions.

Aerospace Medicine↗

PubMedDate not supplied

Astronaut-induced disturbances to the microgravity environment of the Mir Space Station.

In preparation for the International Space Station, the Enhanced Dynamic Load Sensors Space Flight Experiment measured the forces and moments astronauts exerted on the Mir Space Station during their daily on-orbit activities to quantify the astronaut-induced disturbances to the microgravity environment during a long-duration space mission. An examination of video recordings of the astronauts moving in the modules and using the instrumented crew restraint and mobility load sensors led to the identification of several typical astronaut motions and the quantification of the associated forces and moments exerted on the spacecraft. For 2806 disturbances recorded by the foot restraints and hand-hold sensor, the highest force magnitude was 137 N. For about 96% of the time, the maximum force magnitude was below 60 N, and for about 99% of the time the maximum force magnitude was below 90 N. For 95% of the astronaut motions, the rms force level was below 9.0 N. It can be concluded that expected astronaut-induced loads from usual intravehicular activity are considerably less than previously thought and will not significantly disturb the microgravity environment.

Acceleration↗

PubMed2006

Cardiac health for astronauts: coronary calcification scores and CRP as criteria for selection and retention.

Due to the limited treatment and return capabilities of most space vehicles, an in-flight cardiac event could result in significant mission impact or even failure. The current literature supports including electron-beam computed tomography (EBCT) and highly selective C-reactive protein (hsCRP) for diagnosis of coronary artery disease (CAD) in asymptomatic, low-pretest probability cohorts. This paper will examine the issues surrounding adding these tests to astronaut retention and selection algorithms. An evidenced-based literature review was performed and consensus obtained from subject-matter experts to create novel cardiac screening algorithms for astronaut applicants and the current astronaut corps. The main focus of this paper is to derive an evidenced-based approach for improving the diagnosis of significant CAD using EBCT and hsCRP testing. The recommended initial astronaut selection and long-duration mission assignment screening algorithms use EBCT-derived calcium scores and serum hsCRP levels to screen for CAD and predict individual cardiac risk. The current medical evidence is compelling for the international space medicine community to consider: (1) Astronaut candidates with a coronary artery calcium score >0 should be disqualified from initial selection; (2) Astronauts with a coronary artery calcium score >100 should be disqualified from selection for long-duration missions; (3) Elevated hsCRP is a reliable risk factor for helping predict future cardiac events that should warrant primary prevention but not necessarily medical disqualification.

Aerospace Medicine↗

PubMed2004

Stress-induced subclinical reactivation of varicella zoster virus in astronauts.

Varicella zoster virus (VZV) becomes latent in human ganglia after primary infection. VZV reactivation occurs primarily in elderly individuals, organ transplant recipients, and patients with cancer and AIDS, correlating with a specific decline in cell-mediated immunity to the virus. VZV can also reactivate after surgical stress. The unexpected occurrence of thoracic zoster 2 days before space flight in a 47-year-old healthy astronaut from a pool of 81 physically fit astronauts prompted our search for VZV reactivation during times of stress to determine whether VZV can also reactivate after non-surgical stress. We examined total DNA extracted from 312 saliva samples of eight astronauts before, during, and after space flight for VZV DNA by polymerase chain reaction: 112 samples were obtained 234-265 days before flight, 84 samples on days 2 through 13 of space flight, and 116 samples on days 1 through 15 after flight. Before space flight, only one of the 112 saliva samples from a single astronaut was positive for VZV DNA. In contrast, during and after space flight, 61 of 200 (30%) saliva samples were positive in all eight astronauts. No VZV DNA was detected in any of 88 saliva samples from 10 healthy control subjects. These results indicate that VZV can reactivate subclinically in healthy individuals after non-surgical stress.

Adult↗

PubMed2005

Changes in monocyte functions of astronauts.

As part of the systematic evaluation of the innate immune system for long duration missions, this study focused on the antimicrobial functions of monocytes in astronauts participating in spaceflight. The study included four space shuttle missions and 25 astronauts. Nine non-astronauts served as controls. Blood specimens were collected 10 days before launch, within 3h after landing, and again 3 days after landing. The number of monocytes did not differ significantly over the interval sampled in both the astronaut or control groups. However, following 5-11 days of spaceflight, the astronauts' monocytes exhibited reductions in ability to engulf Escherichia coli, elicit an oxidative burst, and degranulate. The phagocytic index was significantly reduced following spaceflight when compared to control values. This reduction in phagocytosis was accompanied by changes in the expression of two surface markers involved in phagocytosis, CD32 and CD64. Levels of cortisol, epinephrine, and norepinephrine after spaceflight did not increase over preflight values.

Adaptation, Physiological↗

PubMed2000

Research into the effects of astronaut motion on the spacecraft: a review.

The paper reviews the research that has been undertaken to understand and quantify the disturbance effects of the astronaut's motion inside and outside the spacecraft on the vehicle's attitude and acceleratory environment. In early investigations, the dynamic interaction of astronauts, modeled as point masses, and the spacecraft, modelled as a rigid body, was analyzed. Through ground-based experiments and the modeling of astronaut-induced forces and moments as stochastic processes, it became possible to estimate the magnitude and energy content of the loads produced by the astronaut. The first experiment in space to measure the astronaut-induced disturbances was conducted on the Skylab orbital station. Loads generated while performing routine operations were measured on board the Space Shuttle in 1994 and on the space station Mir in 1996-1997.

Acceleration↗

PubMed2002

Influence of microgravity on astronauts' sympathetic and vagal responses to Valsalva's manoeuvre.

When astronauts return to Earth and stand, their heart rates may speed inordinately, their blood pressures may fall, and some may experience frank syncope. We studied brief autonomic and haemodynamic transients provoked by graded Valsalva manoeuvres in astronauts on Earth and in space, and tested the hypothesis that exposure to microgravity impairs sympathetic as well as vagal baroreflex responses. We recorded the electrocardiogram, finger photoplethysmographic arterial pressure, respiration and peroneal nerve muscle sympathetic activity in four healthy male astronauts (aged 38-44 years) before, during and after the 16 day Neurolab space shuttle mission. Astronauts performed two 15 s Valsalva manoeuvres at each pressure, 15 and 30 mmHg, in random order. Although no astronaut experienced presyncope after the mission, microgravity provoked major changes. For example, the average systolic pressure reduction during 30 mmHg straining was 27 mmHg pre-flight and 49 mmHg in flight. Increases in muscle sympathetic nerve activity during straining were also much greater in space than on Earth. For example, mean normalized sympathetic activity increased 445% during 30 mmHg straining on earth and 792% in space. However, sympathetic baroreflex gain, taken as the integrated sympathetic response divided by the maximum diastolic pressure reduction during straining, was the same in space and on Earth. In contrast, vagal baroreflex gain, particularly during arterial pressure reductions, was diminished in space. This and earlier research suggest that exposure of healthy humans to microgravity augments arterial pressure and sympathetic responses to Valsalva straining and differentially reduces vagal, but not sympathetic baroreflex gain.

Adult↗

PubMed2001

Space radiation and cataracts in astronauts.

For over 30 years, astronauts in Earth orbit or on missions to the moon have been exposed to space radiation comprised of high-energy protons and heavy ions and secondary particles produced in collisions with spacecraft and tissue. Large uncertainties exist in the projection of risks of late effects from space radiation such as cancer and cataracts due to the paucity [corrected] of epidemiological data. Here we present epidemiological [corrected] data linking an increased risk of cataracts for astronauts with higher lens doses (>8 mSv) of space radiation relative to other astronauts with lower lens doses (<8 mSv). Our study uses historical data for cataract incidence in the 295 astronauts participating in NASA's Longitudinal Study of Astronaut Health (LSAH) and individual occupational radiation exposure data. These results, while preliminary because of the use of subjective scoring methods, suggest that relatively low doses of space radiation may predispose crew to [corrected] an increased incidence and early appearance of cataracts.

Aged↗

PubMed2001

Urine volume and its effects on renal stone risk in astronauts.

BACKGROUND: Urine composition in astronauts during and immediately after spaceflight changes in ways that increase the renal stone-forming potential for calcium oxalate, calcium phosphate, and uric acid saturation. We examined the effect of urine volume on the risk of renal stone formation in 356 astronauts. METHODS: Renal stone-forming risk was evaluated from 24-h urine samples collected from astronauts before and after 4- to 17-d Space Shuttle flights. Urinary chemistries were performed and the relative supersaturations of calcium oxalate, brushite, sodium urate, struvite, and uric acid saturation were calculated from the biochemical results. RESULTS: Urinary supersaturation levels of stone-forming salts were inversely related to urinary output both before and after spaceflight. Urine volume > 2 L x d(-1) reduced the risk of renal-stone development without affecting urinary citrate concentrations as compared with the increased risk observed in those astronauts who excreted urine volumes < L x d(-1). CONCLUSION: Results from this study indicate that increasing daily urinary output alone is an effective countermeasure to reduce the renal stone-forming risk immediately after spaceflight. However, increasing urinary output during flight may not be entirely effective in minimizing the potential risk of renal stone formation due to the changes in the urine chemistry in astronauts exposed to microgravity. KEYWORDS: urine volume, spaceflight, renal calculi.

Adult↗

PubMed2004

Fludrocortisone does not prevent orthostatic hypotension in astronauts after spaceflight.

BACKGROUND: During stand/tilt tests after spaceflight, 20% of astronauts experience orthostatic hypotension and presyncope. Spaceflight-induced hypovolemia is a contributing factor. Fludrocortisone, a synthetic mineralocorticoid, has been shown to increase plasma volume and orthostatic tolerance in Earth-bound patients. The efficacy of fludrocortisone as a treatment for postflight hypovolemia and orthostatic hypotension in astronauts has not been studied. Our purpose was to test the hypothesis that astronauts who ingest fludrocortisone prior to landing would have less loss of plasma volume and greater orthostatic tolerance than astronauts who do not ingest fludrocortisone. METHODS: There were 25 male astronauts who were randomized into 2 groups: placebo (n = 18) and fludrocortisone (n = 7), and participated in stand tests 10 d before launch and 2-4 h after landing. Subjects took either 0.3 mg fludrocortisone or placebo orally 7 h prior to landing. Supine plasma and red cell volumes, supine and standing HR, arterial pressure, aortic outflow, and plasma norepinephrine and epinephrine were measured. RESULTS: On landing day, 2 of 18 in the placebo group and 1 of 7 in the fludrocortisone group became presyncopal (chi2 = 0.015, p = 0.90). Plasma volumes were significantly decreased after flight in the placebo group, but not in the fludrocortisone group. During postflight stand tests, standing plasma norepinephrine was significantly less in the fludrocortisone group compared with the placebo group. CONCLUSIONS: Treatment with a single dose of fludrocortisone results in protection of plasma volume but no protection of orthostatic tolerance. Fludrocortisone is not recommended as a countermeasure for spaceflight-induced orthostatic intolerance.

Adult↗

PubMed2004

Personality characteristics and trait clusters in final stage astronaut selection.

INTRODUCTION: This paper presents personality testing data from final stage applicants to the NASA astronaut program. Questions addressed include whether personality predicted final selection into the astronaut corps, whether women and men demonstrated typical gender differences in personality, and whether three characteristic clusters found in other high performance populations replicated in this group. METHODS: Between 1989 and 1995, 259 final stage astronauts completed the Personal Characteristic Inventory (PCI) which assesses personality characteristics related to the broad traits of Instrumentality and Expressivity. In addition, 147 of these individuals also completed an abbreviated version of the NEO Five Factor Inventory (NEO-FFI) which assesses the "Big Five" traits of Neuroticism, Extraversion, Openness, Agreeableness, And Conscientiousness. RESULTS: Three previously identified trait clusters (Right, Wrong, and No Stuff) were found to replicate in this population. No differences were found on the PCI or on the modified NEO-FFI between applicants who were chosen to become astronauts (n = 63) and those who were not (n = 196). Men scored higher than women on competitiveness, but lower on expressivity and achievement strivings. DISCUSSION: These analyses suggest that the "Right Stuff," "Wrong Stuff" and "No Stuff" clusters originally described in airline pilots and other high performance groups also exist within this population. Consistent with findings from other high performance populations, men and women tend to differ to a lesser extent than found in the general population, particularly on traits related to achievement motivation. Personality trait testing did not predict which applicants were most likely to be accepted into the astronaut corps.

Astronauts↗

PubMed2006

Hemodynamic effects of midodrine after spaceflight in astronauts without orthostatic hypotension.

INTRODUCTION: Orthostatic hypotension and presyncope are common and potentially serious risks for astronauts returning from space. Susceptible subjects fail to generate an adequate adrenergic response to upright posture. The alpha-1 adrenergic agonist, midodrine, may be an effective countermeasure. We tested the hypothesis that midodrine would have no negative hemodynamic effect on healthy astronauts returning from space. METHODS: Five male astronauts participated in preflight and post-flight tilt testing on a control flight as well as on the test flights, where midodrine (10 mg, orally) was administered after landing approximately 1 h before testing. RESULTS: None of these astronauts exhibited orthostatic hypotension or presyncope before or after either flight. Midodrine did not cause any untoward reactions in these subjects before or after flight; in fact, a modest beneficial effect was seen on postflight tachycardia (p = 0.036). DISCUSSION: These data show that midodrine protected against post-spaceflight increases in heart rate without having any adverse hemodynamic effects on non-presyncopal, male astronauts. Among these subjects, midodrine was a safe cardiovascular countermeasure.

Adrenergic alpha-Agonists↗

PubMed1994

Astronaut psychiatric selection procedures: a Japanese experience.

This paper presents the results of the first application of a structured NASA psychiatric interview for Japanese astronaut selection. We undertook a semi-structured, diagnostic, clinical psychiatric interview with 45 Japanese astronaut applicants for the position of mission specialist-astronaut, and performed "select-out" psychiatric evaluations according to DSM-III-R psychiatric diagnostic criteria. Two applicants (4.4%) who met Axis I or Axis II disorder criteria in DSM-III-R were evaluated as "Disqualified." There were 13 applicants "Qualified with Reservation"; the majority of their diagnoses were "hypomania." Those applicants "Qualified with Reservation" and "Disqualified" were not finally selected to be astronauts. This structured interview was not only useful for "select-out" psychiatric screening of Japanese astronauts, but also made clear the Japanese characteristics of this selection procedure.

Adult↗

PubMed2004

Changes in neutrophil functions in astronauts.

Exploration class human spaceflight missions will require astronauts with robust immune systems. Innate immunity will be an essential element for the healthcare maintenance of astronauts during these lengthy expeditions. This study investigated neutrophil phagocytosis, oxidative burst, and degranulation of 25 astronauts after four space shuttle missions and in nine healthy control subjects. Space flight duration ranged from 5 to 11 days. Blood specimens were obtained 10 days before launch, immediately after landing, and 3 days after landing. The number of neutrophils increased by 85% at landing compared to preflight levels. The mean values for phagocytosis of Escherichia coli and oxidative burst capacity in neutrophils from astronauts on the 5-day mission were not significantly different from those observed in neutrophils from the control subjects. Before and after 9- to 11-day missions, however, phagocytosis and oxidative burst capacities were significantly lower than control mean values. No consistent changes in degranulation or expression of surface markers were observed before or after any of the space missions. This study indicates that neutrophil phagocytic and oxidative functions are affected by factors associated with space flight and this relationship may depend on mission duration.

Age Factors↗

PubMed2003

Adaptive response studies may help choose astronauts for long-term space travel.

Long-term manned exploratory missions are planned for the future. Exposure to high-energy neutrons, protons and high charge and energy particles during a deep space mission, needs protection against the detrimental effects of space radiation. It has been suggested that exposure to unpredictable extremely large solar particle events would kill the astronauts without massive shielding. To reduce this risk to astronauts and to minimize the need for shielding, astronauts with highest significant adaptive responses should be chosen. It has been demonstrated that some humans living in very high natural radiation areas have acquired high adaptive responses to external radiation. Therefore, we suggest that for a deep space mission the adaptive response of all potential crew members be measured and only those with high adaptive response be chosen. We also proclaim that chronic exposure to elevated levels of radiation can considerably decrease radiation susceptibility and better protect astronauts against the unpredictable exposure to sudden and dramatic increase in flux due to solar flares and coronal mass ejections.

Adaptation, Physiological↗

PubMed2000

Reactivation and shedding of cytomegalovirus in astronauts during spaceflight.

The reactivation of cytomegalovirus (CMV) in 71 astronauts was investigated, using polymerase chain reaction. A significantly greater (P<.0001) shedding frequency was found in urine samples from astronauts before spaceflight (10.6%) than in urine from the healthy control subject group (1.2%). Two of 4 astronauts studied during spaceflight shed CMV in urine. A significant increase (P<.0001) in CMV antibody titer, compared with baseline values, was also found 10 days before spaceflight. CMV antibody titer was further increased (P<.001) 3 days after landing, compared with 10 days before the mission. Significant increases in stress hormones were also found after landing. These results demonstrate that CMV reactivation occurred in astronauts before spaceflight and indicate that CMV may further reactivate during spaceflight.

Adult↗

PubMed2000

Stress-induced reactivation of Epstein-Barr virus in astronauts.

Herpesviruses are leading causes of infectious blindness and death in immunocompromised individuals. Impaired cellular immunity, which is known to result in increased frequency and severity of herpesvirus infections, has been demonstrated both during and after spaceflight. Therefore, we examined whether Epstein-Barr virus (EBV), a well-characterized latent herpesvirus, undergoes reactivation in astronauts. Sera from Shuttle astronauts, taken before and after spaceflight, were examined for evidence of EBV reactivation. The geometric mean antibody titer to EBV viral capsid antigen (VCA) was significantly increased prior to flight compared to baseline (p = 0. 0001). After spaceflight, evidence of acute lytic replication was found in which 8- to 64-fold increases in EBV early antigen (EA) antibodies occurred without significant increases in antibodies to measles virus. Additionally, stress-induced shifts in circulating leukocytes and elevated levels of urinary cortisol and epinephrine were found. Overall, significant increases in EA or high VCA/EA antibody titers were found in 8 of 23 (35%) male astronauts and 3 of 5 (60%) female astronauts. These results indicate that stress reactivates EBV prior to flight and suggest that acute lytic replication of EBV occurs during spaceflight.

Adrenocorticotropic Hormone↗

PubMed1995

Use of the Remote Access Virtual Environment Network (RAVEN) for coordinated IVA-EVA astronaut training and evaluation.

This paper presents a unique virtual reality training and assessment tool developed under a NASA grant, "Research in Human Factors Aspects of Enhanced Virtual Environments for Extravehicular Activity (EVA) Training and Simulation." The Remote Access Virtual Environment Network (RAVEN) was created to train and evaluate the verbal, mental and physical coordination required between the intravehicular (IVA) astronaut operating the Remote Manipulator System (RMS) arm and the EVA astronaut standing in foot restraints on the end of the RMS. The RAVEN system currently allows the EVA astronaut to approach the Hubble Space Telescope (HST) under control of the IVA astronaut and grasp, remove, and replace the Wide Field Planetary Camera drawer from its location in the HST. Two viewpoints, one stereoscopic and one monoscopic, were created all linked by Ethernet, that provided the two trainees with the appropriate training environments.

Astronauts↗