Neurovestibular Effects of Long-Duration Spaceflight: A Summary of Mir-Phase 1 Experiences

Space motion sickness and associated neurovestibular dysfunction though not completely understood - have been relatively well clinically and operationally characterized on short-duration (1-2 week) Space Shuttle missions (Oman, et al, 1984, 1986; Thornton, et al, 1987; Reschke, et al, 1994). Between March 1995 and June 1998, seven NASA astronauts flew on the Russian Mir space station, as "Phase 1" of the joint effort to build the International Space Station, and provided NASA with invaluable experience on the operational and biomedical problems associated with flights of up to six months in duration. The goal of this paper is to provide a summary of the available information on neurovestibular dysfunction, space motion sickness, and readaptation to Earth's gravity on the NASA Mir flights, based on a set of medical questionnaire data, transcripts, and interviews which are available from the NASA-Mir Phase I program. Records were incomplete and anecdotal. All references to specific crewmembers have been removed, to respect their individual privacy. Material was excerpted from multiple sources of information relating to neurologic function, sensory illusions and motion sickness of NASA-Mir Phase I Program crewmembers. Data were compiled by epoch (in-flight vs landing/postflight) and grouped by neurovestibular topic. The information was recorded either contemporaneously during or within days after landing, or retrospectively weeks to months later. Space motion sickness symptoms are more intense and longer in duration. Sense of spatial orientation takes at least a month to become "natural and instinctive" in space station structures, but mental survey knowledge is apparently not completely developed even after 3 months in some cases. Visual reorientation illusions (VRI) are more easily induced after long exposure to weightlessness. Head movements can cause illusory spinning sensations for up to 7 days postflight. Postural and balance control does not fully recover for at least a month postflight

Exposure to a Rotating Virtual Environment During Treadmill Locomotion Causes Adaptation in Heading Direction

The goal of the present study was to investigate the adaptive effects of variation in the direction of optic flow, experienced during linear treadmill walking, on modifying locomotor trajectory. Subjects (n = 30) walked on a motorized linear treadmill at 4.0 kilometers per hour for 24 minutes while viewing the interior of a 3D virtual scene projected onto a screen 1.5 in in front of them. The virtual scene depicted constant self-motion equivalent to either 1) walking around the perimeter of a room to one s left (Rotating Room group) 2) walking down the center of a hallway (Infinite Hallway group). The scene was static for the first 4 minutes, and then constant rate self-motion was simulated for the remaining 20 minutes. Before and after the treadmill locomotion adaptation period, subjects performed five stepping trials where in each trial they marched in place to the beat of a metronome at 90 steps/min while blindfolded in a quiet room. The subject's final heading direction (deg), final X (for-aft, cm) and final Y (medio-lateral, cm) positions were measured for each trial. During the treadmill locomotion adaptation period subject's 3D torso position was measured. We found that subjects in the Rotating Room group as compared to the Infinite Hallway group: 1) showed significantly greater deviation during post exposure testing in the heading direction and Y position opposite to the direction of optic flow experienced during treadmill walking 2) showed a significant monotonically increasing torso yaw angular rotation bias in the direction of optic flow during the treadmill adaptation exposure period. Subjects in both groups showed greater forward translation (in the +X direction) during the post treadmill stepping task that differed significantly from their pre exposure performance. Subjects in both groups reported no perceptual deviation in position during the stepping tasks. We infer that viewing simulated rotary self-motion during treadmill locomotion causes adaptive modification of sensory-motor integration in the control of position and trajectory during locomotion which functionally reflects adaptive changes in the integration of visual, vestibular, and proprioceptive cues. Such an adaptation in the control of position and heading direction during locomotion due to the congruence of sensory information demonstrates the potential for adaptive transfer between sensorimotor systems and suggests a common neural site for the processing and self-motion perception and concurrent adaptation in motor output. This will result in lack of subjects perception of deviation of position and trajectory during the post treadmill step test while blind folded

Adaptive Effects on Locomotion Performance Following Exposure to a Rotating Virtual Environment

During long-duration spaceflight, astronauts experience alterations in vestibular and somatosensory cues that result in adaptive disturbances in balance and coordination upon return to Earth. These changes can pose a risk to crew safety and to mission objectives if nominal or emergency vehicle egress is required immediately following long-duration spaceflight. At present, no operational countermeasure is available to mitigate the adaptive sensorimotor component underlying the locomotor disturbances that occur after spaceflight. Therefore, the goal of this study is to develop an inflight training regimen that facilitates recovery of locomotor function after long-duration spaceflight. The countermeasure we are proposing is based on the concept of adaptive generalization. During this type of training the subject gains experience producing the appropriate adaptive motor behavior under a variety of sensory conditions and response constraints. As a result of this training a subject learns to solve a class of motor problems, rather than a specific motor solution to one problem, i.e., the subject learns response generalizability or the ability to "learn to learn." under a variety of environmental constraints. We are developing an inflight countermeasure built around treadmill exercise activities. By manipulating the sensory conditions of exercise by varying visual flow patterns, body load and speed we will systematically and repeatedly promote adaptive change in locomotor behavior. It has been shown that variable practice training increases adaptability to novel visuo-motor situations. While walking over ground in a stereoscopic virtual environment that oscillated in roll, subjects have shown compensatory torso rotation in the direction of scene rotation that resulted in positional variation away from a desired linear path. Thus, postural sway and locomotor stability in 1-g can be modulated by visual flow patterns and used during inflight treadmill training to promote adaptive generalization. The purpose of this study was to determine if adaptive modification in locomotor performance could be achieved by viewing simulated self-motion in a passive-immersive virtual ' environment over a prolonged period during treadmill locomotion

Advanced Ultrasonic Diagnosis of Extremity Trauma: The Faster Exam

Ultrasound is of prO)len accuracy in abdominal and thoracic trauma and may be useful to diagnose extremity injury in situations where radiography is not available such as military and space applications. We prospectively evaluated the utility of extremity , ultrasound performed by trained, non-physician personnel in patients with extremity trauma, to simulate remote aerospace or military applications . Methods: Patients with extremity trauma were identified by history, physical examination, and radiographic studies. Ultrasound examination was performed bilaterally by nonphysician personnel with a portable ultrasound device using a 10-5 MHz linear probe, Images were video-recorded for later analysis against radiography by Fisher's exact test. The average time of examination was 4 minutes. Ultrasound accurately diagnosed extremity, injury in 94% of patients with no false positive exams; accuracy was greater in mid-shaft locations and least in the metacarpa/metatarsals. Soft tissue/tendon injury was readily visualized . Extremity ultrasound can be performed quickly and accurately by nonphysician personnel with excellent accuracy. Blinded verification of the utility of ultrasound in patients with extremity injury should be done to determine if Extremity and Respiratory evaluation should be added to the FAST examination (the FASTER exam) and verify the technique in remote locations such as military and aerospace applications

Low-dose aspirin does not improve ovarian stimulation, endometrial response, or pregnancy rates for in vitro fertilization

BACKGROUND: The purpose of this study is to determine if low-dose aspirin improved ovarian stimulation, endometrial response, or IVF pregnancy rates in our program. METHODS: Retrospective analysis of 316 consecutive IVF cycles from 1995 through 2001. Aspirin 80 mg daily was initiated at the start of luteal leuprolide in 72 cycles. The 244 controls received no aspirin during treatment. RESULTS: The live birth rate in aspirin users was 29%, slightly lower compared to 41% in the no aspirin control group (p = 0.07). Implantation rates were 21% with aspirin and 30% in the control population (p = 0.01). There was no difference in the maximal endometrial thickness between aspirin and non-aspirin groups. The two groups were similar regarding age, gonadotropin ampules, embryos, number of embryos transferred, prior parity, diagnosis, use of intracytoplasmic sperm injection, and stimulation protocol. CONCLUSION: Low-dose aspirin was not beneficial to IVF patients in our program. Aspirin does not enhance endometrial thickness, augment the ovarian response, or improve pregnancy rates

Alternative splicing and the progesterone receptor in breast cancer

Progesterone receptor status is a marker for hormone responsiveness and disease prognosis in breast cancer. Progesterone receptor negative tumours have generally been shown to have a poorer prognosis than progesterone receptor positive tumours. The observed loss of progesterone receptor could be through a range of mechanisms, including the generation of alternatively spliced progesterone receptor variants that are not detectable by current screening methods. Many progesterone receptor mRNA variants have been described with deletions of various whole, multiple or partial exons that encode differing protein functional domains. These variants may alter the progestin responsiveness of a tissue and contribute to the abnormal growth associated with breast cancer. Absence of specific functional domains from these spliced variants may also make them undetectable or indistinguishable from full length progesterone receptor by conventional antibodies. A comprehensive investigation into the expression profile and activity of progesterone receptor spliced variants in breast cancer is required to advance our understanding of tumour hormone receptor status. This, in turn, may aid the development of new biomarkers of disease prognosis and improve adjuvant treatment decisions

Ultrasound for Distal Forearm Fracture:A Systematic Review and Diagnostic Meta-Analysis

STUDY OBJECTIVE:To determine the diagnostic accuracy of ultrasound for detecting distal forearm fractures. METHODS:A systematic review and diagnostic meta-analysis was performed according to the PRISMA statement. We searched MEDLINE, Web of Science and the Cochrane Library from inception to September 2015. All prospective studies of the diagnostic accuracy of ultrasound versus radiography as the reference standard were included. We excluded studies with a retrospective design and those with evidence of verification bias. We assessed the methodological quality of the included studies with the QUADAS-2 tool. We performed a meta-analysis of studies evaluating ultrasound to calculate the pooled sensitivity and specificity with 95% confidence intervals (CI95%) using a bivariate model with random effects. Subgroup and sensitivity analysis were used to examine the effect of methodological differences and other study characteristics. RESULTS:Out of 867 publications we included 16 studies with 1,204 patients and 641 fractures. The pooled test characteristics for ultrasound were: sensitivity 97% (CI95% 93-99%), specificity 95% (CI95% 89-98%), positive likelihood ratio (LR) 20.0 (8.5-47.2) and negative LR 0.03 (0.01-0.08). The corresponding pooled diagnostic odds ratio (DOR) was 667 (142-3,133). Apparent differences were shown for method of viewing, with the 6-view method showing higher specificity, positive LR, and DOR, compared to the 4-view method. CONCLUSION:The present meta-analysis showed that ultrasound has a high accuracy for the diagnosis of distal forearm fractures in children when used by proper viewing method. Based on this, ultrasound should be considered a reliable alternative, which has the advantages of being radiation free

Persuasive Communication: Source, Message, Audience

Persuasive communication, defined as any message designed to influence people’s attitudes or behaviors, is a core concept in social psychology. It is possible that persuasive communication scholarship would not exist if not for Carl I. Hovland, Irving L. Janis, and Harold H. Kelley’s seminal text Communication and Persuasion, and its theoretical propositions are still being examined today. The approach outlined in that text, which has since informed multiple theories and research programs, suggests a tripartite model, where source, message, and audience features dictate persuasive impact.https://scholar.dominican.edu/faculty-authored-book-contributions/1004/thumbnail.jp