Changes in hemodynamic and post-flights orthostatic tolerance of cosmonauts under application of the preventive device--thigh cuffs bracelets in short-term flights

Specific aims: to evaluate the influence of the use thigh cuffs "Bracelet" on the hemodynamic adaptation to microgravity during short-term (up to a month) space flights, in-flight tolerance to LBNP-tests and post-flight orthostatic tolerance. 6 cosmonauts applied and 7 others did not apply the occlusive cuffs when on flight. The "Bracelet" device notably relieved the cosmonauts from the subjective discomfort following by the blood redistribution at initial period of exposure to microgravity. It was established that "Bracelet" lessened shifts in central and peripheral hemodynamics typical for exposure to microgravity, venous stasis in the cervical-cephalic region in particular. There were no differences between the hemodynamic reaction on LBNP-test in cosmonauts who applied and not applied "Bracelet" during short-term flights. The objective data are received, that the application of the device during short-term space flight does not make negative effects on post-flight orthostatic tolerance.     

Reference values of blood biochemical indices in Russian cosmonauts

In the period from 2000 to 2012, the values of 40 diagnostically significant biochemical indices in venous blood were determined during the preflight clinical and physiological examination of 28 Russian cosmonauts aged 35 to 54, members of the main and backup crews of missions on board the International Space Station. The examination was conducted 45-30 days prior to the launch. Since most cosmonauts performed several flights during this period and they were repeatedly included in backup crews, each of the cosmonauts participated in preflight examinations one to five times. The reference values were calculated for each of the studied indices. It was found that reference interval boundaries for 15 indices were narrower as compared to the generally accepted ranges. The upper boundaries of the reference ranges of the activities of a number of enzymes, as well as of the concentrations of some metabolites of energy and plasticity metabolism, were higher than the population’s mean values. Thus, it was found that Russian cosmonauts, being a specific professional team, had reference values of a number of blood biochemical indices that were different from the population’s mean values. This was due to the characteristics of selection, physical training, and psychic and emotional states of crew members during the preflight period.     

Contemporary conception of anti-G protection of cosmonauts in flights aboard "Soyuz" space vehicles

To ensure safety of cosmonauts impacted by +Gx loads during insertion into orbit of a Soyuz-type space vehicle, it is critical to conduct appropriate medical selection of candidates to space flights, to give them proper complete physical and specialized centrifuge training, and to make it sure that at the moment of actual injection the cosmonaut's posture is optimal relative to the g-vector and that the body is tight fitting the custom-molded couch. No AGS is needed. For the purposes of protection of cosmonauts descending in the Soyuz vehicles, vital are countermeasures applied in the course of flight, water-salt supplements on the descent day, and the optimal posture, an anti-g suit, and a custom-molded couch with an additional body-restraint system and dampers used on the phase of reentry.     

Metabolic features of cosmonauts after ballistic descent from the Earth orbit

The features of metabolic reactions in five cosmonauts after long-term flights on the International Space Station (ISS) and landing along a ballistic trajectory and in the cosmonauts returning to Earth in the mode of automatic controlled descent were studied. Venous blood samples were collected, and 50 biochemical parameter values that reflect the functional state of organs and tissues and characterize the main metabolic pathways were determined. On the first day of the recovery period after ballistic descent, the activity of the myocardial, liver, and gastrointestinal enzymes in the blood serum of cosmonauts was increased 1.3- to 2.1-fold; a number of the parameter values exceeded the upper normal limit. The level of C-reactive protein increased fivefold as compared with the preflight values. Marked signs of glycolysis, glycogenolysis and lipolysis activation as well as disorders of acid–base balance were observed. Changes in the biochemical parameter values in cosmonauts after landing along a ballistic trajectory differed significantly from those revealed in the same cosmonauts after long-term missions followed by automatic controlled descent to Earth. Negative metabolic changes tendency after landing along a ballistic trajectory remained for at least 14 days of the recovery period. It was concluded that changes in the metabolic reactions of cosmonauts after long-term missions to the ISS depend on the flights final stage conditions. After landing on Soyuz spaceships in the ballistic descent mode, the cosmonauts had adverse prognosis changes in the biochemical values characterizing the state of the cardiovascular system and marked shifts in the activity of the liver and gastrointestinal constellation enzymes. The dynamics of carbohydrate, lipid, and protein metabolism as well as acid–base balance indicates a significant tension of all body systems and exhaustion of its functional reserves.     

Countermeasures for long-term space flights, lessons learned from the Russian space program

Physical exercises (PE) constitute the most important part of the Russian countermeasure system which is proved to be highly successful in fighting negative effects of weightlessness on the physiological systems of the body. To control the intensity and volume of the workload and also specific features of the regimens used by cosmonauts during SF there were provided monthly 3-days recordings of cosmonaut training sessions with the subsequent downlinking of the obtained information to the ground control center. Additionally once a month cosmonauts performed a fitness test that was composed of 11 minutes of locomotion on the passive treadmill including slow, middle range and maximal running. The results of 3-days recordings and fitness test allowed to evaluate correctly effectiveness of PE protocols used by cosmonauts and to form recommendations for their corrections. The effectiveness of the onboard exercise program after SF was evaluated based on results of detailed studies of alterations that were recorded in different parts of sensory-motor system.     

Some changes of the heart bioelectric activity at the cosmonauts under the influence of LBNP in the long duration flights

There was selected the group of the cosmonauts, who carry out long duration flights on the orbital complex "Mir", in which the tolerance of LBNP test was evaluated as poor (by hemodynamic indices--heart rate, arterial pressure, rheoencephalographic indices). The in-depth analysis of the electrocardiogram (in DS leads) indices was carry oiled on possible disturbances of conductivity and dynamics of temporary or amplitude characteristics. Furthermore is carry oiled the comparative estimation of these indices with the results of ECG analysis at the cosmonauts, who tolerance test good. Studies showed that the most informative ECG indices are the R, T-amplitudes and QT-interval. Under the influence of LBNP, especially during rarefactions on 45 and 50 mm Hg was noted reduction in the R, T-amplitude and the relative extension of QT-interval. The directivity of changes in these indices are identical for the cosmonauts with good and poor tolerance of the test; however in flight manifestation of the changes is more significant for the cosmonauts with poor tolerance of LBNP test. Thus, in the formation of orthostatic stability together with the hemodynamic influences take part the bioelectric processes, which are formed in the myocardium.     

Elaboration of on-board automated training system

Long-term space flight requires regular controlling of crewmembers physical state and exercise training to prevent negative effect of microgravity. Considering a limited telecommunication we suppose on-board automated training system to become an effective alternative of on-earth mission teams. The purpose: to elaborate an expert system software permitting to automate the process of solution elaboration to estimate cosmonaut current psycho-physiological state and to form an individual program of physical training to prevent negative effects of long-term space flight. The first problem--to develop a formalized algorithm for expert evaluation of physical working capability basing the results of on-board compulsory running test MC 108-2.     

Some approaches to prophylactic measures in a martian expedition

Physiological and methodological principles of the organization of physical training (PT) and its computerization during a space flight to Mars under the conditions of autonomous activity of the crew, including interaction with onboard medical systems, self-maintenance of health, preventive measures, diagnostic examinations, and, if necessary, treatment, are discussed. The conditions of unusually long-term autonomous space flights make the ground-based monitoring of the state of health of crew members substantially more difficult, which calls for computerization of the control over the crew members’ health, including prophylactic measures. The situation is further complicated because it is impossible to receive the necessary information from, and transmit it to, the spacecraft in a real-time mode or to quickly return the crew to Earth in case of an emergency. Under these conditions, physical prevention should be based on an onboard automated expert system ensuring the control over the activities of all crew members aimed at optimizing their psychophysical state. The problems of the control of training, including the use of an onboard automated expert system, are discussed.     

Antibodies to muscle fiber antigens in the cosmonauts after a space flight]

The study of serum samples, obtained from 15 cosmonauts before and after space flights, with the use of the indirect fluorescent method showed that in 7 cosmonauts antibodies to different elements of the human heart muscle appeared after flights. Strong and very strong luminescence of the elements of heart muscle tissue was detected in the cosmonauts after the third space flight. When studying the sera on sections of bovine heart muscle tissue, the reactions of the sera taken before and after flights were found to have no essential differences.     

Effect of space flight factors on health of cosmonauts in the near and late term after space flights

Cytogenetical studies of cosmonauts' peripheral blood lymphocytes after space flights on MIR orbital station showed a statistically significant increase in the yields of radiation-induced chromosomal aberrations. However, similar studies with in vitro irradiation of biological objects with accelerated charged particles are of great importance for elucidation of the nature of cytogenetical damage induced in vivo. It is also important to investigate the structure of cosmonatus' diseases over their life, in particular, lens opacities and oncological diseases. Thus, the purpose of the investigations planned is to study cytogenetical damage in blood lymphocytes from cosmonauts after space flights on the ISS in vivo, as well as in donor blood lymphocytes after in vitro exposure to accelerated charged particles. The tasks of the project are as follows: determination of the yields and types of chromosomal aberrations in cosmonauts' blood lymphocytes before and after space flights, comparative studies of biological effects induced in vitro by different types of ionizing radiation in human blood lymphocytes in ground experiments, assessment of cytogenetical risks, analysis of the structure of cosmonatus' diseases comparing with that of whole population, study of the mortality and frequency of cataracts and oncological diseases in cosmonauts. The results to be obtained will be used for setting of health norms applied to the influence of radiations of different types, and for elaboration of measures to reduce health risks from space flight factors.     

The volume of extracellular fluid under conditions of long-term space flights

The volume of extracellular fluid (the bromine space) was determined in 18 cosmonauts 30 days before the start of a space flight and on the first day after landing. The duration of space flights on the Mir orbital station was from 126 to 438 days. Moreover, the volume of extracellular fluid was determined in seven cosmonauts directly during long-term space flights approximately two weeks before landing. After long-term space flights, the volume of extracellular fluid was decreased in all cosmonauts studied. The bromine space volume was significantly decreased compared to its initial preflight value. A decrease in the volume of extracellular fluid was caused not only by the reduction in the dense mass of the body but also by its dehydration. These processes developed independently of the duration of weightlessness but are mainly determined by the individual features of human beings.     

Cluster analysis in the fitness evaluation of cosmonauts during long-term missions on board the International Space Station

Cluster analysis of the following parameters was performed in 13 cosmonauts: the duration (min), amount (m), and speed (km/h) of physical locomotor exercise (PLE) including running, and total locomotion (running + walking). These activities were the part of the program of long-term missions on board the International Space Station. The cosmonauts were divided into three groups, which included two, five, and six subjects, respectively. The parameters of the PLE amount and speed significantly increased (p < 0.03) when going from the first to the third group. There was no significant difference in the duration of PLE between the groups (p < 0.125). It is concluded that cluster analysis is an appropriate method for fitness evaluation of cosmonauts during long-term space flights.     

Cytogenetic studies of blood lymphocytes of cosmonauts after long-ter, space flights

An analysis was performed of unstable chromosomal aberrations in peripheral blood of 36 cosmonauts after long-term space missions on "Mir" orbital station. 25 cosmonauts were examined before their flights to score spontaneous yields of cytogenetical damage. In all cases the doses absorbed by crews during space flights did not exceed permissible levels of irradiation, adopted for cosmonauts. The frequencies of chromosomal-type aberrations after space missions were found to increase significantly compared to the pre-flight levels. The yields of dicentrics and centric rings on the average were as high as 0.12 +/- 0.02 and 0.47 +/- 0.06% before and after the 1st flight, 0.18 +/- 0.05 and 0.71 +/- 0.11% before and after the 2nd flight respectively. During the inter-flight periods, usually lasted 1.5-2 years, the yields of chromosome damage lowered, but did not reach their spontaneous values. After each next flight the yields of chromosome aberrations increased again. The cytogenetical damage detected in cosmonauts' peripheral blood lymphocytes after chronic action of low doses of space radiation points out a possible increase in risks of stochastic effects in distant future for crews after long-term space missions.     

Adaptation of the water-electrolyte metabolism to space flight and at its imitation

A fifty-year study of water-electrolyte metabolism, the condition of the water medium of the body, and hormonal regulation during space flights and the postflight period or their on-ground modeling (hypokinesia, bed rest, immersion, etc.) has shown the important role of water-salt homeostasis in adaptation of the human and animal body to weightlessness. It has been revealed that, in weightlessness, the conditions for the development of a negative balance of a liquid (hydrohydration) and basic electrolytes are created. After termination of long space flights, attributes of the development of adaptive reactions, compensating for the loss of extracellular liquid volume come to light. In order to assess the state of the kidneys and water-electrolyte metabolism in cosmonauts and investigators, functional load tests, and special methods of diagnostics were developed. This is the basis for the research aimed at improving the scheme of correction of the water balance of the body of cosmonauts at different stages of a flight.     

Reference values of the hemostasis system indices in cosmonauts

The values of 11 diagnostically significant hemostasis system indices were determined during the preflight (30–45 days before start) clinical and physiological examination of 39 cosmonauts aged 35 to 54 years, who were the members of the main and backup crews of missions to the International Space Station (ISS) during the period from 2007 to 2014. Since most of the cosmonauts performed several flights over this period and were repeatedly included in backup crews, each of them underwent examinations one to five times. The reference values were calculated for each of the studied indices. It was found that the reference ranges for the parameters indicative of the integral pro- and anticoagulant and fibrinolytic blood plasma potential were somewhat narrowed and close to the boundaries of general population ranges, which indicates that the cosmonauts had a relatively decreased procoagulant potential and increased regulative potential of the hemostasis system. This was probably due to the criteria of selection, physical training status, and emotional status of crew members during the preflight professional activity, when adaptive changes against stressinducing effects occur in the body. The cosmonauts who underwent strict medical examination may also have some genetic features in which they differ from the general population and which provide higher body resistance and more rapid adaptation processes.     

Vestibular Function after Repeated Space Flights

This paper presents the results from testing the vestibular function on return from repeated space flights (SF) in 32 cosmonauts of the International Space Station that were in long SFs of 125–215 days. The cosmonauts were tested twice before the flight (baseline data collection) and on days 1–2, 4–5, and 8–9 after landing. The testing was made using two methods for recording eye movements (with simultaneous recording of head movements): electro-oculography and video-oculography. It is shown that the repeated stay in the long SF leads to a considerable statistically significant reduction in the de-adaptation period. Atypical vestibular disorders and changed patterns of the otolith-semicircular canal interaction are observed mostly in the cosmonauts who have made their maiden flights to microgravity.     

Calcium metabolism characteristics in microgravity]

The results of research of calcium exchange parameters at cosmonauts taken part in long space flights (SF) onboard of orbital stations "SALUT" and "MIR" within 1978-1998 were generalized. The analysis of data received during observation of 44 cosmonauts (18 of them have taken part in long SF twice) was done. The observation was carried out before and after SF by duration 30-438 days. The content of a total calcium in blood serum was increased basically by the increase of its ionized fraction after flights of moderate (3-6 months) and large duration (6-14 months) along with the significant increase of PTH and decrease of calcitonin levels. The content of osteocalcin after SF was increased. Three cosmonauts participated in research of calcium kinetics using stable isotopes before, in time and after a 115-day SF. Reduction of intestinal absorption, excretion through a gastrointestinal tract, and increase of calcium excretion with urine were marked in time of SF. In early postflight period a level of intestinal absorption, on the average, was much lower than in SF, and the calcium removal through intestine was increased. Both renal and intestinal excretion of calcium were not normalized in 3.5-4.5 months after end of SF. Increase of resorbtive processes in bone tissues which induced negative bone balance during flight was observed in all test subjects, proceeding from estimations of speed of the basic calcium flows made on the basis of mathematical modeling. The conclusion about decrease in speed of bone tissue remodeling and strengthening of its resorption proves to be true by data of research of biochemical and endocrine markers.     

Calcium metabolism and its regulation in man during adaptation to microgravitation

This work generalizes the results of studies of calcium metabolism in the participants of long-term space flights of 30 to 438 days on the Salyut and Mir orbital stations during 1978–1998. The results of pre- and postflight examination of 44 cosmonauts (18 subjects participated twice in long-term space flights) were analyzed. After space flights of medium (of 3 to 6 months) and long (of 6 to 14 months) duration, the total blood calcium content was increased, mainly due to its ionized fraction; the blood level of parathyroid hormone was significantly increased and the level of calcitonin was decreased. The content of osteocalcin was increased after space flights. Calcium kinetics was studied using stable isotopes in three cosmonauts before, during, and after the 115-day flight. During the flight, intestinal absorption of calcium and its gastrointestinal excretion were decreased, whereas its renal excretion was increased. Early postflight intestinal absorption was, on average, lower than during the flight, whereas intestinal excretion increased. Both renal and intestinal excretion of calcium were not normalized 3.5 to 4.5 months after the glight. The mathematical models used for evaluating the rates of main calcium flows revealed increased bone tissue resorption that resulted in the negative bone balance during the flight. The conclusion about the decreased rate of bone tissue remodeling and its increased resorption was confirmed by biochemical data, including endocrine markers.     

Dynamics of the body liquids and composition in long-duration space flight (Bioimpedance Analysis)

Bioimpedance measurement was used to study dynamics of human hydration status and body composition on board the International space station (ISS). At different stages of 100- to 200-day flights of 12 cosmonauts, the volume of their body liquid was reduced: the overall, intra-, and extracellular volumes became on average 5.2 to 10.4% less per group as compared to the baseline level. The in-flight changes in the body composition of the cosmonauts were also consistent: while the lean mass loss determined by impedance measurement was insignificant (on average, from 1.9 to 4.0%), the gain of the fatty mass ranged from 4.6 to 8.2% during the first three months of the flight. Thus, hydration of a human body decreased during the long-term space flight, which was accompanied by reduction of the muscular mass and the gain in fatty mass.     

Detection of renal and urinary tract proteins in urine before and after space flight

The urine protein composition (proteome) of healthy humans was analyzed using proteomic techniques to obtain data under normal physiological conditions and after six-month space flights. It was shown that, after long space flights, specific minor proteins are revealed in cosmonauts’ urine that can be identified as proteins coming from kidneys and urinary tracts.