Differences in Otolith and Abdominal Viscera Graviceptor Dynamics: Implications for Motion Sickness and Perceived Body Position

Human graviceptors, located in the trunk by Mittelstaedt probably transduce acceleration by abdominal viscera motion. As demonstrated previously in biodynamic vibration and impact tolerance research the thoraco-abdominal viscera exhibit a resonance at 4 to 6 Hz. Behavioral observations and mechanical models of otolith graviceptor response indicate a phase shift increasing with frequency between 0.01 and O.5 Hz. Consequently the potential exists for intermodality sensory conflict between vestibular and visceral graviceptor signals at least at the mechanical receptor level. The frequency range of this potential conflict corresponds with the primary frequency range for motion sickness incidence in transportation, in subjects rotated about Earth-horizontal axes (barbecue spit stimulation) and in periodic parabolic flight microgravity research and also for erroneous perception of vertical oscillations in helicopters. We discuss the implications of this hypothesis for previous self motion perception research and suggestions for various future studies

Preflight Adaptation Training for Spatial Orientation and Space Motion Sickness

Two part-task preflight adaptation trainers (PATs) are being developed at the NASA Johnson Space Center to preadapt astronauts to novel sensory stimulus conditions similar to those present in microgravity to facilitate adaptation to microgravity and readaptation to Earth. This activity is a major component of a general effort to develop countermeasures aimed at minimizing sensory and sensorimotor disturbances and Space Motion Sickness (SMS) associated with adaptation to microgravity and readaptation to Earth. Design principles for the development of the two trainers are discussed, along with a detailed description of both devices. In addition, a summary of four ground-based investigations using one of the trainers to determine the extent to which various novel sensory stimulus conditions produce changes in compensatory eye movement responses, postural equilibrium, motion sickness symptoms, and electrogastric responses are presented. Finally, a brief description of the general concept of dual-adopted states that underly the development of the PATs, and ongoing and future operational and basic research activities are presented

Sex-specific predictors of improved walking with step-monitored, home-based exercise in peripheral artery disease

The aim of this study was to determine whether baseline clinical characteristics and the duration and intensity of ambulation during our step-monitored home-based exercise program were predictive of changes in ambulatory outcomes at completion of the program in symptomatic patients with peripheral artery disease (PAD). Twenty-two men (ankle–brachial index (ABI) = 0.71 ± 0.19) and 24 women (ABI = 0.66 ± 0.23) completed the home exercise program, consisting of intermittent walking to mild-to-moderate claudication pain for 3 months. Ambulatory outcome measures were peak walking time (PWT) and claudication onset time (COT) during a treadmill test, and the distance recorded during a 6-minute walk distance test (6MWD). Men experienced significant increases (p<0.01) in COT, PWT, and 6MWD following the home exercise program, and women had significant increases in 6MWD (p<0.01) and PWT (p<0.05). In women, average exercise cadence during the home exercise sessions was the only predictor that entered the model for change in COT (p=0.082), and was the first predictor in the model for change in PWT (p=0.029) and 6MWD (p=0.006). In men, the ABI was the only predictor that entered the model for change in 6MWD (p=0.002), and ABI was a predictor along with metabolic syndrome in the model for change in COT (p=0.003). No variables entered the model for change in PWT. Faster ambulatory cadence during the step-monitored home-based exercise program may predict greater improvements in ambulatory function in women, whereas having less severe PAD and comorbid burden at baseline may predict greater improvements in ambulatory function in men. ClinicalTrials.gov Identifier: NCT00618670Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Creating functional autogenous vascular access in older patients

ObjectiveArteriovenous fistulas (AVFs) are the preferred choice for hemodialysis vascular access (AV access); however, there is debate over the utility of AVFs in older patients, particularly concerning access maturation and functionality. We reviewed our AV access experience in patients ≥65 years of age.MethodsWe analyzed consecutive AV access patients ≥65 years old with access operations between March 2003 and December 2009. All patients had ultrasound vessel mapping. In addition to overall outcomes review, the data for patients ≥65 years old were stratified into three 10-year increments by age for further analysis. We compared functional patency data for our older patients with those of our non-elderly patients aged 21 to 64 years treated during the same time period.ResultsFour hundred sixty-one consecutive AV access patients new to our practice were included in this study. Ages were 65 to 94 years (mean, 73 years). Two hundred thirty-six (51.2%) were female, 276 (59.9%) patients were diabetic, and 103 (22.3%) were obese. One hundred seven (23.2%) patients had previous access operations. Radiocephalic AVFs were constructed in 29 (6.3%) patients, 99 (21.5%) patients had brachial artery inflow AVFs, 330 (71.6%) had proximal radial artery AVFs, and three were based on the femoral artery. Transposition AVFs were used in 124 (26.9%) patients. No grafts were used for AV access in any patient during the study period. Time to AVF use was 0.5 to 6 months (mean, 1.5 months). Primary, primary assisted, and cumulative patency for patients aged 65 to 94 years were 59.9%, 93.7%, and 96.9% at 12 months and 45.3%, 90.1%, and 94.6% at 24 months, respectively. Follow-up was 1.5 to 77 months (mean, 17.0 months). Subgroup age stratification (65-74 [n = 268], 75-84 [n = 167], 85-94 [n = 26] years) found no statistical difference in functional access outcomes. Primary, primary assisted, and cumulative patency rates were not statistically different in the elderly and non-elderly populations (P = .29, .27, and .37, respectively). One hundred fifty-six patients died during the study period, 1.3 to 61 months (mean, 20 months) after access creation. No deaths were related to access operations.ConclusionsAVFs are feasible and offer functional and timely AV access in older patients. There was no difference in functional access outcomes for older patients with subgroup age stratification. AVF patency rates were not statistically different in the elderly and non-elderly populations. Cumulative AVF patency for patients ≥65 years of age was 96.9% at 12 months and 94.6% at 24 months

Self-attitude awareness training: An aid to effective performance in microgravity and virtual environments

This paper describes ongoing development of training procedures to enhance self-attitude awareness in astronaut trainees. The procedures are based on observations regarding self-attitude (perceived self-orientation and self-motion) reported by astronauts. Self-attitude awareness training is implemented on a personal computer system and consists of lesson stacks programmed using Hypertalk with Macromind Director movie imports. Training evaluation will be accomplished by an active search task using the virtual Spacelab environment produced by the Device for Orientation and Motion Environments Preflight Adaptation Trainer (DOME-PAT) as well as by assessment of astronauts' performance and sense of well-being during orbital flight. The general purpose of self-attitude awareness training is to use as efficiently as possible the limited DOME-PAT training time available to astronauts prior to a space mission. We suggest that similar training procedures may enhance the performance of virtual environment operators

Development and implementation of Inflight Neurosensory Training for Adaptation/Readaptation (INSTAR)

Resolution of space motion sickness, and improvements in spatial orientation, posture and motion control, and compensatory eye movements occur as a function of neurosensory and sensorimotor adaptation to microgravity. These adaptive responses, however, are inappropriate for return to Earth. Even following relatively brief space Shuttle missions, significant re-adaptation disturbances related to visual performance, locomotion, and perceived self-motion have been observed. Russian reports suggest that these disturbances increase with mission duration and may be severe following landing after prolonged microgravity exposure such as during a voyage to Mars. Consequently, there is a need to enable the astronauts to be prepared for and more quickly re-adapt to a gravitational environment following extended space missions. Several devices to meet this need are proposed including a virtual environment - centrifuge device (VECD). A short-arm centrifuge will provide centripetal acceleration parallel to the astronaut's longitudinal body axis and a restraint system will be configured to permit head movements only in the plane of rotation (to prevent 'cross-coupling'). A head-mounted virtual environment system will be used to develop appropriate 'calibration' between visual motion/orientation signals and inertial motion/orientation signals generated by the centrifuge. This will permit vestibular, visual and somatosensory signal matches to bias central interpretation of otolith signals toward the 'position' responses and to recalibrate the vestibulo-ocular reflex (VOR)

Space Flight and Manual Control: Implications for Sensorimotor Function on Future Missions

Control of vehicles, and other complex mechanical motion systems, is a high-level integrative function of the central nervous system (CNS) that requires good visual acuity, eye-hand coordination, spatial (and, in some cases, geographic) orientation perception, and cognitive function. Existing evidence from space flight research (Paloski et.al., 2008, Clement and Reschke 2008, Reschke et al., 2007) demonstrates that the function of each of these systems is altered by removing (and subsequently by reintroducing) a gravitational field that can be sensed by vestibular, proprioceptive, and haptic receptors and used by the CNS for spatial orientation, navigation, and coordination of movements. Furthermore, much of the operational performance data collected as a function of space flight has not been available for independent analysis, and those data that have been reviewed are equivocal owing to uncontrolled environmental and/or engineering factors. Thus, our current understanding, when it comes to manual control, is limited primarily to a review of those situations where manual control has been a factor. One of the simplest approaches to the manual control problem is to review shuttle landing data. See the Figure below for those landing for which we have Shuttle velocities over the runway threshold

Influence of diabetes on ambulation and inflammation in men and women with symptomatic peripheral artery disease

AbstractObjectiveTo determine whether diabetes and sex were factors associated with ambulatory function, endothelial cell inflammation, oxidative stress, and apoptosis, and with circulating biomarkers of inflammation and antioxidant capacity in patients with peripheral artery disease (PAD) and claudication.Materials/MethodsAmbulatory function of 180 symptomatic men and women with PAD was assessed during a graded maximal treadmill test, 6-minute walk test, and 4-meter walk test. Patients were further characterized on endothelial effects of circulating factors present in the sera using a cell culture-based bioassay on primary human arterial endothelial cells, and on circulating inflammatory and vascular biomarkers.ResultsMen and women with diabetes had greater prevalence (p = 0.007 and p = 0.015, respectively) of coronary artery disease (CAD) than patients without diabetes. To assure that this difference did not influence planned comparisons, the data set was stratified on CAD. Diabetic men with CAD had a lower peak walking time (PWT) during the treadmill test and a slower 4-meter gait speed compared to non-diabetic men with CAD (p < 0.05). Diabetic women with CAD had a lower PWT compared to their non-diabetic counterparts (p < 0.01). Additionally, diabetic men with CAD had higher pigment epithelium-derived factor (p < 0.05) than their non-diabetic counterparts, and diabetic women with CAD had higher leptin (p < 0.01) and interleukin-8 levels (p < 0.05).ConclusionsIn patients with PAD, diabetic men and women with CAD had more severe claudication than their non-diabetic counterparts, as measured by shorter PWT, and the men had further ambulatory impairment manifested by slower 4-meter gait speed. Furthermore, the diabetic patients with CAD had elevations in interleukin-8, leptin, and PEDF