BACKGROUND: Cardiopulmonary resuscitation (CPR) in microgravity requires specific methods to counteract weightlessness. Automatic chest compression devices (ACCDs) could improve CPR in microgravity. We aimed to compare ACCDs versus manual CPR in microgravity simulated through parabolic flights.
METHODS: This prospective, open, controlled study compared 3 ACCDs (LUCAS 3©, AUTOPULSE©, EASYPULSE©) to manual CPR during the 66th CNES (Centre National d\'Etudes Spatiales) parabolic flights campaign onboard the Novespace Air Zero-G A310 aircraft. Chest compression depths and rates were monitored by a Laerdal© Resusci-Ann-QCPR manikin.
RESULTS: The LUCAS 3© device had a median compression depth of 53.0 [53.0 - 54.0] mm, significantly higher than the EASYPULSE©, AUTOPULSE©, and Manual CPR (Handstand method), measured at 29.0 [26.0 - 32.0] mm, 29.0 [27.5 - 30.7] mm and 34.5 [29.6 - 43.3] mm, respectively (p value <0.001). Compression rates were 101 [101 - 101], 100 [100 - 100] and 80 [80 - 80] compressions per minute (cpm) for the LUCAS 3©, EASYPULSE©, and AUTOPULSE©, respectively. Manual CPR provided a significantly higher compression rate with 115 [109 - 123] cpm (p value <0.001).
CONCLUSIONS: Only LUCAS 3© provided effective CPR according to international guidelines. ACCDs should implement microgravity CPR algorithms.

Fourier transform infrared spectroscopy (FTIRS) can provide rich information on the composition and content of samples, enabling the detection of subtle changes in tissue composition and structure. This study represents the first application of FTIRS to investigate cartilage under microgravity. Simulated microgravity cartilage model was firstly established by tail-suspension (TS) for 7, 14 and 21 days, which would be compared to control samples. A self-developed hollow optical fiber attenuated total reflection (HOF-ATR) probe coupled with a FTIR spectrometer was used for the spectral acquisition of cartilage samples in situ, and one-way analysis of variance (ANOVA) was employed to analyze the changes in the contents of cartilage matrix at different stages. The results indicate that cartilage degenerates in microgravity, the collagen content gradually decreases with the TS time, and the structure of collagen fibers changes. The trends of proteoglycan content and collagen integrity show an initial decrease followed by an increase, ultimately significantly decreasing. The findings provide the basis for the cartilage degeneration in microgravity with TS time, which must be of real significance for space science and health detection.

Sleep is known to be affected in space travel and in residents of the international space station. But little is known about the direct effects of gravity changes on sleep, if other factors, such as sleep conditions, are kept constant. Here, as a first exploration, we investigated sleep before and after exposure to short bouts of microgravity and hypergravity during parabolic flights. Sleep was measured through actigraphy and self-report questionnaires in 20 healthy men and women before and after parabolic flight. Higher sleep fragmentation and more awakenings were found in the night after the flight as compared with the night before, which was discrepant from participants\' reports showing better and longer sleep after the parabolic flight. Variable levels of experience with parabolic flights did not affect the results, nor did levels of scopolamine, a medication typically taken against motion sickness. Pre-existing sleep problems were related to sleep fragmentation and wake after sleep onset by a quadratic function such that participants with more sleep problems showed lower levels of sleep fragmentation and nighttime awakenings than those with few sleep problems. These novel findings, though preliminary, have important implications for future research, directed at prevention and treatment of sleep problems and their daytime consequences in situations of altered gravity, and possibly in the context of other daytime vestibular challenges as well.

Space travel has been associated with musculoskeletal pain, yet little is known about the nociceptive changes and pain experience during spaceflight. This preliminary study aims to investigate the pain experience and sensory alterations in astronauts following a 17-day mission to the International Space Station (ISS) on Axiom Space\'s AX-1 commercial space flight. Two participants were enrolled, and data were collected pre-flight, in-flight, post-flight, and three-month post-flight. Validated pain questionnaires assessed anxiety, catastrophizing, impact on physical and mental health, disability, and overall pain experience. Qualitative interviews were conducted post-landing and conditioned pain modulation (CPM) and quantitative sensory testing (QST) were performed. Both astronauts reported musculoskeletal pain during and after the flight, which was managed with anti-inflammatories and stretching techniques. Pain levels returned to baseline after three months. Pain questionnaires revealed heightened pain experiences in-flight and immediately post-flight, although their adequacy in assessing pain in space is uncertain. Qualitative interviews allowed astronauts to describe their pain experiences during the flight. Sensory changes included increased mechanical touch detection thresholds, temporal pain summation, heat pain thresholds, and differences in conditioned pain modulation post-flight. This preliminary study suggested that spaceflight may affect various aspects of sensory perception and regulation in astronauts, albeit in a variable manner. More data are needed to gain insight of on gain and loss of sensory functions during space missions. Further investigation into the multifactorial stressors affecting the somatosensory system during space travel could contribute to advancements in space and pain medicine.

UNASSIGNED: To evaluate ocular rigidity and choroidal thickness changes in response to microgravity and the Valsalva maneuver in a private astronaut.
UNASSIGNED: Ophthalmological examination and Optical Coherence Tomography were performed before, during, and after space flight. Choroidal thickness was measured at all time points at rest and during the Valsalva maneuver. Ocular rigidity was obtained before and after flight using a non-invasive method enhanced with deep learning-based choroid segmentation.
UNASSIGNED: Ocular rigidity decreased after space flight compared to baseline. There was an increase in average choroidal thickness during the Valsalva maneuver compared to the resting condition before, during, and after space flight, and such increase was greater when the Valsalva maneuver was performed during space flight.
UNASSIGNED: The data indicates biomechanical changes to ocular tissues because of space flight and greater choroidal thickness increase. The findings could lead to a better understanding of space flight-associated neuro-ocular syndrome and may have repercussions for short duration missions in a nascent industry.

Different gravity fields have important effects on the structural morphology of bone. The fluid flow caused by loadings in the bone lacunar-canalicular system (LCS), converts mechanical signals into biological signals and regulates bone reconstruction by affecting effector cells, which ensures the efficient transport of signaling molecules, nutrients, and waste products. In this study, the fluid flow and mass transfer effects of bone lacunar-canalicular system at multi-scale were firstly investigated, and a three-dimensional axisymmetric fluid-solid coupled finite element model of the LCS within three continuous osteocytes was established. The changes in fluid pressure field, flow velocity field, and fluid shear force variation on the surface of osteocytes within the LCS were studied comparatively under different gravitational fields (0 G, 1 G, 5 G), frequencies (1 Hz, 1.5 Hz, 2 Hz) and forms of cyclic compressive loading. The results showed that different frequencies represented different exercise intensities, suggesting that high-intensity exercise may accelerate the fluid flow rate within the LCS and enhance osteocytes activity. Hypergravity enhanced the transport of solute molecules, nutrients, and signaling molecules within the LCS. Conversely, the mass transfer in the LCS may be inhibited under microgravity, which may cause bone loss and eventually lead to the onset of osteoporosis. This investigation provides theoretical guidance for rehabilitative training against osteoporosis.

Microgravity has been shown to induce many changes in cell growth and differentiation due to offloading the gravitational strain normally exerted on cells. Although many studies have used two-dimensional (2D) cell culture systems to investigate the effects of microgravity on cell growth, three-dimensional (3D) culture scaffolds can offer more direct indications of the modified cell response to microgravity-related dysregulations compared to 2D culture methods. Thus, knowledge of 3D cell culture is essential for better understanding the in vivo tissue function and physiological response under microgravity conditions. This review discusses the advances in 2D and 3D cell culture studies, particularly emphasizing the role of hydrogels, which can provide cells with a mimic in vivo environment to collect a more natural response. We also summarized recent studies about cell growth and differentiation under real microgravity or simulated microgravity conditions using ground-based equipment. Finally, we anticipate that hydrogel-based 3D culture models will play an essential role in constructing organoids, discovering the causes of microgravity-dependent molecular and cellular changes, improving space tissue regeneration, and developing innovative therapeutic strategies. Future research into the 3D culture in microgravity conditions could lead to valuable therapeutic applications in health and pharmaceuticals.

BACKGROUND: \"Spaceflight associated neuro-ocular syndrome\" (SANS) represents a challenging health condition in modern space medicine. Forty-eight percent of astronauts are diagnosed with SANS after long-term space missions. The pathophysiological mechanism seems to be multifactorial, and yet remains unknown. In this proof-of-concept study we plan to investigate retinal microcirculatory changes in weightlessness and aim to identify their role in the development of SANS.
METHODS: Healthy individuals will take part in a parabolic flight campaign, which recreates fractioned total weightlessness periods. The airplane is specifically equipped, and designed for the execution of parabolic flight maneuvers and scientific research in microgravity. Retinal microcirculation will be assessed with a modified fundus camera, which allows dynamic vessel analysis. We will additionally measure intra-ocular pressure and hemodynamic changes during each phase of the flight. Blood samples will be analyzed at baseline, one hour and 24 hours after exposure to weightlessness.
CONCLUSIONS: This pilot study aims to investigate the feasibility of retinal microcirculation assessment during varying gravity. Results of this study may generate insights whether venous stasis in the eye, surrogated by the dilatation of retinal vessels and increase in intraocular pressure as signs of venous insufficiency, may potentially contribute to the development of SANS.

BACKGROUND: The bone lacunar-canalicular system (LCS) is an important microstructural basis for signaling and material transport in bone tissue, guaranteeing normal physiological processes in tissues. Spaceflight astronauts and elderly osteoporosis are related to its function, so it is necessary to reveal the mass transfer laws in bone microstructure under different gravity fields to provide insight for effective clinical treatment.
METHODS: Using the natural LCS structure of bovine tibial cortical bone as the object, the mass transfer experiments on cortical bone were conducted by using sodium fluorescein tracer through different frequency pulsating pressure provided by dynamic perfusion loading device and different high G environments provided by high-speed centrifuge to analyze the mass transfer laws under different gravity fields and different pulsating pressures.
RESULTS: The fluorescence intensity of lacunae within the osteon was lower the farther away from the Haversian canal. As the gravity field magnitude increased, the fluorescence intensity within each lacuna enhanced, and the more distant the lacunae from the Haversian canal, the greater the fluorescence intensity enhancement. High-frequency pulsating pressure simulated high-intensity exercise in humans can improve mass transfer efficiency in the LCS.
CONCLUSIONS: High-intensity exercise may greatly increase solute molecules, nutrients, and signaling molecules in osteocytes and improve the activity of osteocytes. Hypergravity can enhance the transport of solute molecules, nutrients, and signaling molecules in the LCS, especially promoting mass transfer to deep layer lacunae. Conversely, mass transfer to deep layer lacunae may be inhibited under microgravity, causing bone loss and ultimately leading to osteoporosis.

BACKGROUND: Astronauts have a higher risk of cervical intervertebral disc herniation. Several mechanisms have been attributed as causative factors for this increased risk. However, most of the previous studies have examined potential causal factors for lumbar intervertebral disc herniation only. Hence, we aim to conduct a study to identify the various changes in the cervical spine that lead to an increased risk of cervical disc herniation after spaceflight.
METHODS: A cohort study with astronauts will be conducted. The data collection will involve four main components: a) Magnetic resonance imaging (MRI); b) cervical 3D kinematics; c) an Integrated Protocol consisting of maximal and submaximal voluntary contractions of the neck muscles, endurance testing of the neck muscles, neck muscle fatigue testing and questionnaires; and d) dual energy X-ray absorptiometry (DXA) examination. Measurements will be conducted at several time points before and after astronauts visit the International Space Station. The main outcomes of interest are adaptations in the cervical discs, muscles and bones.
CONCLUSIONS: Astronauts are at higher risk of cervical disc herniation, but contributing factors remain unclear. The results of this study will inform future preventive measures for astronauts and will also contribute to the understanding of intervertebral disc herniation risk in the cervical spine for people on Earth. In addition, we anticipate deeper insight into the aetiology of neck pain with this research project.
BACKGROUND: German Clinical Trials Register, DRKS00026777. Registered on 08 October 2021.