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Bettina L. Beard

Publications and source records attributed to Bettina L. Beard.

The Value of a Spaceflight Clinical Decision Support System for Earth-Independent Medical Operations

As NASA prepares for crewed lunar missions over the next several years, plans are also underway to journey farther into deep space. Deep space exploration will require a paradigm shift in astronaut medical support toward progressively earth-independent medical operations (EIMO). The Exploration Medical Capability (ExMC) element of NASA’s Human Research Program (HRP) is investigating the feasibility and value of advanced capabilities to promote and enhance EIMO. Currently, astronauts rely on real-time communication with ground-based medical providers. However, as the distance from Earth increases, so do communication delays and disruptions. Moreover, resupply and evacuation will become increasingly complex, if not impossible, on deep space missions. In contrast to today’s missions in low earth orbit (LEO), where most medical expertise and decision-making are ground-based, an exploration crew will need to autonomously detect, diagnose, treat, and prevent medical events. Due to the sheer amount of pre-mission training required to execute a human spaceflight mission, there is often little time to devote exclusively to medical training. One potential solution is to augment the long duration exploration crew’s knowledge, skills, and abilities with a clinical decision support system (CDSS). An analysis of preliminary data indicates the potential benefits of a CDSS to mission outcomes when augmenting cognitive and procedural performance of an autonomous crew performing medical operations, and we provide an illustrative scenario of how such a CDSS might function.

Brian K. Russell↗

Characterization of How CO2 Level May Impact Crew Performance Related to the HSIA Risk

Safety and mission critical anomalies are inevitable on NASA exploration missions. Delays and interruptions in communication with Earth-experts drives the requirement that crew resolve these anomalies on their own. The Human Factors and Behavioral Performance (HFBP) element of the NASA Human Research Program (HRP) recently stood-up the Human-System Integration Architecture (HSIA) risk. The specific risk statement is: “Given decreasing real-time ground support for execution of complex operations during future exploration missions, there is a possibility of adverse performance outcomes including that crew are unable to adequately respond to unanticipated critical malfunctions or detect safety critical procedural errors.” Reliable, on-board capabilities will need to support the crew - not only to resolve anomalies, but also to promote situation awareness (SA) and to reduce workload. Unfortunately, the present level of technological advancement limits the range of achievable intelligent support (Wu & Vera, 2019). The Human Capabilities Assessment for Autonomous Missions (HCAAM) projects were devised to identify how technology may benefit crew situation awareness and enhance crew trust in the intelligent systems. A suite of time-critical and complex exploration tasks have been identified (Holden et al., 2019) that may advance human-integration Concept of Operations (ConOps) development. This ConOps (a future HFBP directed task) along with standards and guidelines (Holden et al., 2019) may be used as the foundation for human-system requirements for a self-reliant crew. Spaceflight CO2 levels are elevated relative to terrestrial levels. Above 2.5 mmHg there is an increase in the incidence of crew headaches (Law et al., 2014) and Mission Control reports of mood and performance changes in the crew. The concern is that elevated CO2 effects may exacerbate the HSIA risk. Unfortunately, effects of higher concentrations of CO2 on performance decrements are not well established. The main goal of the current report is to identify how elevated CO2 impacts the HSIA risk. The approach taken is to trace the relationship between cognitive and motor abilities required for anomaly response with critical mission tasks and the level of technological advancement to support anomaly resolution to identify how elevated CO2 may impact the HSIA risk. The conclusion is that elevated CO2 could exacerbate the HSIA risk. Several research gaps are identified.

cognition↗

The Cognition and Fine Motor Skills Test Batteries: Normative Data and Interdependencies

Space mission success and safety relies upon astronaut functional state. Since spaceflight stressors affect cognitive processing and fine motor skills, NASA requires that measures of performance of these things remain within clinically accepted values (NASA STD 3001). NASA is in the process of developing two test batteries for the assessment of crew cognitive and fine motor skills before, during and after spaceflight. Toward that goal, the current project collected normative scores in 91 “astronaut-like” military and civilian pilots. The Cognition Test Battery (CTB) contains ten sub-tests that measure a range of cognitive abilities. For five of the ten CTB sub-tests, we propose scores to improve the battery’s sensitivity. Among the ten sub-tests, response times were more highly correlated than accuracy scores. Principle component analysis of the correlations revealed that the first response time factor could explain over 40% of the total variance and appeared to represent the tendency of observers to try to respond more quickly. The first accuracy factor (explaining only 20%) gave a high weight to the higher level cognitive sub-tests and a negative weight to tasks associated with motor and lower level cognitive processing. The Fine Motor Skills (FMS) test battery contains four sub-tests (Tracking, Pointing, Tracing, Rotating) performed on an Apple iPad tablet computer. Principle component analysis on the sub-test response time correlations revealed that the first two factors accounted for ~80% of the variance in performance. The first component captured overall speed on all four of the sub-tests. The second factor separated the sub-tasks into two groups (Drag-Point vs Trace-Rotate). Previous work found the first group response times correlated with that of a standard peg board task, while those of the other group did not. Correlations were computed between the first FMS factor and the response time and accuracy scores from each CTB sub-task. Performing fine motor behaviors rapidly was significantly correlated with the ability to perform many of the CTB sub-tests rapidly. This ability cannot be simple motor speed since scores on the Psychomotor Vigilance Test (PVT) subtask did not correlate with the ability to perform the other tasks rapidly. Speed on fine motor skills correlated significantly with accuracy on the short-term-memory sub-test. We hypothesize that eye movements, which can be regarded as a fine motor skill, may explain this relationship.

cognition↗

Crew Performance Support System to Aid in Anomaly Resolution: Concept of Operations

As missions progress into deep space, communication delays and disruptions will disenable the crew’s reliance on Earth experts. There are also limitations in the amount of data that can be downlinked to the ground. It is prudent to assume that critical, complex vehicle or habitat sub-systems will malfunction at a time when a lunar or Mars’ crew cannot rely on the Earth-Support team to detect, diagnose and resolve the problem and it is impractical to expect a small crew to step-in with the same level of expertise as 50+ authorities. The crew will need novel processes and advanced technological support to independently identify and resolve safety- and time-critical anomalies. That a self-reliant crew is unable to respond appropriately to time-critical anomalies is a significant risk to crew safety and mission success. This risk is driven by several factors; novel and unanticipated anomalies would not have been trained pre-flight, the crew could forget their pre-flight training or spaceflight stressors could impair the crew’s problem-solving ability. At last year’s IWS, Beard reported that a single spaceflight stressor (elevated CO2) could undermine the crew’s ability to independently respond to emergencies. Concept of Operations (ConOps) provide a common view of future system functions to all stakeholders. For the current project, a ConOps was developed that describes the operational processes, practices and capabilities needed by a crew of astronauts on deep space missions to autonomously respond to anticipated and unanticipated anomalies. It is crucial to recognize that, as of August 2018 existing technologies are unable to effectively support crew anomaly response to unanticipated events. “Intelligent technology” has not reached a maturity level that permits generalizing a solution to novel situations. For example, to train intelligent technology requires volumes of data that do not exist. The complexities involved in a manned mission to Mars cannot be compared to sending rovers to Mars using scripted software. This ConOps proposes a Crew Performance Support System (CPSS) that will push NASA and its industry partners toward what will be required for a safe and successful manned mission to Mars. Anomaly resolution during a deep space mission will take place within a dynamic, or changing, context. The figure to the left shows five broad contextual variables: the organizational culture, mission context, system characteristics, team characteristics and individual characteristics. The yellow arrow indicates that spaceflight and task-related stressors can affect system, team and individual crewmember characteristics and therefore anomaly response potential. The figure depicts a protective umbrella of Human-System Integration (HSI) principles that should be instituted during CPSS development including a balanced workload, shared situation awareness and building an appropriate level of trust in the automation. The figure also depicts two interrelated and cooperative components, an HSI Data System and other Enabling Capabilities will be required to support crew anomaly response and Earth-Support situation awareness. As we journey from ISS to Gateway to Mars, multiple, simultaneous and integrated research and development efforts (i.e., support systems co-evolution) must be implemented to meet the problem-solving challenges a self-reliant crew will face on a Mars’ mission. The crossovers between the capabilities are just as important as the discrete capabilities themselves. As the capabilities mature, the lines between the support subdomains will blur and an integrated system will emerge. The ConOps summarizes current knowledge about how highly trained people solve anomalies in safety- and time-critical situations, describes a group of capabilities that could help to reduce the extant risk and documents requirements levied on additional systems that provides critical inputs to the CPSS. Scenarios are used to promote a shared understanding of processes, practices and technological goals needed for safe and productive manned missions beyond LEO.

HSIA risk↗

Medical System Requirements Development for Lunar Operations

The major health hazards of spaceflight include higher levels of damaging radiation, altered gravity, extended periods of isolation and confinement, a closed and potentially hostile living environment, and the stress associated with being a long distance from Earth. As we increase the duration of lunar stays with foreseeable communication latencies and disruptions, there will be a progressive need for crew to maintain their own health and independently respond to critical medical events. The Exploration Medical Capability element of the NASA Human Research Program is developing a set of Medical System requirements for lunar transit and surface operations. These requirements specify the capabilities, processes and procedures of a habitat Medical System needed for a range of conditions known to occur during spaceflight. Requirement text is written so as not to constrain innovative design solutions necessary for a resilient system. The requirement set includes attributes and functions the Medical System imposes on eight additional habitat systems. A key property of the Medical System is the provision of medical knowledge that will be stored, updated, analyzed, and secured within a Habitat Data System. A Task Performance Support System will aid in medical data acquisition and interpretation, crew training, medical condition prevention, diagnosis and treatment, provide interactive procedures, and track medical inventory. A Wellness System will focus on the provision of countermeasures to prevent, mitigate or treat adverse physical and behavioral health effects while the Medical System recommends adjustments to these countermeasures to maintain crew health. An Environmental Monitoring System will share out-of-bounds readings of air and water quality, acoustics, and radiation exposure levels with the Medical System to help identify issues before they affect crew health and performance. A Communications System will provide secured and private consultations between crew and the ground medical team and their loved ones on Earth. The Medical System also imposes requirements on a Research & Testbed System, fostering advanced medical science such as human research. A Waste Management System provides biohazard waste containment and waste disposal options (recycle and reuse). An Extravehicular Activity System supports crew health during lunar surface activities. And finally, a Maintenance Support System ensures that medical equipment is performing as expected. These requirements are being specifically developed for lunar surface operations but could help to identify Medical System requirements for any space habitat (e.g., I-Hab, commercial endeavors, etc.).

technology↗