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NASA NTRS2013

NASA Models of Space Radiation Induced Cancer, Circulatory Disease, and Central Nervous System Effects

The risks of late effects from galactic cosmic rays (GCR) and solar particle events (SPE) are potentially a limitation to long-term space travel. The late effects of highest concern have significant lethality including cancer, effects to the central nervous system (CNS), and circulatory diseases (CD). For cancer and CD the use of age and gender specific models with uncertainty assessments based on human epidemiology data for low LET radiation combined with relative biological effectiveness factors (RBEs) and dose- and dose-rate reduction effectiveness factors (DDREF) to extrapolate these results to space radiation exposures is considered the current "state-of-the-art". The revised NASA Space Risk Model (NSRM-2014) is based on recent radio-epidemiology data for cancer and CD, however a key feature of the NSRM-2014 is the formulation of particle fluence and track structure based radiation quality factors for solid cancer and leukemia risk estimates, which are distinct from the ICRP quality factors, and shown to lead to smaller uncertainties in risk estimates. Many persons exposed to radiation on earth as well as astronauts are life-time never-smokers, which is estimated to significantly modify radiation cancer and CD risk estimates. A key feature of the NASA radiation protection model is the classification of radiation workers by smoking history in setting dose limits. Possible qualitative differences between GCR and low LET radiation increase uncertainties and are not included in previous risk estimates. Two important qualitative differences are emerging from research studies. The first is the increased lethality of tumors observed in animal models compared to low LET radiation or background tumors. The second are Non- Targeted Effects (NTE), which include bystander effects and genomic instability, which has been observed in cell and animal models of cancer risks. NTE's could lead to significant changes in RBE and DDREF estimates for GCR particles, and the potential effectiveness of radiation mitigator's. The NSRM- 2014 approaches to model radiation quality dependent lethality and NTE's will be described. CNS effects include both early changes that may occur during long space missions and late effects such as Alzheimer's disease (AD). AD effects 50% of the population above age 80-yr, is a degenerative disease that worsens with time after initial onset leading to death, and has no known cure. AD is difficult to detect at early stages and the small number of low LET epidemiology studies undertaken have not identified an association with low dose radiation. However experimental studies in mice suggest GCR may lead to early onset AD. We discuss modeling approaches to consider mechanisms whereby radiation would lead to earlier onset of occurrence of AD. Biomarkers of AD include amyloid beta (A(Beta)) plaques, and neurofibrillary tangles (NFT) made up of aggregates of the hyperphosphorylated form of the micro-tubule associated, tau protein. Related markers include synaptic degeneration, dentritic spine loss, and neuronal cell loss through apoptosis. Radiation may affect these processes by causing oxidative stress, aberrant signaling following DNA damage, and chronic neuroinflammation. Cell types to be considered in multi-scale models are neurons, astrocytes, and microglia. We developed biochemical and cell kinetics models of DNA damage signaling related to glycogen synthase kinase-3(Beta) (GSK3(Beta)) and neuroinflammation, and considered multi-scale modeling approaches to develop computer simulations of cell interactions and their relationships to A(Beta) plaques and NFTs. Comparison of model results to experimental data for the age specific development of A(Beta) plaques in transgenic mice will be discussed.

Cucinotta, Francis A.↗
NASA NTRS2014

Mechanisms of Orthostatic Tolerance Improvement Following Artificial Gravity Exposure Differ Between Men and Women

We recently determined that a short exposure to artificial gravity (AG) improved the orthostatic tolerance limit (OTL) of cardiovascularly deconditioned subjects. We now seek to determine the mechanisms of that improvement in these hypovolemic men and women. Methods. We determined the orthostatic tolerance limit (OTL) of 9 men and 8 women following a 90 min exposure to AG compared to 90 min of head down bed rest (HDBR). In both cases (21 days apart), subjects were made hypovolemic (low salt diet plus 20 mg intravenous furosemide). Orthostatic tolerance was determined from a combination of head up tilt and increasing lower body negative pressure until presyncope. Mean values and correlations with OTL were determined for heart rate, blood pressure, stroke volume, cardiac output and peripheral resistance (Finometer), cerebral artery blood velocity (DWL), partial pressure of carbon dioxide (Novametrics) and body segmental impedance (UFI THRIM) were measured during supine baseline, during OTL to presyncope and during supine recovery Results. Orthostatic tolerance of these hypovolemic subjects was significantly greater on the day of AG exposure than on the HDBR day. Regression of OTL on these variables identified significant relationships on the HDBR day that were not evident on the AG day: resting TPR correlated positively while resting cerebral flow correlated negatively with OTL. On both days, women's resting stroke volume correlated positively with orthostatic tolerance. Higher group mean values of stroke volume and cerebral artery flow and lower values of blood pressure, peripheral vascular and cerebrovascular resistance both at control and during OTL testing were observed on the AG day. Even though regression of OTL on resting stroke volume was significant only in women, presyncopal stroke volume reached the same level on each day of study for both men and women while the OTL test lasted 30% longer in men and 22% longer in women. Cerebral artery flow appeared to follow stroke volume and absolute values of cerebral flow did not correlate with the development of presyncope. Women responded to AG exposure with elevated cerebral flow at resting control and throughout the OTL test, implying a loss of autoregulation in deconditioned (hypovolemic) women following AG exposure. Conclusions. Before countermeasures to space flight cardiovascular deconditioning are established, gender differences in cardiovascular responses to orthostatic stress, in general, and to orthostatic stress following exposure to artificial gravity, in particular, need to be determined. Since, in both men and women, a single, acute bout of AG exposure improved orthostatic tolerance, the feasibility of short exposures to AG during longer spaceflights or prior to entry into a gravity (Earth or Mars) environment, should be explored. Given the known beneficial effects of AG on other organ systems, the present study indicates that the positive effects of AG on cardiac stroke volume make AG a likely candidate for maintaining cardiovascular conditioning.

Evans, J. M.↗
NASA NTRS2014

Astronaut Bone Medical Standards Derived from Finite Element (FE) Models of QCT Scans from Population Studies

This work was accomplished in support of the Finite Element [FE] Strength Task Group, NASA Johnson Space Center [JSC], Houston, TX. This group was charged with the task of developing rules for using finite-element [FE] bone-strength measures to construct operating bands for bone health that are relevant to astronauts following exposure to spaceflight. FE modeling is a computational tool used by engineers to estimate the failure loads of complex structures. Recently, some engineers have used this tool to characterize the failure loads of the hip in population studies that also monitored fracture outcomes. A Directed Research Task was authorized in July, 2012 to investigate FE data from these population studies to derive these proposed standards of bone health as a function of age and gender. The proposed standards make use of an FE-based index that integrates multiple contributors to bone strength, an expanded evaluation that is critical after an astronaut is exposed to spaceflight. The current index of bone health used by NASA is the measurement of areal BMD. There was a concern voiced by a research and clinical advisory panel that the sole use of areal BMD would be insufficient to fully evaluate the effects of spaceflight on the hip. Hence, NASA may not have a full understanding of fracture risk, both during and after a mission, and may be poorly estimating in-flight countermeasure efficacy. The FE Strength Task Group - composed of principal investigators of the aforementioned population studies and of FE modelers -donated some of its population QCT data to estimate of hip bone strength by FE modeling for this specific purpose. Consequently, Human Health Countermeasures [HHC] has compiled a dataset of FE hip strengths, generated by a single FE modeling approach, from human subjects (approx.1060) with ages covering the age range of the astronauts. The dataset has been analyzed to generate a set of FE strength cutoffs for the following scenarios: a) Qualify an applicant for astronaut candidacy, b) Qualify an astronaut for a long-duration (LD) mission, c) Qualify a veteran LD astronaut for a second LD mission, and d) Establish a non-permissible, minimum hip strength following a given mission architecture. This abstract will present the FE-based standards accepted by the FE Strength Task Group for its recommendation to HHC in January 2015.

Sibonga, J. D.↗
NASA NTRS2014

Quantification of In-flight Physical Changes: Anthropometry and Neutral Body Posture

Currently, NASA does not have sufficient in-flight anthropometric data gathered to assess the impact of physical body shape and size changes on suit sizing. For developing future planetary and reduced gravity suits, NASA needs to quantify the impacts of microgravity on anthropometry, body posture, and neutral body postures (NBP) to ensure optimal crew performance, fit, and comfort. To obtain these impacts, anthropometric data, circumference, length, height, breadth, and depth for body segments (i.e. chest, waist, bicep, thigh, calf) from astronauts for pre, in-, and postflight conditions needs to be collected. Once this data has been collected, a comparison between pre, in-, and postflight anthropometric values will be analyzed, yielding microgravity factors. The NBP will be used to determined body posture (joint angle) changes between subjects throughout the duration of a mission. Data collection, starting with Increments 37/38, is still in progress with the completion of 3 out of 12 subjects. NASA suit engineers and NASA's Extravehicular Activity (EVA) Project Office have identified that suit fit in microgravity could become an issue. It has been noted that crewmembers often need to adjust their suit sizing once they are in orbit. This adjustment could be due to microgravity effects on anthropometry and postural changes, and is necessary to ensure optimal crew performance, fit, and comfort in space. To date, the only data collected to determine the effects of microgravity on physical human changes have been during Skylab, STS-57, and a recent HRP study on seated height changes due to spinal elongation (Spinal Elongation, Master Task List [MTL] #221). The Skylab and the STS-57 studies found that there is a distinct neutral body posture (NBP) based on photographs. The still photographs showed that there is a distinguishable posture with the arms raised and the shoulder abducted; and, in addition, the knees were flexed with noticeable hip flexion and the foot plantar flexed [1,2]. This is the one standard set of body joint angles for a NBP in microgravity. A recent simulated microgravity NBP study [3] has shown an individual variability and inconsistencies in defining NBP. This variation may be influenced by spinal growth, the type of suit fit, and other potential anthropometry factors such as spinal curvature, age, and gender. The variation aspect of this essential data is required for all kinds of space device designs (e.g. suits, habitat, mobility aids, etc.). The method proposed considers the dynamic nature of body movement and will use a measurement technique to continually monitor posture and develop a probability likelihood of the natural posture and how the NBP postures are affected by anthropometry. Additionally, Skylab studies found that crewmembers experienced a stature growth of up to 3%. The data included 3 crewmembers that showed that there is a bi-phasic stature growth once the crew enters into weightlessness. However, the Spinal Elongation study identified that the crewmembers could experience about a 6% growth in seated height and a 3% stature growth, when exposed to microgravity. The results prove that not all anthropometric measurements have the same microgravity percent growth factor. For EVA and suit engineers to properly update the sizing protocol for microgravity, they need additional anthropometric data from space missions. Hence, this study is aimed to gather additional in-flight anthropometric measurements, such as length, depth, breadth, and circumference, to determine the changes to body shape and size due to microgravity effects. It is anticipated that by recording the potential changes to body shape and size, a better suit sizing protocol will be developed for ISS and other space missions. In essence, this study will help NASA quantify the impacts of microgravity on anthropometry to ensure optimal crew performance, fit, and comfort. This study will use simplistic data collection techniques, 3D laser scanning, digital still, and video data, and perform photogrammetric analyses to determine the changes that occur to the body shape, size, and NBP when exposed to a microgravity environment.

Young, K. S.↗
NASA NTRS2015

Risk of Crew Adverse Health Event Due to Altered Immune Response

Determining the effect of space travel on the human immune system has proven to be extremely challenging. Limited opportunities for in-flight studies, varying mission durations, technical and logistical obstacles, small subject numbers, and a broad range of potential assays have contributed to this problem. Additionally, the inherent complexity of the immune system, with its vast array of cell populations, sub-populations, diverse regulatory molecules, and broad interactions with other physiological systems, makes determining precise variables to measure very difficult. There is also the challenge of determining the clinical significance of any observed immune alterations. Will such a change lead to disease, or is it a transient subclinical observation related to short-term stress? The effect of this problem may be observed by scanning publications associated with immunity and spaceflight, which began to appear during the 1970s. Although individually they are each valid studies, the comprehensive literature to date suffers from widely varying sampling methods and assay techniques, low subject counts, and sometimes a disparate focus on narrow aspects of immunity. The most clinically relevant data are derived from in-flight human studies, which have demonstrated altered cell-mediated immunity and reactivation of latent herpes viruses. Much more data are available from post-flight testing of humans, with clear evidence of altered cytokine production patterns, altered leukocyte distribution, continued latent viral reactivation, and evidence of dramatically altered virus-specific immunity. It is unknown if post-flight assessments relate to the in-flight condition or are a response to landing stress and readaptation. In-flight culture of cells has clearly demonstrated that immune cells are gravity-sensitive and display altered functional characteristics. It is unknown if these data are related to in vivo immune cell function or are an artifact of microgravity culture. Ground analog testing of humans and animals, as well as microgravity-analog cell culture, has demonstrated utility. However, in all cases, it is not known with certainty if these data would reflect similar testing during space travel. Given their ready availability, ground analogs may be extremely useful for assay development and the evaluation of potential countermeasures. In general, the evidence base suffers from widely disparate studies on small numbers of subjects that do not directly correlate well with each other or spaceflight itself. Also lacking are investigations of the effect of gender on adaption to spaceflight. This results in significant knowledge 'gaps' that must be filled by future studies to completely determine any clinical risk related to immunity for human exploration-class space missions. These gaps include a significant lack of in-flight data, particularly during long-duration space missions. The International Space Station represents an excellent science platform with which to address this knowledge gap. Other knowledge gaps include lack of a single validated ground analog for the phenomenon and a lack of flight-compatible laboratory equipment capable of monitoring astronauts (for either clinical or research purposes). However, enough significant data exist, as described in this manuscript, to warrant addressing this phenomenon during the utilization phase of the ISS. A recent Space Shuttle investigation has confirmed the 31 in-flight nature of immune dysregulation, demonstrating that it is not merely a post-flight phenomenon. Several current studies are ongoing onboard the ISS that should thoroughly characterize the phenomenon. NASA recognizes that if spaceflight-associated immune dysregulation persists during exploration flights in conjunction with other dangers, such as high-energy radiation, the result may be a significant clinical risk. This emphasizes the need for a continued integrated comprehensive approach to determining the effect of prolonged spaceflight, separated from transient launch and landing stresses, on human immunity. After such studies, the phenomenon will be understood, and, hopefully, a monitoring strategy will have been developed that could be used to monitor the effectiveness of countermeasure

Crucian, Brian↗
NASA NTRS2016

Quantification of ln-Flight Physical Changes: Anthropometry and Neutral Body Posture

Currently, NASA does not have sufficient in-flight anthropometric data to assess the impact of changes in body shape and size. For developing future planetary and reduced-gravity suits, NASA needs to quantify the impacts of microgravity on anthropometry and body posture to ensure optimal crew performance, fit, and comfort. To obtain data on these changes, circumference, length, height, breadth, and depth for body segments (chest, waist, bicep, thigh, calf) from astronauts for preflight, in-flight, and post-flight conditions needs to be collected. Once these data have been collected, pre-flight, in-flight, and post-flight anthropometric values will be compared, yielding microgravity factors. The neutral body posture (NBP) will also be measured, to determine body posture (joint angle) changes between subjects throughout the duration of a mission. Data collection, starting with Increments 37/38, is still in progress but has been completed for 6 out of 9 subjects. NASA suit engineers and NASA's Extravehicular Activity (EVA) Project Office have identified that suit fit in microgravity could become an issue. It has been noted that crewmembers often need to adjust their suit sizing once they are in orbit. This adjustment could be due to microgravity effects on anthropometry and postural changes, and is necessary to ensure optimal crew performance, fit, and comfort in space. To date, the only data collected to determine the effects of microgravity on physical human changes were collected during Skylab 4, the Apollo-Soyuz Test Project (ASTP), Space Shuttle mission STS-57, and a recent HRP study on seated height changes due to spinal elongation (Spinal Elongation, Master Task List [MTL] #221). The Skylab 4, ASTP, and the STS-57 studies found that, according to photographs, a distinct NBP exists. The still photographs showed a distinguishable posture with the arms raised and the shoulders abducted; in addition, the knees are flexed, with noticeable hip flexion, and the foot is plantar flexed [1,2]. This combination is considered to be the standard set of body joint angles for an NBP in microgravity. A recent simulated microgravity NBP study [3] showed individual variability and inconsistencies in defining NBP. This variation may be influenced by spinal growth, and other potential anthropometry factors such as spinal curvature, age, and gender. Data on the variation of this posture data is required for all kinds of space device designs (such as suits, habitat, and mobility aids). The method proposed in this study considers the dynamic nature of body movement and will use a measurement technique to continually monitor posture and develop a probability likelihood of the neutral posture and how the NBP postures are affected by anthropometry. Additionally, Skylab studies found that crewmembers experienced a stature growth of up to 3 percent. The data included 3 crewmembers and showed that a biphasic stature growth occurs once the crewmember enters into weightlessness. However, the HRP Spinal Elongation study showed that crewmembers could experience about a 6 percent growth in seated height and a 3 percent stature growth, when exposed to microgravity. The results of that study prove that not all anthropometric measurements have the same microgravity percent growth factor. For EVA and suit engineers to properly update the sizing protocol for microgravity, they need additional anthropometric data from space missions. Hence, this study is aimed at gathering additional in-flight anthropometric measurements, such as length, depth, breadth, and circumference, to determine the changes to body shape and size caused by microgravity effects. It is anticipated that by recording the potential changes to body shape and size, NASA will develop a better suit sizing protocol for the International Space Station and other space missions. In essence, this study will help NASA quantify the impacts of microgravity on anthropometry to ensure optimal crew performance, fit, and comfort. This study will use standard anthropometry data collection techniques, 3D laser scanning, digital still photography, and video data, and perform photogrammetric analyses to determine the changes that occur to the body shape and size, and to NBP, when the human body is exposed to a microgravity environment.

Young, K. S.↗
NASA NTRS2015

Daytime Cognitive Performance in Response to Sunlight or Fluorescent Light Controlling for Sleep Duration

Light is the primary synchronizer of the human circadian rhythm and also has acute alerting effects. Our study involves and comparing the alertness, performance and sleep of participants in the NASA Ames Sustainability Base, which uses sunlight as its primary light source, to in a traditional office building which uses overhead florescent lighting and varying exposure to natural light. The purpose of this study is to determine whether the use of natural lighting as a primary light source improves daytime cognitive function and promotes nighttime sleep. Participants from the Sustainability Base will be matched by gender and age to individuals working in other NASA buildings. In a prior study we found no differences in performance between those working in the Sustainability Base and those working in other buildings. Unexpectedly, we found that the average sleep duration among participants in both buildings was short, which likely obscured our ability to detect a difference the effect of light exposure on alertness. Given that such sleep deprivation has negative effects on cognitive performance, in this iteration of the study we are asking the participants to maintain a regular schedule with eight hours in bed each night in order to control for the effect of self-selected sleep restriction. Over the course of one week, we will ask the participants to wear actiwatches continuously, complete a psychomotor vigilance task (PVT) and digit symbol substitution task (DSST) three times per day, and keep daily sleepwork diaries. We hope that this study will provide data to support the idea that natural lighting and green architectural design are optimal to enhance healthy nighttime sleep patterns and daytime cognitive performance.

cognitive performance↗
NASA NTRS2017

Carotid Intima Media Thickness in the Astronaut Corps: Association to Spacecraft

Background: Carotid Intima Media Thickness (CIMT) has been demonstrated to be predictive of future cardiovascular events. Within various populations, radiation exposure, stress, and physical confinement have all been linked to an increased CIMT. Recent research discovered CIMT was significantly increased in ten long duration astronauts from pre-flight to four days post flight. The relationship between spaceflight and CIMT is not understood and trends in CIMT within the larger astronaut population are unknown. Methods: In 2010, CIMT was offered as part of the astronaut annual exam at the JSC Flight Medicine Clinic using a standardized CIMT screening protocol and professional sonographers. Between 2010 and 2016, CIMT measurements were collected on 213 NASA astronauts and payload specialists. The values used in this retrospective chart review are the mean of the CIMT from the right and left. Spaceflight exposure was categorized based on the total number of days spent in space at the time of the ground-based ultrasound (0, 1-29, 30-100, 101-200, ≥200). Linear regression with generalized estimating equations were used to estimate the association between spaceflight exposures and CIMT. Results: 530 studies were completed among 213 astronauts with a mean of 2.5 studies (range 1-6) per astronaut over the six year period. As in other populations, CIMT was significantly associated with age; however, gender was not. While there was no significant direct correlation between total spaceflight exposure and CIMT found, astronauts with 30-100 spaceflight days and astronauts with greater than 100 spaceflight days had significantly increased CIMT over astronauts who had never flown (p=0.002 and p=<0.0001 respectively) after adjustment for age. Conclusion: Further work is needed to fully understand CIMT and its association to spaceflight. Current occupational surveillance activities are under way to study CIMT values in conjunction with other cardiovascular risk factors among astronauts as compared to the general population.

Suffredini, John↗
NASA NTRS2017

Autogenic-Feedback Training Exercise (AFTE) Mitigates the Effects of Spatial Disorientation to Simulated Orion Spacecraft Re-Entry: Individual Differences

NASA has identified a potential risk of spatial disorientation to future astronauts during re-entry of the proposed Orion spacecraft. The purpose of this study was to determine if a 6-hour physiological training procedure, Autogenic-Feedback Training Exercise (AFTE), can mitigate these effects. Twenty subjects were assigned to two groups (AFTE and Control) matched for motion sickness susceptibility and gender. All subjects received a standard rotating chair test to determine motion sickness susceptibility; three training sessions on a manual performance task; and four exposures to a simulated Orion re-entry test in the rotating chair. Treatment subjects were given two hours of AFTE training before each Orion test. A diagnostic scale was used to evaluate motion sickness symptom severity. Results showed that 2 hours of AFTE significantly reduced motion sickness symptoms during the second Orion test. AFTE subjects were able to maintain lower heart rates and skin conductance levels and other responses than the control group subjects during subsequent tests. Trends show that performance was less degraded for AFTE subjects. The results of this study indicate that astronauts could benefit from receiving at least 2 hours of preflight AFTE. In addition, flight crews could benefit further by practicing physiologic self-regulation using mobile devices.

human performance↗
NASA NTRS2017

Engineering, Life Sciences, and Health/Medicine Synergy in Aerospace Human Systems Integration: The Rosetta Stone Project

In the realm of aerospace engineering and the physical sciences, we have developed laws of physics based on empirical and research evidence that reliably guide design, research, and development efforts. For instance, an engineer designs a system based on data and experience that can be consistently and repeatedly verified. This reproducibility depends on the consistency and dependability of the materials on which the engineer works and is subject to physics, geometry and convention. In life sciences and medicine, these apply as well, but individuality introduces a host of variables into the mix, resulting in characteristics and outcomes that can be quite broad within a population of individuals. This individuality ranges from differences at the genetic and cellular level to differences in an individuals personality and abilities due to sex and gender, environment, education, etc.

Medicine↗
NASA NTRS2012

Examining Individual Differences in Temporal Profiles of Cardiovascular Responses to the Head Down Tilt during Fluid Loading

Upon returning to Earth after an extended exposure to micro-gravity in space many astronauts have experienced symptoms of light headedness and fainting associated with post-flight orthostatic intolerance (low blood pressure). The main reason for this condition is the reduced fluid volume in the body while in space. A preventative treatment was proposed to prevent this condition by fluid loading to restore lost plasma volume by giving crew members salt tablets and water prior to re-entry. In order to simulate micro-gravity effects on earth test subjects are placed in a supine position with their head below the level of their heart (6 head down tilt-HDT). The purpose of the present study is to define individual differences in the time course of cardiac stroke volume responses to HDT (6 hours) and the effectiveness of fluid loading for mitigating orthostatic intolerance when standing . Echocardiography and impedance cardiography data will be collected on 8 men and 8 women to examine heart function to HDT. A second objective is to determine if the effects of fluid loading vary due to individual differences (e.g., age, gender, height, weight, physical fitness, etc.).

orthostatic intolerance↗
NASA NTRS2019

Field Evaluations of Sampling, Interviewing, and Flight Tracking of NASA's Low Boom Flight Demonstrator Aircraft

The first year’s effort identified sampling and interviewing as the principal risks to assessment of prompt reactions to overflights producing low-amplitude sonic booms. It also 1) established the utility of geo-information system-based route planning for LBFD flight missions, 2) developed and demonstrated a prototype of a geographically-distributed, Internet-enabled instrumentation system capable of wide-area tracking of LBFD aircraft in near-real time. The latter system permits synchronizing the conduct of interviews in multiple overflown communities with arrival times of shock waves at interviewing sites; and of measuring, archiving, and processing their acoustic signatures. Means were also recommended for constructing representative, telephone-based samples of eligible respondents living in households within carpet boom corridors adjacent to LBFD flight tracks, and for conducting interviews with cross-sectional (independent) samples of such respondents about their prompt reactions to exposure to low-amplitude sonic booms. A detailed study design was prepared and accepted by NASA for a set of single-contact attempt telephone interviews with a nationally representative sample of households. The study design focused on testing automated and live agent interview completion rates obtainable without callbacks. A minimal (two monitoring station) version of the aircraft tracking system was built and installed near a civil airport in a successful demonstration of the system’s ability to detect and track aircraft movements. The field exercise also demonstrated the ability of the system to capture the acoustic emissions of departing aircraft, and to serve aircraft position and sound level information to remote, geographically-distributed analysts in near-real time. Upon approval of OMB and IRB of the detailed study plan, a stratified, nationally representative sample of landline and wireless telephone-subscribing households was constructed. A total of 12,734 telephone interview contact attempts of the sort required by a straightforward cross-sectional study design were then made. These contact attempts demonstrated the impracticality of conducting a time-critical, cross-sectional study of prompt community response to low-amplitude sonic booms by means of “independent” (single contact attempt per respondent for each LBFD flight mission) telephone samples of respondents. The observed interview completion rates for these single telephone contact attempts were so low (~ 1% to 3% for automated and live agent interviews, respectively) that: 1) the representativeness of collected opinions would be susceptible to intuitive challenge as inadequate, even absent conclusive evidence of non-representativeness. Refuting challenges to representativeness would have to demonstrate that the composition of the actual sample did not differ from that of the target population, a task that is tantamount to proving a negative; 2) the information required to refute allegations of non-representativeness would require a questionnaire considerably lengthier than that required simply to determine the prevalence of boom-induced startle and annoyance. Such a questionnaire would have to inquire about potentially sensitive and intrusive matters, including respondents’ age, gender, education, employment, home ownership, income, ethnicity, family size, and other demographic factors; and 3) unreasonable numbers of attempts would be required to re-contact households with unsuccessful initial contact attempts, given the limited time available for doing so. For example, if about 500 completed interviews were desired in a supersonically overflown community, approximately 50,000 automated interview attempts would have to be made within ten to fifteen minutes of each LBFD overflight. Such large numbers of contact attempts could well exceed the numbers of households available for interview in areas of similar boom exposure levels in some communities near LBFD flight tracks. Such large numbers of interviews could be cost-effectively undertaken only by means of automated (i.e., outgoing interactive voice response) interviewing, a data collection method ill-suited for complex and sensitive questionnaire items. The infeasibility of independent sampling for evaluating prompt responses to LBFD overflights in a cross-sectional study is due in large part to simple non-response: that is, potential respondents – particularly those contacted on wireless telephones – refusing to answer calls with unfamiliar caller IDs. It is also due in part, however, to 1) the lack of time to attempt to contact the same respondent more than once within a few minutes after the arrival of a shock wave at the respondent’s location; and 2) the need to place calls during weekday/daytime hours, when response rates are notably lower than during evenings and weekends. Despite the poor interview completion rates achieved under the above constraints, cross sectional assessments of delayed reactions to LBFD overflights could still be feasible, if multiple attempts could be made to contact respondents during evening and weekend time periods, over extended time periods. Detailed plans for a longitudinal (panel) sample were developed as an alternative to a cross sectional sample design.

Fidell, Sanford↗
NASA NTRS2019

Medical Decision Making in the Physician Hierarchy: A Pilot Pedagogical Evaluation

Context: Recently, The American College of Graduate Medical Education (ACGME) has included the medical decision making as a core competency in several specialties. To date, the ability to demonstrate and measure a pedagogical evolution of medical judgment in a medical education program has been limited. Objective: In this study we hope to examine differences in medical decision making ability of different physicians across their various stages of post-graduate hierarchy. Method: Physcians spanning a wide spectrum of scientific disciplines were recruited for three catagories: administrative physicians(AP) representing physcians with the most experience but mostly practice administratively; resident physicians completing their postgraduate medical training (RP) and seasoned attending physicians with mastery level experience (MP). Participants completed four medical simulations focused on abdominal pain: cholecystitis (CH) and renal colic(RC) and chest pain; Cardiac ischemia (STEMI) and pneumothorax (PX). Simulation were ordered randomly so that there was no systematic bias due to learning or to fatigue. The Medical judgment metric (MJM) was used to evaluate medical decision-making. Results: There were no significant differences between the AP, RP, and MP groups in the gender, race, ethnicity, education, and baseline heart rate. There was a significant (p=0.002) interaction effect for simulation time and RP group, 6.2 minutes (+/-1.58); MP group, 8.7 minutes (+/-2.46); and AP group, 10.3 minutes (+/-2.78). The RC MJM scores were significantly (P=0.10) worse in the AP group 12.3 (+/-2.66) then the RP 14.7(+/-1.15) and MP17.7 (+/-1.15) groups. In every simulation, the AP group MJM scores were worse on average (no significantly) compared to the MP and RP groups. The AP group was significantly (P=0.040) less likely to stabilize the subject in the RC simulation than MP and RP groups. Conclusion: There remains significant variability in the medical education and skill retention influences medical decision making throughout a physician's career.

Rosasco, John↗
NASA NTRS2018

Pre-Flight Training of Autonomic Responses for Mitigating the Effects of Spatial Disorientation During Spaceflight

The National Aeronautics and Space Administration (NASA) has identified a potential risk of spatial disorientation, motion sickness, and degraded performance to astronauts during re-entry and landing of the proposed Orion crew vehicle. The purpose of this study was to determine if a physiological training procedure, Autogenic-Feedback Training Exercise (AFTE), can mitigate these adverse effects. Fourteen men and six women were assigned to two groups (AFTE, no-treatment Control) matched for motion sickness susceptibility and gender. All subjects received a standard rotating chair test to determine motion sickness susceptibility; three training sessions on a manual performance task; and four exposures in the rotating chair (Orion tests) simulating angular accelerations of the crew vehicle during re-entry. AFTE subjects received 2 hours of training before Orion tests 2, 3, and 4. Motion sickness symptoms, task performance, and physiological measures were recorded on all subjects. Results showed that the AFTE group had significantly lower symptom scores when compared to Controls on test 2 (p=.05), test 3 (p=.03), and test 4 (p=.02). Although there were no significant group differences on task performance, trends showed that AFTE subjects were less impaired than Controls. Heart rate change scores (20 revolutions per minute minus baseline) of AFTE subjects indicated significantly less reactivity on Test 4 compared to Test 1 (10.09 versus 16.59, p=.02), while Controls did not change significantly across tests. Results of this study indicate that AFTE may be an effective countermeasure for mitigating spatial dis-orientation and motion sickness in astronauts.

Orion↗
NASA NTRS2019

Predictive Modeling for Differential Diagnosis and Mortality Risk Assessment

The prevalence of electronic health record (EHR) systems has brought prodigious biomedical informatics opportunity. Automated machine learning methods can effectively utilize such data and have become common tools for healthcare predictive modeling. Researches in medical informatics have explored the potential of deep learning and classical models in emergent care scenarios. In particular, predicting differential diagnoses for admissions have proven useful in decreasing unnecessary lab tests and improving inpatient triage decision-making. Moreover, identification of high-risk patients for in-hospital mortality is vitally important to maximize allocation of medical resources.The Medical Information Mart for Intensive Care (MIMIC-III) database, containing de-identified critical care inpatient was used in our study. This data set captures hospital patient laboratory measurements, pharmacologic prescriptions, diagnostic data and procedure event recordings. When considering adult patients and discounting admissions with ICU length of stay less than 24 hours, there were 37,787 unique admissions and 30,414 total patients. We examined the top 25 most prevalent ICD-9 group-level disease specificities in MIMIC-III using a multi-label classification model. In-hospital mortality was modeled as binary classification with 4,155 (13%) adult patients that expired, of which 3,138 (75.5%) were in the ICU setting. The metrics AUC, F1 score, sensitivity and specificity values calculated for each disease label measured prediction performance.The usage of ICD-9 group codes reduced feature dimension from 14,567 to 942 and greatly improved distribution of patient diagnostic categories. Disease temporal patterns were captured by considering the most frequently sampled 6 vital signs and 13 laboratory values. Missing data were imputed at each time-stamp. Time-series raw hourly average values were converted into 5 summary features (mean, standard deviation, number of observations, min & max values). Patient demographic variables such as age, gender, marital status and ethnicity were also factored into the modeling. Choi et al showed that contextual embedding of medical data, diagnostic and procedural codes alone can predict future diagnoses with sensitivity as high as 0.79. We utilized an embedding technique called word2vec which allowed sparse representations of medical history to be transformed into dense word vectors. The mappings captured contextual information by treating each admission as a sentence and learning the most likely neighboring words in a sliding window fashion. Binary and multi-label classification was achieved via collapse models, which do not consider temporal information, as well as recurrent neural networks with regularization, Softmax output layer activation together with categorical cross-entropy as the loss function.

US Army collaboration↗
NASA NTRSDate not supplied

The Value of Diversity in the Renewable Energy Industry and Research Community

Part of creating a successful solar industry is developing a capable workforce. It has been repeatedly shown that organizations and companies are more productive when they have diverse and inclusive cultures. The solar industry in the U.S. performs well in some aspects (non-white workforce, positive work environment) but drastically under-performs in many others. We discuss these metrics and how this impacts the renewable energy industry and the solar research community. We highlight some initial actions which are necessary to begin to remediate these deficiencies, such as demographic tracking, recruiting strategies, and mentoring. We also present the historical and ongoing efforts to improve the diversity and inclusion of the Photovoltaic Specialists Conference, particularly through the work of this year’s Diversity and Inclusion (D&I) oversight committee. This year’s D&I committee is implementing diversity tracking, a women’s lunch, a diversity lunch, childcare resources, pronouns on badges, gender-neutral restrooms, addressing accessibility issues, and publishing a diversity statement and code of conduct to the PVSC website.

workforce↗
NASA NTRSDate not supplied

The Value of Diversity in the Renewable Energy Industry and Research Community

Part of creating a successful solar industry is developing a capable workforce. It has been repeatedly shown that organizations and companies are more productive when they have diverse and inclusive cultures. The solar industry in the U.S. performs well in some aspects (non-white workforce, positive work environment) but drastically under-performs in many others. We discuss these metrics and how this impacts the renewable energy industry and the solar research community. We highlight some initial actions which are necessary to begin to remediate these deficiencies, such as demographic tracking, recruiting strategies, and mentoring. We also present the historical and ongoing efforts to improve the diversity and inclusion of the Photovoltaic Specialists Conference, particularly through the work of this year’s Diversity and Inclusion (D&I) oversight committee. This year’s D&I committee is implementing diversity tracking, a women’s lunch, a diversity lunch, childcare resources, pronouns on badges, gender-neutral restrooms, addressing accessibility issues, and publishing a diversity statement and code of conduct to the PVSC website.

Emily Warren↗
NASA NTRS2020

Motion Sickness and Concerns for Urban Air Mobility Vehicles: A Literature Review

Motion sickness is a general term for a constellation of signs and symptoms, generally due to exposure to abrupt, periodic, or unnatural accelerations, especially when traveling in a vehicle. Motion sickness results from a mismatch of the visual and nonvisual (vestibular and kinesthetic) information, the observed scene and the motion felt or lack of it. Motion sickness onset is associated with a pattern of physiological changes in heart rate, peripheral blood flow, respiration, and skin conductance and the pattern is repeatable for a particular subject but variable between subjects. Demographic factors such as gender and age that affect motion sickness are well known with children, women, and older adults more likely to be susceptible. Often motion sickness is assessed and quantified using variations of the motion sickness susceptibility questionnaires including the Pensacola Diagnostic Rating Scale and the Simulator Sickness Questionnaire. Even though symptoms are easily identified by such questionnaires, they commonly are subjective. Tools such as these questionnaires for screening individuals susceptible to motion sickness are useful, however, they are only mildly predictive. Moreover, models for predicting motion sickness, which have largely been developed for sea sickness, do not consider task characteristics. Predictions of motion sickness rates and prevalence for Urban Air Mobility (UAM) vehicles are not possible at present because data from actual flight or full-fidelity simulation are simply not yet available. Extrapolation from other modes of transportation (i.e., automobiles, buses, trains, boats, other types of aircraft) is difficult because of differences in the motion stimulus experienced, trip duration, and other factors. How UAM vehicles will change the social dynamics of passenger interaction and vehicle interior design changes (e.g., seat orientations) is unknown. Should motion sickness prove to be an issue, vehicle design modifications such as having passengers face forward, providing additional seat recline, giving each person their own climate control for airflow, perhaps ensuring the horizon is visible to all passengers (reducing visual occlusion by the headrest) and visually stabilizing displays on carry-on devices (smart phones, tablets, etc.) may benefit passengers. Several commercial companies provide wearable devices for physiological monitoring that have been validated and are suitable for use with passengers in UAM vehicles or high-fidelity simulators. Potential countermeasures for motion sickness include user-worn devices, anti-motion sickness medications, and non-pharmacological approaches such as biofeedback and Autogenic Feedback Training Exercise. Both simulator and in-vehicle UAM research is needed to evaluate the effectiveness of any potential countermeasure.

motion sickness↗