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IMPACT - Information for the Development of Human Health and Performance Systems

IMPACT is a suite of computational and systems engineering tools. Currently being developed for NASA Exploration Medical Capabilities (ExMC) and could be extended to other Human Research Program (HRP) elements. The purpose is to provide a data-driven means to inform human health and performance risk mitigation during exploration missions considering resource constraints in the medical system. IMPACT enables systematic trade studies to evaluate options. IMPACT uses Probabilistic Risk Assessment (PRA) as a systematic methodology to evaluate risks. IMPACT is currently under development to inform decision-makers the risks involved with trade-options that have likelihoods and consequences backed by scientific research in a medical evidence library. IMPACT supports multi-segment analysis to determine probabilities and risks in different mission segments. There are currently 122 medical conditions and 900 resources in the IMPACT Medical Database. IMPACT modeling is using mission segments and multiple vehicles for the NASA Artemis campaign and could support future complex missions in deep space.

IMPACT PRA↗

Minimizing Human Risk: Human Performance Models in the Human Factors and Behavioral Performance Element

Human space exploration has never been more exciting than it is today. Human presence to outer worlds is becoming a reality as humans are leveraging much of our prior knowledge to the new mission of going to Mars. Exploring the solar system at greater distances from Earth than ever before will possess some unique challenges, which can be overcome thanks to the advances in modeling and simulation technologies. The National Aeronautics and Space Administration (NASA) is at the forefront of exploring our solar system. NASA's Human Research Program (HRP) focuses on discovering the best methods and technologies that support safe and productive human space travel in the extreme and harsh space environment. HRP uses various methods and approaches to answer questions about the impact of long duration missions on the human in space including: gravitys impact on the human body, isolation and confinement on the human, hostile environments impact on the human, space radiation, and how the distance is likely to impact the human. Predictive models are included in the HRP research portfolio as these models provide valuable insights into human-system operations. This paper will provide an overview of NASA's HRP and will present a number of projects that have used modeling and simulation to provide insights into human-system issues (e.g. automation, habitat design, schedules) in anticipation of space exploration.

human systems integrations↗

Medical System Concept of Operations for Mars Exploration Missions

Future exploration missions will be the first time humanity travels beyond Low Earth Orbit (LEO) since the Apollo program, taking us to cis-lunar space, interplanetary space, and Mars. These long-duration missions will cover vast distances, severely constraining opportunities for emergency evacuation to Earth and cargo resupply opportunities. Communication delays and blackouts between the crew and Mission Control will eliminate reliable, real-time telemedicine consultations. As a result, compared to current LEO operations onboard the International Space Station, exploration mission medical care requires an integrated medical system that provides additional in-situ capabilities and a significant increase in crew autonomy. The Medical System Concept of Operations for Mars Exploration Missions illustrates how a future NASA Mars program could ensure appropriate medical care for the crew of this highly autonomous mission. This Concept of Operations document, when complete, will document all mission phases through a series of mission use case scenarios that illustrate required medical capabilities, enabling the NASA Human Research Program (HRP) Exploration Medical Capability (ExMC) Element to plan, design, and prototype an integrated medical system to support human exploration to Mars.

Urbina, M.↗

Medical System Concept of Operations for Mars Exploration Missions

Future exploration missions will be the first time humanity travels beyond Low Earth Orbit (LEO) since the Apollo program, taking us to cis-lunar space, interplanetary space, and Mars. These long-duration missions will cover vast distances, severely constraining opportunities for emergency evacuation to Earth and cargo resupply opportunities. Communication delays and blackouts between the crew and Mission Control will eliminate reliable, real-time telemedicine consultations. As a result, compared to current LEO operations onboard the International Space Station, exploration mission medical care requires an integrated medical system that provides additional in-situ capabilities and a significant increase in crew autonomy. The Medical System Concept of Operations for Mars Exploration Missions illustrates how a future NASA Mars program could ensure appropriate medical care for the crew of this highly autonomous mission. This Concept of Operations document, when complete, will document all mission phases through a series of mission use case scenarios that illustrate required medical capabilities, enabling the NASA Human Research Program (HRP) Exploration Medical Capability (ExMC) Element to plan, design, and prototype an integrated medical system to support human exploration to Mars.

Urbina, Michelle↗

Minimizing Human Risk: Human Performance Models in the Space Human Factors and Habitability and Behavioral Health and Performance Elements

Human space exploration has never been more exciting than it is today. Human presence to outer worlds is becoming a reality as humans are leveraging much of our prior knowledge to the new mission of going to Mars. Exploring the solar system at greater distances from Earth than ever before will possess some unique challenges, which can be overcome thanks to the advances in modeling and simulation technologies. The National Aeronautics and Space Administration (NASA) is at the forefront of exploring our solar system. NASA's Human Research Program (HRP) focuses on discovering the best methods and technologies that support safe and productive human space travel in the extreme and harsh space environment. HRP uses various methods and approaches to answer questions about the impact of long duration missions on the human in space including: gravity's impact on the human body, isolation and confinement on the human, hostile environments impact on the human, space radiation, and how the distance is likely to impact the human. Predictive models are included in the HRP research portfolio as these models provide valuable insights into human-system operations. This paper will provide an overview of NASA's HRP and will present a number of projects that have used modeling and simulation to provide insights into human-system issues (e.g. automation, habitat design, schedules) in anticipation of space exploration.

space human factors and habitability↗

Coordination of International Risk-Reduction Investigations by the Multilateral Human Research Panel for Exploration

Effective use of the unique capabilities of the International Space Station (ISS) for risk reduction on future deep space missions involves preliminary work in analog environments to identify and evaluate the most promising techniques, interventions and treatments. This entails a consolidated multinational approach to biomedical research both on ISS and in ground analogs. The Multilateral Human Research Panel for Exploration (MHRPE) was chartered by the five ISS partners to recommend the best combination of partner investigations on ISS for risk reduction in the relatively short time available for ISS utilization. MHRPE will also make recommendations to funding agencies for appropriate preparatory analog work. In 2011, NASA's Human Research Program (HRP) and the Institute of Biomedical Problems (IBMP) of the Russian Academy of Science, acting for MHRPE, developed a joint US-Russian biomedical program for the 2015 one-year ISS mission (1YM) of American and Russian crewmembers. This was to evaluate the possibilities for multilateral research on ISS. An overlapping list of 16 HRP, 9 IBMP, 3 Japanese, 3 European and 1 Canadian investigations were selected to address risk-reduction goals in 7 categories: Functional Performance, Behavioral Health, Visual Impairment, Metabolism, Physical Capacity, Microbial and Human Factors. MHRPE intends to build on this bilateral foundation to recommend more fully-integrated multilateral investigations on future ISS missions commencing after the 1YM. MHRPE has also endorsed an on-going program of coordinated research on 6-month, one-year and 6-week missions ISS expeditions that is now under consideration by ISS managers. Preparatory work for these missions will require coordinated and collaborative campaigns especially in the psychological and psychosocial areas using analog isolation facilities in Houston, Köln and Moscow, and possibly elsewhere. The multilateral Human Analogs research working group (HANA) is the focal point of those planning discussions, with MHRPE coordinating between the national programs and then supporting implementation on ISS. Experience gained during preparations for the 1YM has identified improvements in both American and Russian processes to enable well-integrated investigations on all subsequent ISS expeditions. Among those is that the greatest efficiency is to be gained with investigations that are fully integrated from their conception, with co-principal investigators, a consolidated proposal and integrated plans for crewmember time and other flight-related resources. Analog investigations preceding future ISS expeditions will employ these lessons in efficiency to evaluate the techniques and tools to be validated aboard ISS. In this way, the resources and capabilities of ISS can be applied most efficiently to solving the problems facing astronauts of all nations in missions deep into the solar system.

Charles, John B.↗

Lunar Human Research Requirements (LHRR)

Biomedical research will be conducted during transit and on the surface of the Moon to prepare for extended stays on the Moon and to prepare for the exploration of Mars. The objective of the Human Research Program (HRP) is to preserve the health and enhance performance of astronaut explorers. Specific objectives of the HRP include developing the knowledge, capabilities, and necessary countermeasures and technologies in support of human space exploration; focusing on mitigating the highest risks to crew health and performance; and defining and improving human spaceflight medical, environmental, behavioral, and human factors standards. This document contains a detailed description of the resource accommodations, interfaces, and environments to be provided by the Constellation Program (CxP) to support the HRP research in transit and on the lunar surface. Covered, specifically, are the requirements for mass and volume transport; crew availability; ground operations, baseline data collection, and payload processing; power, and data. Volumes and mass are given for transport of conditioned samples only. They do not account for the engineering solution that the Constellation Program will implement (refrigerator/freezer volume/mass). This document does not account for requirements on the Orion vehicle for transportation to and from the International Space Station (ISS). The ISS Program has supplied requirements for this mission.

Denkins, Pamela↗

Analogs and the BHP Risk Reduction Strategy for Future Spaceflight Missions

In preparation for future exploration missions to distant destinations (e.g., Moon, Near Earth Objects (NEO), and Mars), the NASA Human Research Program s (HRP) Behavioral Health and Performance Element (BHP) conducts and supports research to address four human health risks: Risk of Behavioral Conditions; Risk of Psychiatric Conditions; Risk of Performance Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team; and Risk of Performance Errors due to Sleep Loss, Fatigue, Circadian Desynchronization, and Work Overload (HRP Science Management Plan, 2008). BHP Research, in collaboration with internal and external research investigators, as well as subject matter experts within NASA operations including flight surgeons, astronauts, and mission planners and others within the Mission Operations Directorate (MOD), identifies knowledge and technology gaps within each Risk. BHP Research subsequently manages and conducts research tasks to address and close the gaps, either through risk assessment and quantification, or the development of countermeasures and monitoring technologies. The resulting deliverables, in many instances, also support current Medical Operations and/or Mission Operations for the International Space Station (ISS).

Whitmire, Sandra↗

Perspectives on Asthenia in Astronauts and Cosmonauts: Review of the International Research Literature

The Behavioral Health and Performance Element (BHP) is one of the 6 elements in the NASA Human Research Program (HRP) and is responsible for managing 4 of the identified and named risks to human health and performance from human space exploration: a) Risk of Behavioral Conditions (BMed), b) Risk of Psychiatric Disorders (BMed), c) Risk of Performance Decrements due to inadequate Cooperation, Coordination, Communication and Psychological Adaptation within a Team (Team), and d) Risk of Performance Errors due to Sleep Loss, Circadian De-synchronization, Fatigue and Work Overload (Sleep). Each risk is reviewed by a NASA HRP Standing Review Panel (SRP), and recently the Behavioral Medicine Risk of Psychiatric Disorders was reviewed. The aim of this report is to address one of the recommendations made by that panel, specifically the recommendation that the "literature on asthenia should be evaluated (possibly as a psychological or psychosomatic / psycho-physiological analogue of chronic fatigue syndrome)" (SRP p. 4), in addition to General Recommendation 4, which states that "all reviews must include non-English language materials as well as materials appearing in conferences reports, books, and other non-refereed journal outlets" (SRP p. 2).

Sandoval, Luis↗

Remote Support of ISS Payload Operations During the COVID19 Pandemic

As part of the Human Health and Performance Contract (HHPC) with the NASA Johnson Space Center, the Human Research Program’s (HRP) Research Operations and Integration (ROI) element conducts the planning, implementation, and closing of human research operations on-board the International Space Station (ISS). These operations are supported out of the Telescience Support Center (TSC) located in the Mission Control Center at Houston’s Johnson Space Center (MCC-H). HRP ROI has an Emergency Response Plan in place to allow for remote operations to be completed in the case of inclement weather or other natural disaster; however, nominally, the remote support is only expected to last one to two weeks. In response to the COVID-19 global pandemic, HRP ROI was challenged to complete a quick transition to supporting on-orbit operations remotely and distanced for an indefinite amount of time. This shift in ground support required close collaboration with various external groups as well as the implementation or adaptation of various technologies and tools to ensure no loss of science data. Operational adjustments were put into place for ground commanding, telemetry monitoring, personnel staffing and private and public audio and video with the ISS. Adjustments were also put in place for communication and collaboration with MCC-H, the Payload Operation and Integration Center (POIC) at Marshall Space Flight Center (MSFC), as well as between the various HRP ROI console team members spread across Houston, TX. The ability to successfully support a variety of on-orbit operations from any remote location is more in demand as the commercialization of low Earth orbit is expanding.

Operations↗

Development of A Crew Health and Performance System Probabilistic Risk Assessment Tool: Proof-of-Concept Approach

The crew health and performance (CHP) system represents the span of technological interventions and tested processes and procedures that in combination address the human risk to space flight. The Human Research Program (HRP) mental model of the CHP system breaks the capabilities needed to meet NASA human flight systems standards into specific categories (i.e., countermeasures, behavioral health, medical intervention). These categories are further broken down into specific sub-groups generally associated with the human system risks that these capabilities seek to mitigate. Like the approach used to develop the Integrated Medical Model (IMM) and the Medical Extensible Dynamic Probabilistic Risk Analysis Tool (MEDPRAT), HRP tasked NASA GRC’s Cross-Cutting Computational Modeling Project with developing a CHP probabilistic risk assessment tool, the CHP-PRA. The CHP-PRA model seeks to quantify and relatively assess the human risk state within the crew health and performance domain, using a combination of knowledge about human system risks and technology and practices likely to be applied during space flight missions. This modeling system will incorporate customer and stakeholder feedback and be flexible enough to address multiple different questions about important low-level mission-specific parameters. This presentation will introduce the initial concept and development timeline for this tool and demonstrate proof-of-concept through an application addressing a specific human risk question posed within the Artemis program.

Risk analysis↗

Managing HRP's External Deliverables: The Process and the Customers

The Human Research Program’s (HRP) external deliverables (EDs) are the final outcomes of the research that the HRP Elements develop and execute. The NASA Human Health and Performance directorate’s primary stakeholders, i.e., the customers for the EDs, include the Office of the Chief Health and Medical Officer (OCHMO) (Standards Team, Chief Health and Performance Officers and Chief Medical Officers, Human System Risk Board), and the agency’s System Capability Leadership Teams. The EDs may address the need of a specific customer, a specific design reference mission, or a vehicle lifecycle milestone. HRP’s Maturation and Integration Office External Programs facilitates the process of delivering the EDs to the targeted customers according to the customer’s expectations. This presentation describes this coordinated process and provides an overview of the nature of different types of EDs and how they impact the customers’ products. Successful transfer of the EDs to the customers will help mitigate the health and performance risks that crewmembers will face during NASA’s future exploration missions.

research↗

Plant Growth Research for Future Food Production - Seed Microbiome Project

Humanity is currently on the precipice of a new era: one where human civilization is no longer bound to the confines of a single planet. Now, organizations like the National Aeronautics and Space Administration (NASA) have extended their areas of research and are beginning to focus not just on getting humans into space, but also to keep them safe, healthy, and sane. This focus falls under the Human Research Program (HRP). A focus of this program is "dedicated to discovering the best methods and technologies to support safe, productive human space travel" [1]. For "safe and productive space travel" to occur, astronauts must have proper nutrition [1]. While sending up large amounts of dried and packaged food with every shuttle might work fairly well in the short term, when only a few people need to be fed, it will not be sustainable, especially as NASA looks toward longer space journeys beyond the Earth's orbit. Research into this area falls under Advanced Life Support (ALS), whose mission is to develop regenerative life support systems to support future NASA long-duration missions [2]. This would involve growing crops in space to supplement astronaut diets [2]. An important, yet often overlooked, part of growing crops in any environment is the microbial organisms that inhabit the plants' microbiomes. The Seed Microbiome Project aims to investigate the microbial presence throughout the life stages of three crops, Mizuna Mustard, 'Outredgeous' Red Romaine Lettuce, and 'Red Robin' Tomato, that have either been or will be grown on the ISS.

Birtell, Eva↗

Characterizing the Risk: Review of Sensorimotor Evidence and Research Roadmap

BACKGROUND: NASA’s Artemis program will take astronauts back to the lunar surface for the first time in almost 50 years. Despite the successes of the previous Apollo program, the Artemis missions will differ in duration, vehicle characteristics, and landing tasks that may exacerbate the risks to crew health/safety and mission objectives. NASA’s Human Research Program identifies the risk of altered sensorimotor/vestibular function impacting critical mission tasks as one of the top priority risks to lunar exploration missions. This session will review the existing evidence and remaining gaps in knowledge for the sensorimotor risk. DESCRIPTION: Alterations in sensorimotor processing during spaceflight can lead to motion sickness, spatial disorientation, and decrements in postural control, locomotion, and fine motor control during and following gravity-transitions. The risk of impairment is greatest during and soon after gravity-transitions, when performance decrements may have high operational impacts (e.g., manual landings, immediate egress following landing, and early extravehicular activities (EVAs)). Recent studies have specifically improved the risk characterization of changes in perception, motion sickness, postural and locomotor control, manual control, and fine-motor coordination. However, given the difficulty in obtaining measurements during and soon after gravity-transitions, evidence for initial decrements immediately following gravity-transitions remains limited. The most significant gaps in the risk include manual control ability around gravity-transitions, the incidence and severity of motion sickness during landings, and the ability to perform egress/EVAs soon after gravity-transition. To address these gaps, current research roadmaps leverage both spaceflight studies and ground-based analogs for risk characterization and countermeasure development/validation. DISCUSSION: This panel will further describe the current sensorimotor research strategies with an emphasis on the operational scenarios of manual control, crew egress, and EVA. The goal of this research is to accommodate the needs of the crew and facilitate human capabilities to ensure lunar mission success. This work will prepare NASA for successful Artemis missions and enable the next giant leap, the exploration of Mars.

Timothy Ryan Macaulay↗

Space Radiation and Central Nervous System Impacts: NASA Standards and Evidence

It is well understood that large radiation localized doses to the brain cause clinically significant impacts to the central nervous system in human populations. However, the effects in adults exposed to lower doses remain unclear due to lack of data in relevant human cohorts. The impact of exposure to high-energy particles is even less understood. NASA’s Human Research Program relies heavily on model systems to characterize the impacts of the space radiation environment on the human brain and how potential changes may effect mission success and long term health and well-being. Animal, cellular, and molecular experiments implicate multiple – and possibly related – mechanisms that mediate impacts to the central nervous system in model systems including, but not limited to inflammation, immune responses, oxidative stress, metabolism, myelination, molecule transport, electrophysiology, and a variety of “omic” changes. While animal studies demonstrate potential changes across a number of cognitive and behavioral domains the direct applicability to the astronaut population remains unclear. Furthermore data access experiments and model systems can be inconsistent and dependent on multiple experimental variables indicating a clear need for robust validation. To minimize potential impacts to astronauts NASA limits dose to the CNS based on a combination of terrestrial epidemiology informed by experimental evidence in model systems. To date no recommendations have been provided by the National Committee on Radiation Protection and Measurements. This presentation will provide an overview of NASA’s current dose limits for CNS exposure to space radiation as well as highlights of the current state of evidence and ongoing research.

S Robin Elgart↗

Multilateral Research Opportunities in Ground Analogs

The global economy forces many nations to consider their national investments and make difficult decisions regarding their investment in future exploration. International collaboration provides an opportunity to leverage other nations' investments to meet common goals. The Humans In Space Community shares a common goal to enable safe, reliable, and productive human space exploration within and beyond Low Earth Orbit. Meeting this goal requires efficient use of limited resources and International capabilities. The International Space Station (ISS) is our primary platform to conduct microgravity research targeted at reducing human health and performance risks for exploration missions. Access to ISS resources, however, is becoming more and more constrained and will only be available through 2020 or 2024. NASA's Human Research Program (HRP) is actively pursuing methods to effectively utilize the ISS and appropriate ground analogs to understand and mitigate human health and performance risks prior to embarking on human exploration of deep space destinations. HRP developed a plan to use ground analogs of increasing fidelity to address questions related to exploration missions and is inviting International participation in these planned campaigns. Using established working groups and multilateral panels, the HRP is working with multiple Space Agencies to invite International participation in a series of 30- day missions that HRP will conduct in the US owned and operated Human Exploration Research Analog (HERA) during 2016. In addition, the HRP is negotiating access to Antarctic stations (both US and non-US), the German :envihab and Russian NEK facilities. These facilities provide unique capabilities to address critical research questions requiring longer duration simulation or isolation. We are negotiating release of international research opportunities to ensure a multilateral approach to future analog research campaigns, hoping to begin multilateral campaigns in the latter facilities by 2017. Collaborative use of analog facilities and shared investment in the development of spaceflight countermeasures through multilateral campaigns or missions that leverage the global scientific community will focus high quality research and provide sufficient power to accelerate the development of countermeasures and drive sound recommendations for exploration missions. This panel will provide an overview of efforts to encourage and facilitate multilateral collaboration in analog missions or campaigns and describe the facilities currently under consideration to reach the common goal of enabling safe, reliable, and productive human space exploration.

Corbin, Barbara J.↗

DCS: A Case Study of Identification of Knowledge and Disposition Gaps Using Principles of Continuous Risk Management

The Human Research Program (HRP) is formulated around the program architecture of Evidence-Risk-Gap-Task-Deliverable. Review of accumulated evidence forms the basis for identification of high priority risks to human health and performance in space exploration. Gaps in knowledge or disposition are identified for each risk, and a portfolio of research tasks is developed to fill them. Deliverables from the tasks inform the evidence base with the ultimate goal of defining the level of risk and reducing it to an acceptable level. A comprehensive framework for gap identification, focus, and metrics has been developed based on principles of continuous risk management and clinical care. Research towards knowledge gaps improves understanding of the likelihood, consequence or timeframe of the risk. Disposition gaps include development of standards or requirements for risk acceptance, development of countermeasures or technology to mitigate the risk, and yearly technology assessment related to watching developments related to the risk. Standard concepts from clinical care: prevention, diagnosis, treatment, monitoring, rehabilitation, and surveillance, can be used to focus gaps dealing with risk mitigation. The research plan for the new HRP Risk of Decompression Sickness (DCS) used the framework to identify one disposition gap related to establishment of a DCS standard for acceptable risk, two knowledge gaps related to DCS phenomenon and mission attributes, and three mitigation gaps focused on prediction, prevention, and new technology watch. These gaps were organized in this manner primarily based on target for closure and ease of organizing interim metrics so that gap status could be quantified. Additional considerations for the knowledge gaps were that one was highly design reference mission specific and the other gap was focused on DCS phenomenon.

Norcross, Jason↗

Envisioning the Future Role of an Exploration Clinical Decision Support System

The Exploration Medical Capability Element of the NASA Human Research Program seeks to fuse new and existing technologies with practical mission goals into feasible and fiscally realizable human missions to the Moon and Mars. Expected communication delays with Earth-based medical experts will require unprecedented crew self-reliance to rapidly identify and treat anticipated and unforeseen medical conditions using constrained onboard resources with limited crew clinical skill. During this session, the current status of this project will be presented. We will discuss how current modes of decision support (e.g., alerts of critical values, reminders of overdue preventive health tasks, guided clinical workflows, advice for drug prescribing, critiques of existing health care orders, and suggestions for various active care issues) can be tailored to exploration crew needs.

human-system integration↗