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Directed Acyclic Graphs: A Tool for Understanding the NASA Human Spaceflight System Risks - Human System Risk Board

For over a decade, the National Aeronautics and Space Administration (NASA) has tracked and configuration-managed approximately 30 risks to astronaut health and performance that occur before, during and after spaceflight. The Human System Risk Board (HSRB), a Health and Medical Technical Authority (HMTA) Board at NASA Johnson Space Center, is the entity responsible for identifying, assessing, analyzing, and monitoring the official understanding of the risk or risk posture for each of the Human System Risks and determining – based on evaluation of the available evidence – when that risk posture changes. The ultimate purpose of tracking and researching these risks is to find ways to reduce the risk that astronaut crews face during spaceflight. Historically, research, development and operations relevant to one risk have been conducted in isolation from other risks; these individual risk ‘silos’ enabled initial characterization of each specific risk. In spaceflight however, the impact of exposure to risk for astronaut crews is cumulative, and not independent of exposures or other risks, as all the adverse effects of the spaceflight environment begin at launch, continue throughout the duration of the mission and in some cases across the lifetime of the crews. In January of 2020, the HSRB at NASA embarked on a pilot project designed to assess the potential value of causal diagramming as a tool to facilitate understanding of these cumulative and interdependent effects as applied within Human System Risk management. This process uses directed acyclic graphs as a means of formalizing a shared mental model of the causal flow of risk among Risk Board stakeholders. Initially this model was to improve communication among those stakeholders, but the potential value exceeds communication alone. The causal diagrams are formulated as directed acyclic graphs (DAGs) to function as a type of knowledge graph for reference for the board and its stakeholders. This document is a sister document to NASA/TM 20220006812 Directed Acyclic Graph Guidance Documentation (1). In that document, the basic guidance for creating and standardizing directed acyclic graphs as tools for cross-risk analysis is provided. This document contains the initial configuration managed DAGs that were created as a result of applying those principles. These initial versions were accepted by the HSRB in January of 2022. Each of the Human System Risks are represented by a DAG that has been reviewed by the larger Human Health and Performance community at NASA including life scientists, physical scientists, physicians, nurses, pharmacists, exercise specialists and more. These results show the starting point for Human System Risk DAGs as shared mental models and communication aids across the boundaries of the various expertise needed to understand and mitigate the human risks in spaceflight. Because they are a starting point, each of these DAGs can be expected to change over time as new or refined evidence becomes available. The process for updating these DAGs can be found in the JSC-66705 Human System Risk Management Plan (2) that is publicly available on the NASA Technical Reports Server.

Erik L. Antonsen↗

Nutritional status changes in humans during a 14-day saturation dive: the NASA Extreme Environment Mission Operations V project

Ground-based analogs of spaceflight are an important means of studying physiologic and nutritional changes associated with space travel, and the NASA Extreme Environment Mission Operations V (NEEMO) is such an analog. To determine whether saturation diving has nutrition-related effects similar to those of spaceflight, we conducted a clinical nutritional assessment of the NEEMO crew (4 men, 2 women) before, during, and after their 14-d saturation dive. Blood and urine samples were collected before, during, and after the dive. The foods consumed by the crew were typical of the spaceflight food system. A number of physiologic changes were observed, during and after the dive, that are also commonly observed during spaceflight. Hemoglobin and hematocrit were lower (P < 0.05) after the dive. Transferrin receptors were significantly lower immediately after the dive. Serum ferritin increased significantly during the dive. There was also evidence indicating that oxidative damage and stress increased during the dive. Glutathione peroxidase and superoxide dismutase decreased during and after the dive (P < 0.05). Decreased leptin during the dive (P < 0.05) may have been related to the increased stress. Subjects had decreased energy intake and weight loss during the dive, similar to what is observed during spaceflight. Together, these similarities to spaceflight provide a model to use in further defining the physiologic effects of spaceflight and investigating potential countermeasures.

Diving/physiology↗

Evaluation of the Validity of Bio-Mathematical Models in Predicting Fatigue in an Operational Environment

During long-duration spaceflight missions, crewmembers and ground-support staff experience irregular sleep schedules, erratic natural light patterns, and high workload due to mission demands. Such conditions can cause circadian misalignment and sleep loss, which in turn cause deficits in cognitive performance. While bio-mathematical models have been implemented within workplace settings to predict fatigue profiles, the accuracy of sleep-wake models under conditions of non-traditional shiftwork is little known. Thus, the present study aims to evaluate the validity of four sleep-wake models (e.g., SAFTE-FAST, the Unified Model of Performance, the Adenosine-Circadian Model, and the State-Space Model) designed to predict human performance and fatigue levels against objective measures of performance in a spaceflight analog. To accomplish this aim, we will collect Psychomotor Vigilance Task (PVT) data from four crews (n=16) in the Human Exploration Research Analog (HERA) over 45 days. HERA is a closed, 3-story habitat at Johnson Space Center where inhabitants are exposed to extreme space exploration scenarios under varying sleep-wake conditions. The PVT is a simple reaction time test that involves minimal learning, making it sensitive to the effects of sleep loss and circadian misalignment. Findings from this study will help inform work scheduling and implementation of effective countermeasures (e.g., caffeine, lighting) to improve work efficiency and combat fatigue, as well as offer valuable insight into the applicability of bio-mathematical fatigue models in future space exploration missions.

fatigue↗

Principles for Termination of Medical Care in Austere Analog Environments for Development of Spaceflight Protocols

INTRODUCTION: When compared to operations in low earth orbit, exploration class missions will have substantially limited resources and ground medical support while the risk of a significant medical event is projected to be higher. Termination of care (TOC) may need to be considered in certain instances. We aim to utilize data from earth-based analogs to identify common principles that can help develop future guidelines to this complex medical and ethical challenge. METHODS: A comprehensive literature review was conducted in medline, nasa.gov, Defense Technical Information Center(DTIC) and google scholar. Key search terms including “withdrawal of care, termination of care, termination of CPR, military medicine, wilderness medicine, futility, potentially inappropriate” and others were used to identify analog studies of relevance. These were qualitatively evaluated for recurring principles or themes that were reviewed and structured. RESULTS: Mission planning termination of care principles: definitions of clear medical goals, separate protocols for each relevant condition, protocols developed using best available evidence, crew involvement in development, protocols rehearsal pre-launch, and inclusion of palliative capabilities. In-mission termination of care principles: 1. Crew Medical Officer directed stabilization of the patient; 2. Consultation with mission control with standardized information exchange; 3. Multidisciplinary medical and ethical conference among the mission directors, flight surgeons and relevant specialist experts; 4. Multidisciplinary risk review examining both medical and mission risks for relevant options; 5. Provision of a transparent explanation of the process and decision to crew; 6. Allowing crew feedback and inquiry to review board; 7. Support of the crew in the enacted decision. DISCUSSION: By utilizing the best available evidence in conjunction with expert opinion we have identified common principles from earth-based analogs that could be used to help design future TOC protocols.

Samuel Stephenson↗

Achieving the Proper Balance Between Crew and Public Safety

A paramount objective of all human-rated launch and reentry vehicle developers is to ensure that the risks to both the crew onboard and the public are minimized within reasonable cost, schedule, and technical constraints. Past experience has shown that proper attention to range safety requirements necessary to ensure public safety must be given early in the design phase to avoid additional operational complexities or threats to the safety of people onboard, and the design engineers must give these requirements the same consideration as crew safety requirements. For human spaceflight, the primary purpose and operational concept for any flight safety system is to protect the public while maximizing the likelihood of crew survival. This paper will outline the policy considerations, technical issues, and operational impacts regarding launch and reentry vehicle failure scenarios where crew and public safety are intertwined and thus addressed optimally in an integrated manner. An overview of existing range and crew safety policy requirements will be presented. Application of these requirements and lessons learned from both the Space Shuttle and Constellation Programs will also be discussed. Using these past programs as examples, the paper will detail operational, design, and analysis approaches to mitigate and balance the risks to people onboard and in the public. Manned vehicle perspectives from the Federal Aviation Administration (FAA) and Air Force organizations that oversee public safety will be summarized as well. Finally, the paper will emphasize the need to factor policy, operational, and analysis considerations into the early design trades of new vehicles to help ensure that both crew and public safety are maximized to the greatest extent possible.

Gowan, John↗

Developing Mars-Based Clinical Scenarios for an Earth Independent Medical Operations (EIMO) – Based Decision Support Service

As crewed missions move beyond Low-Earth Orbit, pre-mission planning cannot fully buy down the medical risks of exploration-class missions. Martian missions, where increased hazards exist, (such as long-duration spaceflight, surface-level EVA operations, and communications delays) will require a paradigm shift in the structure of a medical system. An Earth-Independent Medical Operations-based Medical System (EIMO-MS) will need to optimize four critical domains to help provide medical care: utilization of Pre-Mission Planning, augmentation of Acute and Prolonged Medical Decision Making, automated tracking of Resource Management, and assistance in Task Load Balance. The ideal EIMO-MS will be able to accomplish this goal by having an interactive, adaptable interface that will be able to provide real-time medical services. It must respond based on the level of crewmember training, medical situation, and available medical and non-medical resources. To showcase the capabilities and requirements of such a sophisticated automated MS, a series of clinical scenarios of escalating complexity were developed with clinical and systems engineering input. These scenarios describe in clinical detail what a theoretical future medical system, enhanced with multiple information streams (such as a medical database, an AI-based Decision Support System, real-time monitoring, enhanced in-situ laboratory imaging, etc.) can achieve in conjunction with a trained and experienced crew. Scenarios are comprised of: a context section including objectives and applicable spaceflight environment, a highlighted assumptions section, a clinical narrative section, and a systems engineering activity diagram demonstrating the integrated Medical System (MS). The “swim lanes” of the activity diagram act as the logistical core of each scenario and show how the MS will interact with the crew, ground support, and other in-flight systems. The Design Reference Mission that is used for the scenarios is based on existing reference mission profiles [1] with a projected 30-sol stay on the Martian surface. Scenarios span the spectrum from planned evaluations, minor medical care, urgent care, surgical guidance, critical and expectant management, and behavioral health care. Mission complexity will exponentially increase during deep space and Mars exploration-class missions, and medical support for these missions will likewise need to increase in autonomy and adaptability. The integrated system that will support these missions will need to provide assistance in a variety of anticipated and unforeseen scenarios. These medical scenarios, guided by clinician input, are initial steps in crafting the requirements for an EIMO-based medical system. By working in a systems engineering framework, requirements and capabilities can be extracted and mapped while maintaining a clinical core.

Prashant Parmar↗

Mechanisms of microgravity induced orthostatic intolerance: implications for effective countermeasures

The development of orthostatic hypotension and instability immediately after return from spaceflight has been a significant operational problem to astronauts for more than four decades. Significant reductions in stroke volume and peripheral vascular resistance contribute to ineffective maintenance of systemic arterial blood pressure during standing after spaceflight despite compensatory elevations in heart rate. The primary mechanism underlying reduced stroke volume appears to be a reduction in preload associated with reduced circulating blood volume, although cardiac atrophy might also contribute. Space flight and ground based experiments have demonstrated that an inability to provide adequate peripheral vasoconstriction in astronauts that become presyncopal may be associated with several mechanisms including reduced sympathetic nerve activity, arterial smooth muscle atrophy and/or hyporeactivity, hypersensitivity of beta-adrenergic receptors, etc. In addition, an inability to provide adequate tachycardia in presyncopal subjects may be associated with reduced carotid-cardiac baroreflex sensitivity. Based on the current knowledge and understanding of cardiovascular mechanisms that are altered during exposure to microgravity, a major focus of future research should be directed to the systematic evaluation of potential countermeasures that specifically target and restore the function of these mechanisms. Based on a preliminary systematic evaluation presented in this review, acute physical exercise designed to elicit maximal effort, G-suit inflation, artificial gravity, and specific pharmacological interventions, alone or in combination, have shown promise as successful countermeasures that provide protection against post-flight orthostatic intolerance.

Review↗

Configuring the HYSPLIT Model for National Weather Service Forecast Office and Spaceflight Meteorology Group Applications

For expedience in delivering dispersion guidance in the diversity of operational situations, National Weather Service Melbourne (MLB) and Spaceflight Meteorology Group (SMG) are becoming increasingly reliant on the PC-based version of the HYSPLIT model run through a graphical user interface (GUI). While the GUI offers unique advantages when compared to traditional methods, it is difficult for forecasters to run and manage in an operational environment. To alleviate the difficulty in providing scheduled real-time trajectory and concentration guidance, the Applied Meteorology Unit (AMU) configured a Linux version of the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) (HYSPLIT) model that ingests the National Centers for Environmental Prediction (NCEP) guidance, such as the North American Mesoscale (NAM) and the Rapid Update Cycle (RUC) models. The AMU configured the HYSPLIT system to automatically download the NCEP model products, convert the meteorological grids into HYSPLIT binary format, run the model from several pre-selected latitude/longitude sites, and post-process the data to create output graphics. In addition, the AMU configured several software programs to convert local Weather Research and Forecast (WRF) model output into HYSPLIT format.

Dreher, Joseph G.↗

NASA HRP Immunology Discipline - Use of Terrestrial Analogs

Due to the cost and operational constraints, as well as technical implementation limitations, it is desirous to perform relevant space physiology investigations first in terrestrial 'space analogs'. This is particularly true for initial investigations, which may then provide appropriate focus for subsequent flight investigations, or for mechanistic investigations that simply cannot be performed during spaceflight. Appropriate analog choice is extremely important. There are a wide variety of terrestrial space analogs, each relevant to a particular physiological discipline (or disciplines) and each with a particular fidelity (or lack thereof) to spaceflight, and each with unique operational constraints. The HRP Immunology Discipline is tasked with managing the HRP Risk concerning clinical risk for Astronaut crews related to spaceflight-associated immune dysregulation. Such dysregulation has been documented to occur during spaceflight, and found to persist for the duration of a 6-month ISS mission. Studies continue to characterize the onorbit phenomenon, but it generally consists of diminished immunocyte function, dysregulated cytokine profiles, and persistent herpesvirus reactivation. Causes are thought to synergistically include microgravity, psychological or physiological stress, radiation, and/or circadian misalignment. An appropriate terrestrial analog for immune dysregulation would replicate as many of these influences as possible. Such analogs may include clinostat or bioreactor cell culture (microgravity), hindlimb suspension (stress, fluid shifts, hypokinesis), or human deployment to remote or extreme environments (isolation, stress, circadian). Also, the laboratory setting may be used as an analog, or to augment analogs, such as sleep deprivation/misalignment or human centrifugation to replicate gravitational stress. As an appropriate example of a NASA Disciplines use of Terrestrial space analogs, this talk will discuss spaceflight associated immune dysregulation, terrestrial immune analogs, and recent analog investigations.

Crucian, Brian↗

Evolution of Training in NASA's Mission Operations Directorate

NASA s Mission Operations Directorate provides all the mission planning, training, and operations support for NASA's human spaceflight missions including the International Space Station (ISS) and its fleet of supporting vehicles. MOD also develops and maintains the facilities necessary to conduct training and operations for those missions including the Mission Control Center, Space Station Training Facility, Space Vehicle Mockup Facility, and Neutral Buoyancy Laboratory. MOD's overarching approach to human spaceflight training is to "train like you fly." This approach means not only trying to replicate the operational environment in training but also to approach training with the same mindset as real operations. When in training, this means using the same approach for executing operations, responding to off-nominal situations, and conducting yourself in the operations environment in the same manner as you would for the real vehicle.

Hutt, Jason↗

Application of Acute Maximal Exercise to Enhance Mechanisms Underlying Blood Pressure Regulation and Orthostatic Tolerance After Exposure to Simulated Microgravity

Development of orthostatic hypotension and intolerance in astronauts who return to earth following a spaceflight mission represents a significant operational concern to NASA. Reduced plasma volume, vascular resistance, and baroreflex responsiveness following exposure to actual and ground-based analogs of microgravity have been associated with orthostatic instability, suggesting that these mechanisms may contribute alone or in combination to compromise of blood pressure regulation after spaceflight. It therefore seems reasonable that development of procedures designed to reverse or restore the effects of microgravity on regulatory mechanisms of blood volume, vascular resistance and cardiac function should provide some protection against postflight orthostatic intolerance. Several investigations have provided evidence that a single bout of exhaustive dynamic exercise enhances functions of mechanisms responsible for blood pressure stability. Therefore, the purpose of our research project was to conduct a series of experiments using ground-based analogs of reduced gravity (i.e., prolonged restriction to the upright standing posture) in human subjects to investigate the hypothesis that a single bout of dynamic maximal exercise would restore blood volume, vascular resistance and cardiac function and improve blood pressure stability.

Convertino, V. A.↗

HERA in the Artemis ERA

As NASA shifts its mission objectives to the lunar surface and the return of humans to the moon in the next few years, analogs that simulate lunar transit or surface exploration are in a unique position to support spaceflight research that is aligned with future Artemis missions, especially a sustained lunar presence. NASA’s spaceflight analogs have historically focused on mission scenarios and operations for Mars exploration, including recent campaigns staged at the Human Exploration Research Analog (HERA) analog at Johnson Space Center. However, beginning in Campaign 8, future HERA missions are planned to mimic lunar operations and support research objectives that directly address knowledge gaps for lunar exploration and habitation. The Research Operations and Integration (ROI) HERA team will present a look-back over HERA mission scenarios and operations supporting NASA’s Human Research Program and international partners’ spaceflight research. An overview of critical capabilities in HERA and other similar analogs will also be presented, such as methods of simulating EVAs. Presenters will then discuss the transition to a high-fidelity lunar surface exploration mission scenario envisioned for Campaign 8, slated to begin in 2026. Operations changes that will be discussed will include simulated lunar surface exploration using a two-person simulated pressurized rover in combination with virtual reality, lunar-relevant communication delays, changes to concepts of how crew communicate with Earth-based mission supports, increased access to family & friends’ communication compared to prior campaigns, and a new mission scenario referencing Artemis mission objectives and tasks. ROI analog mission designs are driven by science objectives. The ROI HERA team will describe how the changes for Campaign 8 support ongoing spaceflight research interests and provide opportunities for investigators to design experiments more closely aligned to lunar missions. A questions and answers session will follow with attendees encouraged to ask questions.

B J Caldwell↗

Thermal Design and Analysis for the Cryogenic MIDAS Experiment

The Materials In Devices As Superconductors (MIDAS) spaceflight experiment is a NASA payload which launched in September 1996 on the Shuttle, and was transferred to the Mir Space Station for several months of operation. MIDAS was developed and built at NASA Langley Research Center (LaRC). The primary objective of the experiment was to determine the effects of microgravity and spaceflight on the electrical properties of high-temperature superconductive (HTS) materials. The thermal challenge on MIDAS was to maintain the superconductive specimens at or below 80 K for the entire operation of the experiment, including all ground testing and 90 days of spaceflight operation. Cooling was provided by a small tactical cryocooler. The superconductive specimens and the coldfinger of the cryocooler were mounted in a vacuum chamber, with vacuum levels maintained by an ion pump. The entire experiment was mounted for operation in a stowage locker inside Mir, with the only heat dissipation capability provided by a cooling fan exhausting to the habitable compartment. The thermal environment on Mir can potentially vary over the range 5 to 40 C; this was the range used in testing, and this wide range adds to the difficulty in managing the power dissipated from the experiment's active components. Many issues in the thermal design are discussed, including: thermal isolation methods for the cryogenic samples; design for cooling to cryogenic temperatures; cryogenic epoxy bonds; management of ambient temperature components self-heating; and fan cooling of the enclosed locker. Results of the design are also considered, including the thermal gradients across the HTS samples and cryogenic thermal strap, electronics and thermal sensor cryogenic performance, and differences between ground and flight performance. Modeling was performed in both SINDA-85 and MSC/PATRAN (with direct geometry import from the CAD design tool Pro/Engineer). Advantages of both types of models are discussed. Correlation of several models to ground testing and flight data (where available) is presented. Both SINDA and PATRAN models predicted the actual thermal performance of the experiment well, even without post-flight correlation adjustments of the models.

Amundsen, Ruth McElroy↗

On-Orbit Cryogenic Refueling: Potential Mission Benefits, Associated Orbital Mechanics, and Fuel Transfer Thermodynamic Modeling Efforts

The placement of cryogenic fuel/propellant depot stations in Earth orbit has the potential to transform the nature and operations for many types of spaceflight missions. Today, spaceflight missions are almost universally required to carry the entire amount of fuel required for the mission, for the entire duration of the mission, from the point of launch. This is the rough equivalent of making a drive from Ohio to California, requiring the traveler to bring along the total sum of gasoline required for the entire trip, without being able to ‘fill-up’ anywhere along the route. Obviously, this framework of travel greatly encumbers the breadth, scope, and efficiency of potential journeys. Cryogenic fuel/propellant depots have not been implemented because many technical, operational, and engineering challenges still exist. These must be overcome prior to the placement of usable on-orbit propellant depots. This thesis investigates three specific engineering challenges related to on-orbit propellant depots, and presents the current state, technological challenges, and ultimate benefits of on-orbit cryogenic refueling.

No vent fill↗

The Cooling Loop A Anomaly of 2013: A Case Study in Human-Systems Resilience

Throughout the history of human spaceflight, NASA has employed an operational paradigm of 24/7 dependence on experts in Mission Control Center (MCC). In addition to nominal flight control and mission operations, these 85+ experts per shift manage anomaly detection, diagnosis, and response, and support the crew in real-time in performing maintenance and repair, procedure execution, and other complex mission operations. Future long-duration exploration missions (LDEMs) beyond low-Earth orbit (LEO) will not operate successfully using this same Human-Systems Integration Architecture (HSIA) where crew rely on ground controllers, have ready access to resupply, and have a fallback plan of evacuation. As distance from Earth increases and the communication delay grows, crews will need to respond independently and adequately to time-critical vehicle malfunctions. It will not always be sufficient or even possible to ‘safe the system’ and then wait upon ground intervention. A new and radically different HSIA is needed to accommodate the paradigm shift of deep-space travel. Historical International Space Station (ISS) data show that for a 30-day mission, the likelihood of a high-consequence vehicle anomaly of uncertain origin that requires rapid response is greater than 10%. The likelihood of such an event is 50% by the fourth month of the mission, and it grows exponentially with time. Our team has conducted in-depth investigations into these events and their corresponding anomaly resolution activities. Using MCC and Mission Evaluation Room (MER) anomaly resolution artifacts (including meeting summaries, caution and warning data, and ISS daily summaries), we created timelines detailing ground actions and in-orbit events for two significant anomalies. We then mapped these timelines onto Mars transit conditions, introducing a ground-crew communications time delay and shifting immediate response, time-critical task execution, and vehicle commanding to the crew. In detailing successful anomaly resolution in transit to Mars, the timelines highlight where effective resolution requires drastically evolved onboard capabilities. Though this research has yielded a rich data set based on ground response in past missions, there is still insufficient knowledge to assess the potential impact of inflight anomalies on a small autonomous crew on future LDEMs beyond LEO. To begin building an evidence base that will inform future HSIA standards and requirements, we are developing an approach to systematically capture crew anomaly response and procedure execution during early Artemis missions. Being the first human spaceflight beyond LEO since Apollo, early Artemis missions provide a rare and unique opportunity to serve as a testbed for Mars missions. Our work aims to capitalize on planned data collection to derive crew operational responses to anomalous events in real-time. Our team is also researching the level of simulation fidelity required for empirically validating proposed HSIA standards and evaluating HSIA implementations for LDEMs beyond LEO. This work will produce a trade space study of HSIA simulation objectives and fidelity requirements. Ultimately, these research efforts will assist in developing the standards and technologies needed to build a next-generation HSIA for LDEMs beyond LEO.

human-systems integration architecture↗

Nutritional Assessment During a 14-d Saturation Dive: the NASA Extreme Environment Mission Operation V Project

Ground-based analogs of spaceflight are an important means of studying physiological and nutritional changes associated with space travel, particularly since exploration missions are anticipated, and flight research opportunities are limited. A clinical nutritional assessment of the NASA Extreme Environment Mission Operation V (NEEMO) crew (4 M, 2 F) was conducted before, during, and after the 14-d saturation dive. Blood and urine samples were collected before (D-12 and D-1), during (MD 7 and MD 12), and after (R + 0 and R + 7) the dive. The foods were typical of the spaceflight food system. A number of physiological changes were reported both during the dive and post dive that are also commonly observed during spaceflight. Serum hemoglobin and hematocrit were decreased (P less than 0.05) post dive. Serum ferritin and ceruloplasmin significantly increased during the dive, while transferring receptors tended to go down during the dive and were significantly decreased by the last day (R + 0). Along with significant hematological changes, there was also evidence for increased oxidative damage and stress during the dive. 8-hydroxydeoxyguanosine was elevated (P less than 0.05) during the dive, while glutathione peroxidase and superoxide disrnutase activities were decreased (P less than 0.05) during the dive. Serum C-reactive protein (CRP) concentration also tended to increase during the dive, suggesting the presence of a stress-induced inflammatory response, Decreased leptin during the dive (P less than 0.05) may also be related to the increased stress. Similar to what is observed during spaceflight, subjects had decreased energy intake and weight loss during the dive. Together, these similarities to spaceflight provide a model to further define the physiological effects of spaceflight and investigate potential countermeasures.

Smith, S. M.↗

Exploration Medical Capability - Advancing Medical System Design and Risk-Informed Decision Making for Deep Space Exploration

BACKGROUND: Within NASA’s Human Research Program, the Exploration Medical Capability (ExMC) Element has three primary focus areas: clinical and scientific research, systems engineering and trade space analysis, and technology development and demonstrations. These focus areas feed into the overarching goal of enabling progressively Earth-Independent Medical Operations (EIMO), a new paradigm that will be necessary for future Artemis and Mars medical and vehicle systems. This EIMO end state aligns with NASA’s Moon to Mars Objectives, which clearly outline the need for NASA deep space exploration missions to reduce their reliance upon Earth and become increasingly autonomous, in preparation for the first human Mars mission. OVERVIEW: To advance exploration medical systems and ultimately, integrated crew health and performance systems, ExMC’s portfolio includes: funding ground development & testing of novel medical capabilities; creation of new approaches for the development of medical protocols and procedures; deployment of innovative technologies into analog environments; technology demonstrations in spaceflight; and eventual transition to operations of new capabilities for deep space exploration missions. The portfolio also includes: pharmaceutical research targeting stability, pharmacokinetics, and pharmacodynamics; integrated data architectures and clinical decision support tools; and systems engineering and trade space analysis tools to assist NASA in the development of future medical system models as well as the medical system requirements that can serve as a foundation for deep space exploration missions. All of these investments are done in a collaborative and coordinated fashion with other NASA stakeholders, such as the Environmental Control and Life Support Systems – Crew Health and Performance System Capability Leadership Team and the Health and Medical Technical Authority. DISCUSSION: In this presentation, ExMC will provide an overview of our work from across our portfolio, all of which will inform future EIMO efforts at NASA. ExMC’s research and development investments are targeted to reduce the human system risks associated with deep space exploration to the Moon and Mars.

Kris Lehnhardt↗

Crew Roles and Interactions in Scientific Space Exploration

Future piloted space exploration missions will focus more on science than engineering, a change which will challenge existing concepts for flight crew tasking and demand that participants with contrasting skills, values, and backgrounds learn to cooperate as equals. In terrestrial space flight analogs such as Desert Research And Technology Studies, engineers, pilots, and scientists can practice working together, taking advantage of the full breadth of all team members training to produce harmonious, effective missions that maximize the time and attention the crew can devote to science. This paper presents, in a format usable as a reference by participants in the field, a successfully tested crew interaction model for such missions. The model builds upon the basic framework of a scientific field expedition by adding proven concepts from aviation and human spaceflight, including expeditionary behavior and cockpit resource management, cooperative crew tasking and adaptive leadership and followership, formal techniques for radio communication, and increased attention to operational considerations. The crews of future spaceflight analogs can use this model to demonstrate effective techniques, learn from each other, develop positive working relationships, and make their expeditions more successful, even if they have limited time to train together beforehand. This model can also inform the preparation and execution of actual future spaceflights.

Love, Stanley G.↗