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Astronauts Need Their Rest Too: Sleep-Wake Actigraphy and Light Exposure During Space Flight

The success and effectiveness of human space flight depends on astronauts' ability to maintain a high level of cognitive performance and vigilance. This alert state ensures the proper operation of sophisticated instrumentation. An important way for humans to remedy fatigue and maintain alertness is to get plenty of rest. Astronauts, however, commonly experience difficulty sleeping while in space. During flight, they may also experience disruption of the body's circadian rhythm - the natural phases the body goes through every day as we oscillate between states of high activity during the waking day and recuperation, rest, and repair during nighttime sleep. Both of these factors are associated with impairment of alertness and performance, which could have important consequences during a mission in space. The human body was designed to sleep at night and be alert and active during the day. We receive these cues from the time of day or amount of light, such as the rising or setting of the sun. However, in the environment of the Space Shuttle or the International Space Station where light levels are highly variable, the characteristics of a 24-hour light/dark cycle are not present to cue the astronauts' bodies about what time of the day it is. Astronauts orbiting Earth see a sunset and sunrise every 90 minutes, sending potentially disruptive signals to the area of the brain that regulates sleep. On STS-107, researchers will measure sleep-wake activity with state-of-the-art technology to quantify how much sleep astronauts obtain in space. Because light is the most powerful time cue to the body's circadian system, individual light exposure patterns of the astronauts will also be monitored to determine if light exposure is associated with sleep disruption. The results of this research could lead to the development of a new treatment for sleep disturbances, enabling crewmembers to avoid the decrements in alertness and performance due to sleep deprivation. What we learn about sleep in space informs treatment for earthbound populations, such as the elderly and insomniacs, who experience frequent sleep disturbances or altered sleep patterns.

Czeisler, Charles

Preliminary Design of an 'Autonomous Medical Response Agent' Interface Prototype for Long Duration Spaceflight

Major challenges for astronauts in future long-duration exploration missions (LDEMs) will be that crewmembers are not expected to be medical professionals, may be under high workload and stress, are facing physiological challenges caused by spaceflight, and will have limited, delayed voice communications with medical support from Earth. An autonomous medical response agent (AMRA) is envisioned to help astronauts address medical complaints, develop a differential diagnosis, and guide self-treatment until a healthy state is restored. AMRA develops a process of personalized diagnosis and treatment through a Bayesian predictive control system that recommends therapeutic control actions including diagnostic tests and treatments to crewmembers (Menon, 2020). The Human Computer Interaction (HCI) lab from NASA Ames Research Center’s Human Systems Integration Division (Code TH) has collaborated with Nahlia Inc in human-centered design augmentation research for AMRA. The project, titled Design of ‘Autonomous Medical Response Agent Interface Prototype for Long Duration Spaceflight, has been funded by the Translational Research Institute for Space Health (TRISH) and introduces an interactive user-interface prototype that guides astronauts through self-diagnosis, treatment, and rehabilitation while communicating with remote specialists in ground support (most notably a patient’s flight surgeon). Our project develops the interaction design for the crewmember using AMRA through user research, iterative design, and usability testing to evaluate the user interface and workflow designed. The interface design deliverable for this project, titled AMRA Aggregate Information Display (AMRA AID) is an integrated information display system for comprehensive autonomous medical guidance, diagnosis, and treatment of in-flight medical conditions experienced by crewmembers. AMRA AID demonstrates how we might ensure crew autonomy, increase the crew’s medical capabilities, and decrease cognitive burden within a front-end user interface. AMRA AID refrains from relying on input from ground or mission control for self-treatment of medical issues—though ground awareness and communication with ground is maintained as a means of ensuring trust between mission control and crew. AMRA AID demonstrates how the crew’s on-board medical system might integrate with information from vehicle monitoring and crew schedule, without assuming causal relationships. AMRA AID’s comprehensive view enables efficient information access for both crew and ground support, reducing cognitive burden in the event of an unplanned or emergency medical incident and enabling informed analytical decisions to be made based on both crew and vehicle health. Human-centered design augmentation advanced within the prototype included: enhanced workflow and treatment guidance for two medical scenarios for a non-specialist user base with various levels of medical training, interaction design which considered speech (conversational user interface) elements and on-screen interactions to be developed in future iterations of the project, communication design and functional requirements relevant to self-care versus caring for another astronaut, as well as user testing of the prototype with an international space medical community. This project arrives at critical findings regarding usability needs, communication requirements, and integrated information requirements for a future technology interface functioning to increase confidence between ground support and LDEM crewmembers.

TRISH

Designing resilient IoT and Edge Computing with federated tinyML

The rapid growth of the Internet of Things (IoT) and Edge Computing (EC) has brought significant conveniences to modern society but has also greatly expanded the cyber attack surfaces, particularly as these technologies are being increasingly integrated into critical systems such as power grids, healthcare, and smart homes. Here, to improve IoT/EC’s cybersecurity posture, we leveraged Artificial Intelligence (AI) and Machine Learning (ML) by employing tinyML to monitor voluminous IoT data for cyber threats while addressing devices’ resource constraints, and utilizing Federated Learning (FL) to share local detection knowledge across the system while preserving privacy. Building on our three-layer architecture combining tinyML and FL to enhance autonomous cyber attack detection, this paper demonstrated that the architecture improves detection accuracy, reduces resource consumption, and enables lightweight, secure IoT device monitoring. These results were validated using the public N-BaIoT dataset as well as real IoT network traffic data collected under multiple attack scenarios from our testbeds. Additionally, we introduced an enhanced FL methodology with a novel preprocessing stage, including federated feature selection and global preprocessor construction, to address IoT/EC data heterogeneity. We developed a physical IoT testbed for attack simulations and data collection, implemented a tinyML-powered detector for realistic model validation, and also built a virtual testbed for scalable evaluations of FL models across diverse network environments.

Cognitive cyber

Manual Crew Override of Vehicle Landings Following G-Transitions

BACKGROUND Manual control during exploration spaceflight consists of both planned automated supervisory control and unplanned crew override. This crew override capability is critical to enable overall mission success during landing contingencies. However, the introduction of manual override capabilities must be implemented to enable crews to mitigate risks introduced by human error. Adaptive changes in the sensorimotor system can manifest during g-transitions as spatial disorientation. While training and landing aids enable successful landing through disorientation, these adaptive changes may increase cognitive demand that needs to be accounted for in the manual control strategy. It is important to characterize these effects as soon as possible following the G-transition to develop appropriate countermeasures. METHODS The following study seeks to inform the risk associated with altered sensorimotor and vestibular function impacting critical mission tasks. We aim to characterize the effects of short and long-duration weightlessness on manual control following G-transitions using simulated lunar landing on a six-degree-of-freedom (6DOF) motion base, a fixed base simulation, and a supervisory control tablet task. The primary goal is to understand the impact of spaceflight on crew ability to perform manual crew override and supervisory control. This aim will be assessed by comparing pre- versus postflight simulation performance in crewmembers assigned to either short duration (< 30 day) or long duration (~6- month) missions to the International Space Station (ISS). We hypothesize there will be postflight increases in the percent time that pilots are outside of the acceptable range for recommended vehicle state parameters and the reaction time for secondary cognitive tasks. Ground-based control subjects, who are demographically matched to the crew considering age (± 5 years) and gender, will undergo the same testing schedule as the crew to examine the effects of flight phase independent of microgravity exposure. The second aim is to examine how adaptive changes in vestibular and cognitive function relate to changes in manual crew override proficiency. Crew performance for a sensorimotor perceptual test battery will evaluate motion perception tracking, roll nulling, and/or vection sensitivity using the 6DOF motion base. We hypothesize that a higher severity of vestibular alterations will be associated with increased percent time outside of guidance limits. Motion sickness severity and sleepiness will also be evaluated. To determine the impact of “just-in-time” training, the third aim seeks to compare performance during on-board lunar landing tasks conducted late in-flight to early postflight. We hypothesize that proficiency on the “just-in-time” laptop trainer late in mission will be positively correlated with early postflight proficiency on the same task. The final aim will establish assessments of performance, training protocols, and the learning progression in a ground-control cohort of first-time users. RESULTS The assessment of the learning progression associated with the piloting task on the motion base system with thirty ground subjects will be reported. Learning curves will be established across four distinct sessions and within session considering trial difficulty. The difficulty of the landing task can be modulated with the landing divert distance and cross or downrange difficulty. Results may include changes in performance across multiple trials of a multi-attribute lunar tablet supervisory control task. Preliminary investigations of eighteen subjects who completed vestibular threshold and motion perception tasks offer expected performance ranges for upcoming preflight crew evaluations. The results yielded an average roll threshold of 0.46 ± 0.30 deg/s and an average roll nulling root mean square error performance of 2.52 ± 0.52 deg/s. RELEVANCE This project will deliver an operational demonstration of crew monitoring capability following spaceflight and identify potential deficits that may require remediation. Comparison of individual vestibular and cognitive changes with crew performance will help better characterize the manual control risks associated with sensorimotor alterations. Ground testing will evaluate learning progression, refine training protocols, and serve as a control cohort for comparisons to crew performance. ACKNOWLEDGEMENTS: The authors acknowledge contributions from Draper, the Dynamic Skills Trainer (DST) Lab, and the Software, Robotics, and Simulation Division toward the development of the lunar landing simulation platforms. This project is funded by the Human Health Countermeasures Element.

Hannah M. Weiss

Summary of Technical Interchange Meetings (TIMs) Designed to Enable Earth Independent Medical Operations (EIMO)

The Exploration Medical Capability Element (ExMC) in NASA’s Human Research Program hosted a series of TIMs in 2023-2024 designed to stimulate discussion around specific topics with the goal of enabling EIMO. In context of the thematic constituent elements of EIMO, namely pre-mission planning, acute/emergent/prolonged medical decision making, supply/resource management and task load management, subject matter experts from industry, academia and government (NASA and other Agencies) provided valuable and actionable guidance and recommendations. Earth-based medical experts will remain indispensable for pre-mission planning, however, management of acute/emergent medical contingencies will require a gradual transition of medical care and decision making from terrestrial to space-based assets to enable support of astronaut health and performance and reduce overall mission risk. Key to achieving these enhancements is providing an integrated data system platform capable of utilizing multiple data streams in concert with a variety of on-board databases and passive monitoring of video and wearable sensors to enable a multi-modal, agentic AI-based clinical decision support system (CDSS) to support crew medical officer (CMO) medical decision-making. The EIMO series of TIMs (I-V) have proven to be instructive and portend a significant paradigm shift will be necessary to maintain crew health and performance on exploration class missions. Importantly, since the expected paradigm shift will be significantly different from the methods of operation that have been employed for the majority of missions from the inception of human spaceflight to date, any proposed methods must be deployed in the setting of ongoing operations early and be “tested, reviewed and practiced” while reliable back-up is available to facilitate an Enterprise-wide level of comfort and acceptance. Serious constraints on data transmission coupled with a large and expanding universe of on-board medical informatics data streams will necessitate implementation of a CDSS to supplant the current reliance on support provided by ground-based SMEs. Establishment of trust in the system by CMO/crew and the ground-based medical support team will be essential. Co-development of a CDSS with industry partners will assure that state of the art tools can be employed, and industry efficiencies can be leveraged. Training regimens, materials and tools must evolve to be responsive (just-in-time training) and facilitate autonomous execution of procedures. Proficiency metrics should be established and be based on validated competencies or milestones as opposed to a prescribed number of training hours. Training should be prioritized for broad, translatable skills that have universal application across a variety of medical conditions. Repetition was deemed to be the key to achieving proficiency and emphasis should lie in procedural training which is known to extinguish more rapidly than diagnostic skills. Advanced tools, e.g., extended reality, can provide more realistic and effective training. Use of advanced probabilistic risk assessment tools will be essential to optimize the medical system capability while carefully balancing risk relative to mass/power/volume limitations. Importance of factoring use-life of medical supplies and maintaining awareness of redundancy and opportunity to re-purpose under off nominal situations was emphasized. Consideration of adopting optimized performance standards vs. “good-enough” performance thresholds is warranted. The use of legacy systems as opposed to creating new systems may be preferable. Managing task load and associated cognitive load will be essential to maintain operational safety and behavioral health. ExMC aspires to create a shared EIMO paradigm and strategic vision for advancing medical system design through novel technologies, training, protocols, and support capabilities, built upon the spirit of successful strategies and innovations over the past six decades of space medicine operations.

Jay Lemery

Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, and Psychosocial Adaptions within a Team

The Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team (the Team Risk) is primarily performance-focused, with a secondary emphasis on behavioral health outcomes resulting from team performance and interpersonal interactions. Monitoring tools, measures, and countermeasures are aimed at enhancing team processes and team composition configurations to optimize team performance and functioning. Long-duration exploration missions (LDEMs) will include major challenges that could affect team performance, including social isolation, physical confinement, a small and diverse crew, communication delays between crew and ground, limited or no crew rotation or evacuation options, limited or no resupply, and a high-consequence environment. Each of these conditions will affect the crew’s coordination, cooperation, psychological well-being, and performance. Although the International Space Station (ISS) remains important for studies that require spaceflight testing and validation, the current conditions on the ISS do not adequately mimic the exploration environment that is required for National Aeronautics and Space Administration (NASA) teams research, and thus access to terrestrial or ground-based analogs of LDEM conditions is paramount. The emphasis on analogs for research is reflected in this updated evidence review of the Team Risk, and includes data from studies conducted at isolated, confined, extreme (ICE) environments (e.g., Antarctic stations), and from several mission simulation analogs such as the Human Exploration Research Analog (HERA) (HERA Experiment Information Package, 2014), also known as isolated, confined, controlled (ICC) environments. These studies have characterized many team factors regarding LDEMs, and the Team Risk has now matured from risk characterization to focusing more on countermeasure development. Because spaceflight evidence for team-level research is lacking, no reliable data is available to quantify the impact of team-level variables on individual and team-level outcomes during spaceflight missions. Until recently, no systematic attempt had been undertaken to measure the performance effects of team cohesion, team composition, team training, or team-related psychosocial adaptation during spaceflight. The Team Risk is a relatively young research area for NASA, with substantial growth only since the 2000s, and with limited access to spaceflight performance data. As a result, spaceflight evidence is lacking to identify specifically what team composition, level of training, amount of cohesion, or quality of psychosocial adaptation is necessary to reduce the risk of performance errors in space. However, astronaut journals and interviews and reports from spaceflight subject matter experts (SMEs) provide testimonies that team performance during spaceflight is important for mission success and to maintain crew health. Team spaceflight data is now being collected as part of the Spaceflight Standard Measures task (Clement, 2021)—a set of core measurements related to many human spaceflight risks that are collected from astronauts before, during, and after long-duration missions. The team-related standard measures focus on team cohesion, team performance, group living, team climate, and team processes. Collection of standard measures data is ongoing and published data is not yet available. Finally, although spaceflight evidence is lacking, evidence gleaned from ground studies and spaceflight analog studies will help close the gaps outlined in the Team Risk. Ground-based studies provide quantitative evidence for team functioning in ICE environments. Academic research on teams has produced dozens of meta-analyses that can be used to understand the general relationships among team inputs (e.g., team member characteristics and skills, job context), team processes, and emergent states (e.g., coordination, communication, cooperation, cohesion, trust, shared cognition), and team outcomes (e.g., effectiveness, errors, adaptation). Teams are complex, incorporating individual characteristics of team members, but also existing at a level that is greater than the sum of its parts. Therefore, the Team Risk must be integrated with other individual-focused NASA Human Research Program (HRP) risks, including Behavioral Medicine (BMed), Sleep, and Human-Systems Integration Architecture (HSIA), and emerging research indicates more integration may needed between the Team Risk and the physiologically oriented risks. Much of this integration occurs through the Human Systems Risk Board (HSRB). A lack of team functioning may be a stressor in some circumstances, but the team often acts as a countermeasure. For example, support for team leaders and teammates can facilitate individual functioning and encourage psychological and physically healthy behaviors and attitudes. However, more research is needed regarding teams during LDEMs and the remaining gaps in the research are described in the current report.

Lauren Blackwell Landon